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

Key takeaways

Zepatier (elbasvir/grazoprevir) and Rebetol (ribavirin) are both antiviral medications used to treat hepatitis C. However, they differ in several ways. Zepatier is a combination medication specifically approved for hepatitis C genotypes 1 and 4, while ribavirin is used for chronic hepatitis C and can also be used in people with HIV coinfection. Zepatier is taken as one tablet once a day, whereas ribavirin is taken in two divided doses based on body weight. Zepatier is not available in a generic form, while ribavirin is, so ribavirin may be more affordable. Common Zepatier side effects include fatigue and headache, while ribavirin can cause more severe side effects like anemia and vision problems. Zepatier should not be used in people with cirrhosis or moderate to severe liver problems, and ribavirin must be used with other antivirals, as it is not effective on its own. Additionally, ribavirin can harm an unborn baby, so it is important to use birth control during and after treatment.

Zepatier

(elbasvir / grazoprevir)

Get free coupons

Ribavirin

(Rebetol)

Get free coupons

Summary for Zepatier

Prescription only

Zepatier (elbasvir / grazoprevir) is a combination medication containing two antiviral medications, elbasvir and grazoprevir. It's one of the first choice treatment options for hepatitis C genotypes 1 and 4.

Indications for Zepatier

Hepatitis C infection genotype 1 and 4

Pros and Cons for Zepatier

Pros

1 tablet once a day is a full regimen for some people and can cure hepatitis C
Doesn't interact with stomach acid medications like Epclusa and Harvoni
Can be taken by people with kidney problems, even those on hemodialysis
Usually has mild side effects
Good option for people taking amiodarone, since it doesn't contain sofosbuvir which can cause slow heartbeat

Cons

Doesn't treat all the types of hepatitis C like other antiviral combos such as Epclusa or Mavyret
People with hepatitis C type 1 need to have resistance testing before starting therapy
Can't be used in people with cirrhosis or moderate to severe liver problems
Some people who have hepatitis B and C have had their hepatitis B come back after taking hepatitis C treatment
Some people need to take Zepatier (elbasvir / grazoprevir) with an antiviral medication called ribavirin, which can have a lot of side effects

Common Side Effects for Zepatier

Fatigue (11%)
Headache (10%)

Warnings for Zepatier

HEPATITIS B REACTIVATION
CHANGE IN LIVER TESTS
RIBAVIRIN RISKS
MEDICATION 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.