Elbasvir and grazoprevir and Tybost

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Cobicistat may significantly increase the blood levels of grazoprevir. This may increase the risk of side effects such as nausea, vomiting, and liver problems. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact. You should seek prompt medical attention during treatment with grazoprevir if you develop signs and symptoms of liver damage such as fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, pale stools, and/or yellowing of the skin or eyes. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Coadministration with cobicistat may increase plasma concentrations of elbasvir and grazoprevir. The proposed mechanism is cobicistat-mediated inhibition of CYP450 3A4 and the hepatic uptake OATP1B transporter. Elbasvir and grazoprevir are both substrates of CYP450 3A4 and grazoprevir is also a substrate of OATP1B. High plasma levels of grazoprevir may increase the risk of adverse effects such as alanine aminotransferase (ALT) elevations. The interaction has been studied with the fixed-dose combination antiretroviral regimen elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (Stribild) and is also expected with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (Genvoya). Administration of elbasvir-grazoprevir 50 mg-100 mg once daily with elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (150 mg/150 mg/200 mg/300 mg once daily) (n=21) increased grazoprevir peak plasma concentration (Cmax), systemic exposure (AUC), and trough plasma concentration (Cmin) by 5.36-fold, 4.59-fold, and 2.78-fold, respectively. Elbasvir Cmax, AUC, and Cmin were also increased by 2.18-fold, 1.91-fold, and 2.38-fold, respectively.

MANAGEMENT: Concomitant use of elbasvir-grazoprevir with the fixed-dose cobicistat-containing antiretroviral regimen elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate or alafenamide should generally be avoided.

Elbasvir and grazoprevir

Generic Name: elbasvir / grazoprevir

Brand name: Zepatier

Synonyms: Elbasvir and Grazoprevir

What is Elbasvir and grazoprevir?

Tybost

Generic Name: cobicistat

Brand name: Tybost

Synonyms: n.a.

What is Tybost?