Mavyret
Mavyret is a combination medication that contains two antivirals, glecaprevir and pibrentasvir. It's a first-choice tratment for both early (acute) and long-term (chronic) hepatitis C. This medication comes as tablets and oral pellets for people 3 years and older. You take your dose by mouth once a day with food. It's taken for 8 to 16 weeks, depending on the type of hepatitis C you have, your liver health, and past treatments. Side effects include headache, tiredness, and nausea.
What is Mavyret (glecaprevir / pibrentasvir)?
What is Mavyret (glecaprevir / pibrentasvir) used for?
- Acute or chronic hepatitis C genotype 1, 2, 3, 4, 5, or 6 infection in people ages 3 years and older
- Hepatitis C genotype 1 infection in people age 3 years and older who were previously treated with an NS5A inhibitor or an HCV protease inhibitor (not both)
How Mavyret (glecaprevir / pibrentasvir) works
Mavyret is a combination of two antiviral medications that work together to treat hepatitis C. Glecaprevir is a protease inhibitor, and pibrentasvir is an NS5A inhibitor. They block two different proteins of the hepatitis C virus (HCV). This helps stop virus from making more copies of itself in your body.
Drug facts
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Side effects of Mavyret (glecaprevir / pibrentasvir)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (16%)
- Fatigue (11%)
- Nausea (9%)
- Diarrhea (7%)
Note: Side effects were from adults without cirrhosis who were treated for hepatitis C for the first time. Side effects might be different for people with cirrhosis or for children.
Mavyret (glecaprevir / pibrentasvir) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Worsening liver problems: nausea, stomach pain, yellowing of your skin or whites of your eyes
More on Mavyret (glecaprevir / pibrentasvir) side effects
The following Mavyret (glecaprevir / pibrentasvir) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
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Pros and cons of Mavyret (glecaprevir / pibrentasvir)
Pros
- Works against six types of hepatitis C
- Only need to take once a day
- Available as oral pellets that can be mixed with soft food for young children
Cons
- Must take multiple tablets or use multiple packets of oral pellets at one time for the full dose
- Risk of making hepatitis B come back if you've had it before
- Can interact with HIV medications, statins, blood thinners, and other medications
Pharmacist tips for Mavyret (glecaprevir / pibrentasvir)
- Take Mavyret (glecaprevir / pibrentasvir) exactly as prescribed for the full length of treatment. If you've never been treated for hepatitis C, you'll take it for 8 weeks. Otherwise, you could need 12 or 16 weeks of treatment. Double check with your prescriber about how long to take Mavyret (glecaprevir / pibrentasvir). Don't stop taking it early because it can make it easier for your hepatitis C to come back.
- Take Mavyret (glecaprevir / pibrentasvir) once a day at the same time every day with food. Taking it with food helps the medication get absorbed into your body better.
- Take your prescribed number of Mavyret (glecaprevir / pibrentasvir) tablets or packets of oral pellets once a day, all at the same time. Don't spread them out or take them at different times during the day.
- For Mavyret tablets: Swallow the tablets whole. Don't crush, cut, or break them. If you have trouble swallowing the tablets whole, ask your prescriber about your options.
- For Mavyret oral pellets: Sprinkle all the oral pellets for the full dose onto a small amount of soft food, like peanut butter, Greek yogurt, or thick jam. Don't use liquids or runny foods because the medication can dissolve and not work as well. Swallow the mixture without chewing within 15 minutes after preparing it. Don't crush or chew the pellets.
- If you miss a dose of Mavyret (glecaprevir / pibrentasvir) and your next dose is more than 6 hours away, take the dose as soon as you remember. But if your next dose is less than 6 hours away, skip the missed dose. Wait to take your usual dose at your next regularly scheduled time. Don't take two doses at once. Tell your prescriber if you miss any doses. They might want to check your blood work to see if your hepatitis C is still under control.
- Tell your prescriber and pharmacist about all the medications and supplements you take or plan to take. Mavyret (glecaprevir / pibrentasvir) can interact with many medications. Some interactions can cause more side effects. Others can make your medications not work as well. Your care team can check your medications and recommend changes if needed to keep you safe.
- Let your prescriber know right away if you become pregnant while taking Mavyret (glecaprevir / pibrentasvir). It's not known if the medication is safe during pregnancy. Your prescriber can explain the risks and benefits. They can help you choose the safest option for treating hepatitis C.
- Talk to your prescriber before breastfeeding while taking Mavyret (glecaprevir / pibrentasvir). It's not know if the medication can pass into breast milk and cause side effects in your baby. Your prescriber can discuss the risks and benefits of breastfeeding while treating hepatitis C.
Common questions about Mavyret (glecaprevir / pibrentasvir)
Yes. Completing your full treatment with Mavyret (glecaprevir / pibrentasvir) can cure hepatitis C. Your prescriber will check your blood about 3 months (or more) after you finish your treatment. If they don't see any signs of the virus in your blood work, it can be considered a cure. Ask your prescriber if you have questions about your lab results or what they mean.
Hepatitis C medications like Mavyret (glecaprevir / pibrentasvir) can start lowering the virus in your blood soon after you begin treatment. The virus level drops quickly in the first 12 hours to 2 days. Then, it keeps going down more slowly over the next few weeks. Take Mavyret (glecaprevir / pibrentasvir) every day for your full treatment (8, 12, or 16 weeks). Stopping too early can make the virus come back and be harder to treat. Talk to your prescriber if you have more questions about how well Mavyret (glecaprevir / pibrentasvir) is working.
