[Elbasvir/grazoprevir photo]
Here is a helpful tip for these new hepatitis C virus drugs:
KEY POINTS
- Elbasvir/ grazoprevir (Zepatier) is a combination pill used to treat hepatitis C virus (HCV) infection
- Elbasvir is an NS5A inhibitor, it blocks HCV NS5A which interferes with viral replication and virion assembly
- Grazoprevir is an NS3/4A inhibitor, which blocks HCV NS3/A4 and interferes with proteolytic cleavage of HCV-encoded polyprotein essential for viral replication
- Refer to HCV treatment guidelines for treatment duration and when it is indicated
- FDA-approved for treatment of HCV genotpype 1 or 4 in adults
- Has activity against HCV genotype 3
- May be used with other medications (e.g., ribavirin or sofosbuvir) when treating certain HCV genotypes
- Resistance testing for genotype 1a patients may be done to identify the presence of NS5A resistance-associated polymorphisms
- Duration and regimen consideration typically include: genotype (and resistance), cirrhosis status, and treatment history
- 12 weeks is a common treatment duration
- Patients should receive proper screening prior to initiating therapy
- Common dose is one tablet (elbasvir 50mg + grazoprevir 100mg) once daily
- Patients should be advised not to miss doses to increase chances of treatment success
- Beware drug-drug interactions
- Beware liver enzyme elevations, fatigue, headache and nausea (amongst other possible adverse effects)
- Generally well tolerated
- Only available brand-name in the United States and is extremely expensive, meaning a treatment course without insurance can be many tens of thousands of dollars
RESOURCES