Zepatier
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.
What is Zepatier (elbasvir / grazoprevir)?
What is Zepatier (elbasvir / grazoprevir) used for?
- Hepatitis C infection genotype 1 and 4
How Zepatier (elbasvir / grazoprevir) works
Zepatier (elbasvir / grazoprevir) contains 2 antiviral medications that work together to stop the hepatitis C virus from making copies of itself in the body.
Drug facts
Side effects of Zepatier (elbasvir / grazoprevir)
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 (11%)
- Headache (10%)
The following Zepatier (elbasvir / grazoprevir) 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 Zepatier (elbasvir / grazoprevir)
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
Pharmacist tips for Zepatier (elbasvir / grazoprevir)
- Take 1 tablet at the same time every day. This will keep the amount of medication in your body consistent and raise your chances of a cure.
- Zepatier (elbasvir / grazoprevir) comes in a blister pack of individual pills. The tablets are sensitive to moisture so keep the tablets in this package until you are ready to take one.
- Zepatier (elbasvir / grazoprevir) can interact with other medications. Tell your provider all the medications you are taking. Do not take the herbal supplement St. John's wort while you're taking medications for hepatitis C.
- If you happen to be hospitalized during your course of heptitis 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 policies and procedures in place so that your treatment will not be interrupted.
- Get your labs drawn when your provider instructs you to. This is how they will monitor your liver and make sure the medication is working against the virus. An important lab called "SVR" will be drawn 12 weeks after you have stopped the medication. The results of this lab will determine if you have been cured of hepatitic C.
Common questions about Zepatier (elbasvir / grazoprevir)
Yes, a successful treatment with Zepatier (elbasvir / grazoprevir) is considered a cure for heptitis C.
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.
Avoid alcohol while taking Zepatier (elbasvir / grazoprevir). It's not known if alcohol interacts with the medication, but alcohol and hepatitis C can both damage the liver.
If you realize you forgot your dose of Zepatier (elbasvir / grazoprevir), take it as soon as you remember unless it's almost time (less than 8 hours) for your next scheduled dose. Never double up on doses.
Zepatier (elbasvir / grazoprevir) can be taken at any time. The most important thing is that you taken the medication at the same time everyday. For people who experience side effects with the medication like a headache, they may prefer to take the medication at night before bedtime so they can sleep through the side effects.
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Risks and warnings for Zepatier (elbasvir / grazoprevir)
Zepatier (elbasvir / grazoprevir) 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 hepatitic C. This can cause liver problems if not caught and treated. You should be tested for hepatitis B before you start Zepatier (elbasvir / grazoprevir). Tell your provider if you've ever had hepatitis B or been treated for it in the past.
CHANGE IN LIVER TESTS
In clinical trials, 1% of people had a large rise in a liver blood test after starting Zepatier (elbasvir / grazoprevir). Your provider will order lab draws for you in order to monitor your liver for this. You might need to stop taking Zepatier (elbasvir / grazoprevir) if your liver test becomes very high. Let your provider know right away if you notice any yellowing of your skin or eyes, stomach pain, loss of appetite, nausea, vomiting, or fatigue.
RIBAVIRIN RISKS
- Risk factors: Taking ribavirin with Zepatier (elbasvir / grazoprevir)
People with certain types of liver problems may need to take an antiviral medication called ribavirin in addition to Zepatier (elbasvir / grazoprevir). 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.
MEDICATION INTERACTIONS
Zepatier (elbasvir / grazoprevir) can interact with other medications that might make it not work as well, or raise the risk of side effects. Other medications can also lower the amount of Zepatier (elbasvir / grazoprevir) and lower your chances of a hepatitis C cure. Make sure your providers and pharmacists know all of the medications you're taking, including prescription and over-the-counter medications and herbal supplements. Your provider might have to change your other medications while you're taking Zepatier (elbasvir / grazoprevir).
Zepatier (elbasvir / grazoprevir) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 50mg/100mg | 28 tablets | $6,995.05 | $249.82 |
Typical dosage for Zepatier (elbasvir / grazoprevir)
The recommended dose is 1 tablet once a day with or without food.
How much does Zepatier (elbasvir / grazoprevir) cost?
$6,995.05
What are alternatives to Zepatier (elbasvir / grazoprevir)?
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