Glecaprevir
MAVYRET
What it isHCV NS3/4A protease inhibitor, given with pibrentasvir; chronic hepatitis C.
Why this onePangenotypic with an eight-week course in most treatment-naive patients, the shortest available.
What limits itContraindicated in decompensated cirrhosis. Hepatitis B reactivation; it inhibits P-gp, BCRP and OATP1B.
FDA-approved for
- chronic hepatitis C (2017)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Chronic hepatitis C (genotypes 1–6) | Adults | 300 mg glecaprevir/120 mg pibrentasvir (3 tablets) QD | 300 mg QD | |
| Chronic hepatitis C (genotypes 1–6) | Peds 3 to <12 yr | Weight-based (pellets/tablets) QD |
Renal No adjustment needed (any degree of impairment, including dialysis)
Hepatic Child-Pugh A: no adjustment; Child-Pugh B/C or prior hepatic decompensation: contraindicated
Instructions
- Take with food
- Test all patients for HBV (HBsAg, anti-HBc) before starting
- Treatment duration 8–16 weeks based on genotype, cirrhosis, and prior therapy
Contraindications
- Moderate or severe hepatic impairment (Child-Pugh B or C) or any history of prior hepatic decompensation
- Coadministration with atazanavir or rifampin
Cautions
- HBV reactivation in HCV/HBV coinfection
- Hepatic decompensation/failure in patients with advanced liver disease
Adverse reactions
- Headache
- Fatigue
- Nausea
Pregnancy No adequate human data; no adverse developmental effects in animals at studied exposures.
Lactation Unknown whether excreted in human milk; present in animal milk without effects on nursing pups.
⚠ BOXED WARNING
- Hepatitis B virus reactivation in patients coinfected with HCV and HBV
Principal riskHepatitis B reactivation; contraindicated in decompensated cirrhosis
Classes and tags
Clinical profile
Mechanism of action: Glecaprevir ballicule
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