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

Key takeaways

Zepatier (elbasvir/grazoprevir) and Viekira Pak (dasabuvir/ombitasvir/paritaprevir/ritonavir) are both antiviral combination medications used to treat hepatitis C. However, they differ in several ways. Zepatier is specifically approved for hepatitis C genotypes 1 and 4, while Viekira Pak is only approved for genotype 1. Zepatier is taken as one tablet once a day, whereas Viekira Pak requires taking four tablets daily and must be taken with food. Common Zepatier side effects include fatigue and headache, while Viekira Pak can cause nausea, itching, and rash. Additionally, Viekira Pak contains ritonavir, which can interact with many other medications. Both medications require testing for hepatitis B before starting treatment due to the risk of reactivation.

Zepatier

(elbasvir / grazoprevir)

Get free coupons

Viekira Pak

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 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