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Viekira Pak
Viekira Pak is a combination antiviral medication used to treat chronic hepatitis C virus (HCV) infection. It contains four active ingredients: ombitasvir, paritaprevir, ritonavir, and dasabuvir. This combination works by targeting different stages of the hepatitis C virus life cycle, effectively reducing the viral load in the body and helping to cure the infection. Viekira Pak is used to treat genotype 1 HCV in adults, including those with cirrhosis or after liver transplants.
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Frequently Asked Questions
How long does it take for Viekira Pak to cure hepatitis C?
The typical treatment duration is 12 weeks, but some patients with cirrhosis or prior treatment experience may require longer therapy.
Can Viekira Pak be taken by patients with liver disease?
Viekira Pak is contraindicated in patients with severe liver impairment (Child-Pugh Class C). For patients with compensated cirrhosis (Child-Pugh Class A), Viekira Pak can be used, but liver function must be closely monitored during treatment.
What should I do if I miss a dose of Viekira Pak?
If you miss a dose of ombitasvir/paritaprevir/ritonavir, take it as soon as you remember, but skip it if it’s more than 12 hours late. For dasabuvir, take it as soon as you remember, unless it’s almost time for your next dose. Do not double doses.
Can Viekira Pak be taken with other medications?
Viekira Pak has several potential drug interactions, so it is important to inform your healthcare provider about all medications and supplements you are taking. Certain medications, such as ethinyl estradiol and simvastatin, should not be used with Viekira Pak.
Can Viekira Pak cure hepatitis C completely?
Yes, Viekira Pak can cure hepatitis C in many patients, with sustained virologic response (SVR) rates above 90%. However, it is crucial to complete the full course of therapy as prescribed to achieve the best results.
Comprehensive Drug Guide
How Does Viekira Pak Work?
- Ombitasvir: Inhibits NS5A, a protein essential for viral RNA replication.
- Paritaprevir: Inhibits the NS3/4A protease, an enzyme necessary for viral replication.
- Dasabuvir: Inhibits NS5B, a viral RNA polymerase responsible for viral replication.
- Ritonavir: Boosts the effects of paritaprevir by inhibiting its breakdown in the liver, increasing its effectiveness.
Common Dosages
- Ombitasvir/paritaprevir/ritonavir: Taken once daily.
- Dasabuvir: Taken twice daily.
Typical Dosing
- Take two ombitasvir/paritaprevir/ritonavir tablets once daily in the morning.
- Take one dasabuvir tablet twice daily, one in the morning and one in the evening.
- Treatment duration is typically 12 weeks, but it may vary depending on the patient's condition (e.g., cirrhosis).
Typical Dosing
FDA Approved Indications
- Chronic hepatitis C genotype 1 infection in adults, including those with compensated cirrhosis and post-liver transplant patients.
Who Shouldn't Take Viekira Pak?
- Severe liver impairment (Child-Pugh Class C)
- Known hypersensitivity to any component of the formulation.
- Concurrent use of drugs highly dependent on CYP3A for clearance, as ritonavir can affect drug metabolism.
Advice From The Pharmacist
- Take Viekira Pak with food to improve absorption and reduce the risk of stomach upset.
- It is essential to take the medications at the same time each day and not to skip doses, as missing doses can reduce the effectiveness of the treatment.
- Avoid alcohol while taking Viekira Pak, as alcohol can worsen liver function.
- If you experience fatigue, nausea, or headache, these are common side effects, but report any severe reactions to your healthcare provider.
Side Effects of Viekira Pak
Common Side Effects
- Fatigue
- Nausea
- Itching
- Insomnia
- Diarrhea
Uncommon/Severe Side Effects
- Liver failure, particularly in patients with underlying cirrhosis.
- Severe allergic reactions (rash, swelling, difficulty breathing).
- Increased liver enzymes (ALT levels), especially in women using ethinyl estradiol-containing contraceptives.
Risks and Warnings of Viekira Pak
- Liver Dysfunction: Viekira Pak can cause liver enzyme elevations, particularly in patients with advanced liver disease. Regular monitoring of liver function is required during treatment.
- Drug Interactions: Viekira Pak interacts with many medications, particularly those metabolized by CYP3A. It is important to inform your healthcare provider of all medications and supplements you are taking to avoid potentially dangerous interactions.
- Ethinyl Estradiol: Women taking ethinyl estradiol-containing contraceptives should discontinue use before starting Viekira Pak, as the combination may lead to elevated liver enzymes and liver injury.
Interactions with Viekira Pak
Common Drug Interactions
- Ethinyl estradiol: Discontinue any contraceptives containing ethinyl estradiol before starting Viekira Pak.
- Antiarrhythmics: Caution is advised when using Viekira Pak with drugs like amiodarone due to the risk of bradycardia.
- Statins: The use of simvastatin or lovastatin with Viekira Pak is contraindicated due to the risk of myopathy.
- CYP3A-metabolized drugs: Viekira Pak can affect the metabolism of medications such as midazolam, alprazolam, and carbamazepine, leading to increased drug levels.
Alternatives to Viekira Pak
- Harvoni (ledipasvir/sofosbuvir): A once-daily, single-pill regimen used to treat chronic hepatitis C.
- Mavyret (glecaprevir/pibrentasvir): Another treatment option for hepatitis C, with a shorter duration of therapy for certain genotypes.
- Epclusa (sofosbuvir/velpatasvir): A pangenotypic treatment option for hepatitis C that covers all genotypes.
