Viekira Pak vs. Ribavirin for Hepatitis C: Important Differences and Potential Risks.

Key takeaways

Viekira Pak (dasabuvir, ombitasvir, paritaprevir, and ritonavir) and Rebetol (ribavirin) are both antiviral medications used to treat hepatitis C. However, they differ in several ways. Viekira Pak is a combination of three antiviral medications and a booster, specifically used to treat hepatitis C genotype 1, while Rebetol is used for chronic hepatitis C and must be combined with other antivirals. Viekira Pak is taken as four tablets daily, whereas Rebetol's dosage is based on body weight and is usually taken twice daily. Viekira Pak is not available in generic form, while Rebetol is, making it potentially more affordable. Common side effects of Viekira Pak include fatigue, nausea, and itching, while Rebetol commonly causes headache, fever, and muscle aches. Viekira Pak has many drug interactions and can't be taken with birth control containing ethynyl estradiol. Rebetol also has many drug interactions, and when taken with azathioprine can cause a decreased blood cell count.

Viekira Pak

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Ribavirin

(Rebetol)

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Summary for Viekira Pak

Prescription only

Viekira Pak is a combination medication containing 3 antiviral medications, ombitasvir, paritaprevir, and dasabuvir and a booster medication, ritonavir. It's a treatment option for hepatitis C type 1.

Indications for Viekira Pak

Hepatitis C infection genotype 1

Pros and Cons for Viekira Pak

Pros

Works well to cure hepatitis C
Comes in easy to follow dose packaging
Not too many side effects; most common include nausea, tiredness, itching, and rash
Treatment length can be as short as 12 weeks
Can be used in people who have received a liver transplant

Cons

Only works for genotype 1
Some people with severe liver problems may need to take another antiviral medication called ribavirin
Requires 4 tablets a day, where other regimens can be as few as 1 tablet
Contains a booster medication called ritonavir (Norvir), which interacts with a lot of medications
Can't be taken with birth control that contains ethynyl estradiol

Common Side Effects for Viekira Pak

Fatigue (34%)
Nausea (22%)
Itching (18%)
Rash (16%)
Insomnia (4%)
Weakness (14%)

Warnings for Viekira Pak

HEPATITIS B REACTIVATION
SERIOUS LIVER PROBLEMS
HIGH LIVER BLOOD TESTS
RIBAVIRIN RISKS
DRUG INTERACTIONS

Summary for Ribavirin

Prescription only

Ribavirin (Rebetol) is an antiviral medication used with other antivirals for the treatment of chronic hepatitis C infection. It has a lot of side effects, so it's usually reserved for people with harder-to-treat chronic hepatitis C infection.

Indications for Ribavirin

Chronic hepatitis C infection
Chronic hepatitis C with HIV coinfection (tablets only)

Pros and Cons for Ribavirin

Pros

Higher chance of cure when added to other antiviral medications for hard-to-treat chronic hepatitis C
Available as generic which can be more affordable
Can be used in both children and adults
Treatment is usually shorter than 1 year.

Cons

Must be taken two times every day with food
Can cause low red blood cells and is not a good choice for people with a history of heart problems
Can harm an unborn baby and can't be used in pregnant women or male partners of women who can become pregnant
Not effective if used by itself; must be combined with other antivirals

Common Side Effects for Ribavirin

In clinical trials ribavirin (Rebetol) was always given with another medication called interferon. It's possible that many of these side effects were caused by interferon.