Mavyret
Combination product
Pronunciation: glek-A-pre-veer and pi-BRENT-as-veer (MAV-i-ret)
What it isNS3/4A protease plus NS5A inhibitor; chronic hepatitis C of any genotype, age 3 and older.
Why this onePangenotypic cure in 8 weeks for treatment-naive patients, versus 12 with sofosbuvir/velpatasvir.
What limits itContraindicated in decompensated (Child-Pugh B/C) cirrhosis; rifampin, atazanavir and ethinyl estradiol interactions.
Pearls
- Three tablets once daily, with food.
- Option after solid-organ transplant, including organs from viremic donors.
“Glee Cap & Pib Brent = Mavericks”
Components (2)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Chronic or acute HCV genotype 1–6 (without cirrhosis or with compensated cirrhosis, Child-Pugh A) | Adults and pediatric patients ≥12 years or weighing ≥45 kg | 3 tablets (glecaprevir 300 mg/pibrentasvir 120 mg) QD with food | Treatment duration 8–16 weeks based on genotype, cirrhosis, and prior treatment | 300 mg/120 mg per day |
| Chronic or acute HCV genotype 1–6 (without cirrhosis or with compensated cirrhosis, Child-Pugh A) | Pediatric patients 3 to <12 years (<45 kg) | Weight-based oral pellets QD with food: <20 kg = 150/60 mg; 20–<30 kg = 200/80 mg; 30–<45 kg = 250/100 mg | Treatment duration 8–16 weeks based on genotype, cirrhosis, and prior treatment | 250 mg/100 mg per day (30–<45 kg) |
Renal No adjustment needed
Hepatic No adjustment for mild (Child-Pugh A); contraindicated in moderate or severe (Child-Pugh B or C) or any history of prior hepatic decompensation
Take with food; treatment duration is 8–16 weeks based on genotype, cirrhosis status, and prior treatment experience.
Instructions
- Test all patients for HBV (HBsAg and anti-HBc) before initiating treatment
- Take with food; tablets — 3 taken together once daily
- Oral pellets — sprinkle total daily dose on a spoonful of soft low-water food and swallow within 15 minutes without chewing/crushing
Available strengths
- tab 100/40 mg
- pellet 50/20 mg
- pellets 50/20 mg/packet
Contraindications
- Patients with moderate or severe hepatic impairment (Child-Pugh B or C) or those with any history of prior hepatic decompensation
- Coadministration with atazanavir or rifampin
Cautions
- Risk of HBV reactivation in HCV/HBV coinfected patients
- Risk of hepatic decompensation/failure in patients with evidence of advanced liver disease
- Reduced therapeutic effect with concomitant carbamazepine, efavirenz-containing regimens, or St. John's wort (not recommended)
Adverse reactions
- Headache
- Fatigue
- Nausea
- (pediatric <12 y also: vomiting, rash, upper abdominal pain)
Pregnancy No adequate human data; animal reproduction studies showed no adverse developmental effects (glecaprevir rabbit exposures limited).
Lactation Unknown whether excreted in human milk; components present in rodent milk without observed effects on nursing pups.
Cost
| Strength | #/mo | generic $ | brand $ | CostPlus | |
|---|---|---|---|---|---|
| 100/40 mg | tab | 30 qd | — | $4,589.50/mo | not offered |
| 50/20 mg | pellet | per unit | — | not offered |
Other forms: Glecaprevir (MAVYRET)
Clinical profile
Defining liabilityHBV reactivation, interactions and hepatic decompensation in advanced liver disease
Part D rank #714.
Self-check
- Which HCV genotypes are covered by Mavyret’s listed indication?
1–6. - Which virus can reactivate during Mavyret treatment in coinfection?
Hepatitis B.