It's generally recommended to avoid alcohol while taking Mavyret (glecaprevir / pibrentasvir). Alcohol can cause more liver damage. It can also weaken the immune system. This can make it harder for your body to fight hepatitis C. There are also some medications you should avoid with Mavyret (glecaprevir / pibrentasvir). Some medications can raise your risk of side effects or make others work less well. Always tell your prescriber and pharmacist about all the medications and supplements you take. They can make sure it's safe for you. Talk to your care team for a more detailed look about what to avoid during treatment.
No. There's no clinical evidence that Mavyret (glecaprevir / pibrentasvir) causes any type of cancer. By helping to cure hepatitis C, it can actually help lower your risk of liver cancer as a complication from the infection.
In studies, itching wasn't a common side effect of Mavyret (glecaprevir / pibrentasvir). Most people who felt itchy had chronic hepatitis C. Itching can sometimes be a sign of an allergic reaction, which can happen with any medication. Tell your prescriber if you have bothersome itching. Get medical help right away if you also have trouble breathing or swelling in the face, as this could be a serious allergic reaction.
No, Mavyret (glecaprevir / pibrentasvir) doesn't usually cause weight loss. But it can cause nausea and diarrhea. This might lower your appetite and affect your nutrition. Talk to your prescriber if you notice big changes in your appetite or weight after starting this medication.
In studies, hair loss wasn't a side effect of Mavyret (glecaprevir / pibrentasvir). Tell your care team if you notice more hair loss, hair shedding, or hair thinning while taking this medication. They can help figure out possible causes and suggest ways to manage it.
No, don't crush the Mavyret (glecaprevir / pibrentasvir) tablets or oral pellets. The tablets and oral pellets have a special coating around them. Crushing them can damage this coating. This can change how the medication gets absorbed into your body. If you have trouble swallowing tablets whole, talk to your prescriber about switching to the oral pellets. These are mixed with soft food and swallowed without chewing.
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Risks and warnings for Mavyret (glecaprevir / pibrentasvir)
Mavyret (glecaprevir / pibrentasvir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of hepatitis B flareup in certain people
- Risk factors: Have both hepatitis B and C infection | Taking medications that weaken the immune system | Taking certain cancer medications
Some people who have both hepatitis B and C have had their hepatitis B flare up while being treated for hepatitis C. This is called hepatitis B reactivation. It usually happens when they aren't taking medications to treat hepatitis B.
Hepatitis B reactivation can make your liver enzyme levels go up. In serious cases, it can lead to liver failure, which can be life-threatening.
Before starting Mavyret (glecaprevir / pibrentasvir), you'll get tested for hepatitis B. Tell your care team if you have had hepatitis B or been treated for it. They can watch for signs of reactivation and manage it if it happens.
Risk of worsening liver health
- Risk factors: History of advanced liver problems
Some people have had serious liver problems, including liver failure, while taking hepatitis C medications like Mavyret (glecaprevir / pibrentasvir). It's not clear if the medication caused it. But it's mostly happened in people who already had severe liver problems before treatment started. These issues usually appeared within the first 4 weeks of treatment.
Before starting Mavyret (glecaprevir / pibrentasvir), your prescriber will check your liver to make sure it's safe for you. You can't take it if you have severe liver problems. If you have milder liver problems, you can still take it but the care team will monitor you more closely.
Tell your care team right away if you notice symptoms of worsening liver problems. Watch for yellowing of your skin or eyes, stomach bloating, or changes in behavior or thinking.
Drug interactions that can make Mavyret (glecaprevir / pibrentasvir) not work as well
Some medications can make Mavyret (glecaprevir / pibrentasvir) not work as well. These include rifampin (Rifadin), carbamazepine (Tegretol), efavirenz, and St. John's wort. It's not recommended to take these medications with Mavyret (glecaprevir / pibrentasvir).
Tell your prescriber and pharmacist about all the medications, vitamins, and supplements you take and plan to take. They can check for drug interactions and adjust your medications to help keep you safe.
Mavyret (glecaprevir / pibrentasvir) dosage
Bottle| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 84 tablets of 100mg/40mg | 1 bottle | $12,857.91 | $12,857.91 |
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 84 tablets of 100mg/40mg | 1 package | $12,852.26 | $12,852.26 |
| 28 packets of 50mg/20mg | 3 packages | $7,609.80 | $2,536.60 |
Typical dosage for Mavyret (glecaprevir / pibrentasvir)
-
Age 12 years or older or those who weigh at least 99 lbs
- Take the tablet form of Mavyret. Each tablet contains 100 mg of glecaprevir and 40 mg of pibrentasvir. The recommended dose is 3 tablets by mouth once a day with food.
-
Age 3 to under 12 years
- Use the oral pellet form of Mavyret and sprinkle onto soft food. Each packet of the oral pellets contains 50 mg of glecaprevir and 20 mg pibrentasvir. The dose is based on your child's weight.
- Weigh 66 lbs to less than 99 lbs: The recommended dose is 5 packets of oral pellets by mouth once a day with food.
- Weigh 44 lbs to less than 66 lbs: The recommended dose is 4 packets of oral pellets by mouth once a day with food.
- Weigh less than 44 lbs: The recommended dose is 3 packets of oral pellets by mouth once a day with food.
The length of treatment is either 8, 12, or 16 weeks. This depends on if you've have any previous HCV treatment regimen before and what they were. How long you take Mavyret also depends on if you have liver cirrhosis.
How much does Mavyret (glecaprevir / pibrentasvir) cost?
$7,609.80
Mavyret (glecaprevir / pibrentasvir) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Mavyret (glecaprevir / pibrentasvir) will not be safe for you to take.
- Moderate or severe liver problems
- Taking atazanavir or rifampin with Mavyret (glecaprevir / pibrentasvir)
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