Viekira Pak
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.
What is Viekira Pak?
What is Viekira Pak used for?
- Hepatitis C infection genotype 1
How Viekira Pak works
Viekira Pak contains 3 antiviral medications that work together to stop the hepatitis C virus from making copies of itself in the body. The fourth medication, ritonavir, raises the levels of the 3 antiviral medications.
Drug facts
Side effects of Viekira Pak
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
- Fatigue (34%)
- Nausea (22%)
- Itching (18%)
- Rash (16%)
- Insomnia (4%)
- Weakness (14%)
Pros and cons of 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
Pharmacist tips for Viekira Pak
- The medication comes in daily dose packages. Each pack contains two PINK tablets (3 medications: ombitasvir, paritaprevir, ritonavir) and two BEIGE tablets (dasabuvir). In the morning, take two pink tablets and one beige tablet. Take the second beige tablet at night 12 hours later.
- Don't remove the tablets from the daily dose pack until you are ready to take them.
- Always take the medication with a meal. The amount of fat or calories in the meal does not matter.
- If you happen to be hospitalized during your course of hepatitis C treatment, make sure you bring your antiviral medications with you to the hospital. Most hospitals do not have hepatitis C medications in stock because they are expensive. They have procedures in place to administer your home medications so that your treatment will not be interupted.
- Make sure your hepatitis C provider has a list of all the medications you are taking. Viekira Pak can interact with a lot of medications and make the levels in the body too high. This is especially important for people who take anti-rejection medications after a transplant.
Common questions about Viekira Pak
Yes, a successful treatment with antivirals is considered a cure for hepatitis C. In clinical trials, Viekira Pak cured 94% to 100% of hepatitis C type 1 cases.
It's not likely that heptitis C will come back after achieving "SVR," which is considered a cure. However, treatment of hepatitis C doesn't make you immune to the virus, so it's possible to become reinfected. After treatment it's important to continue to protect yourself from hepatitis C and not receive unclean tattoos or share things like razors and needles.
If you forget to take the pink pills, take them as soon as you remember as long as it’s been less than 12 hours since the missed scheduled dose. If you forget to take any of the beige pills, take them as long as it's been less than 6 hours since you usually take them. Never double up on doses.
Avoid alcohol while taking Viekira Pak. It's not known if alcohol interacts with the medication, but alcohol and hepatitis C can both damage the liver.
Viekira Pak needs to be taken with a meal so that enough of the medication is absorbed into your body. If you take the tablets on an empty stomach, the medication levels might be too low, which could lower your chances of a successful treatment.
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Risks and warnings for Viekira Pak
Viekira Pak 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.
HEPATITIS B REACTIVATION
- Risk factors: History of hepatitis B infection
Some people who have both hepatitis B and C have had their hepatitis B reactivate or flare up after starting treatment for hepatitis C. This can cause liver problems if not caught and treated. You should be tested for hepatitis B before you start Viekira Pak. Tell your provider if you've ever had hepatitis B or been treated for it in the past.
SERIOUS LIVER PROBLEMS
- Risk factors: Moderate to severe liver disease and cirrhosis
Some people taking Viekira Pak have had serious liver problems after starting the medication. It's more common in people who already have liver problems, including cirrhosis and usually happens during the first few weeks of the medication. Your provider may order labs in the first 4 weeks of therapy to monitor for this. People with moderate to severe liver problems (Child-Pugh B and C) should not take Viekira Pak.
HIGH LIVER BLOOD TESTS
- Risk factors: Taking estrogen-containing medications
During clinical trials, about 1% of people taking Viekira Pak had high levels of an enzyme in the liver called ALT. It happened more often in female patients who were taking birth control medications that contained estrogen. These birth control medications should be stopped before starting Viekira Pak and can be restarted 2 weeks after stopping. Talk to your provider right away if you experience fatigue, weakness, lack of appetite, nausea, yellowing of the eyes, or discolored feces as these may be signs of liver damage.
RIBAVIRIN RISKS
- Risk factors: Taking ribavirin with Viekira Pak
People with certain types of liver problems may need to take an antiviral medication called ribavirin in addition to Viekira Pak. Ribavirin can have a lot of side effects and should not be taken during pregnancy. Make sure to review this medication with your provider and pharmacist before starting your hepatitis C treatment.
DRUG INTERACTIONS
- Risk factors: Taking other medications or supplements
Viekira Pak interacts with many other medications. This might require adjusting the dose of Viekira Pak, or your other medications. If the medication doses are not adjusted for interactions, the dose may be too low for it to work properly, or the dose might end up being too high, which can cause unwanted side effects. Talk to your healthcare provider or pharmacist before starting or stopping any medications.
Viekira Pak dosage
Typical dosage for Viekira Pak
The recommended dose is 2 tablets (which contain ombitasvir 12.5 mg, paritaprevir 75 mg, ritonavir 50 mg) in the morning and 1 tablet of dasabuvir 250 mg in the morning and 1 in the evening.
What are alternatives to Viekira Pak?
