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Flolipid and Mavyret

Determining the interaction of Flolipid and Mavyret and the possibility of their joint administration.

Check result:
Flolipid <> Mavyret
Relevance: 09.11.2022 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Glecaprevir may significantly increase the blood levels of simvastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need to stop taking simvastatin while you are being treated with glecaprevir. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with simvastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. 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.

Professional:

GENERALLY AVOID: Coadministration with glecaprevir-pibrentasvir may significantly increase the plasma concentrations of atorvastatin, simvastatin, and their active acid metabolites. The proposed mechanism is inhibition of organic anion transporting polypeptide (OATP) 1B1-mediated hepatic uptake of the statins and their metabolites by glecaprevir and pibrentasvir. Inhibition of CYP450 3A4-mediated metabolism may also contribute, as glecaprevir and pibrentasvir are weak inhibitors of the isoenzyme. When atorvastatin 10 mg once daily was administered with glecaprevir-pibrentasvir 400 mg-120 mg once daily to 11 study subjects, atorvastatin peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 22.0- and 8.3-fold, respectively. Similarly, when simvastatin 5 mg once daily was administered with glecaprevir-pibrentasvir 300 mg-120 mg once daily to 12 study subjects, simvastatin Cmax and AUC increased by 2.0- and 2.3-fold, respectively, whereas the Cmax and AUC of simvastatin acid increased by approximately 10.7- and 4.5-fold, respectively. High levels of HMG-CoA reductase inhibitory activity in plasma may be associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death.

MANAGEMENT: Concomitant use of atorvastatin or simvastatin with glecaprevir-pibrentasvir is not recommended. Other statins may be used with glecaprevir-pibrentasvir, but a dosage reduction may be required.

References
  • "Product Information. Mavyret (glecaprevir-pibrentasvir)." Abbott Pharmaceutical, Abbott Park, IL.
Flolipid

Generic Name: simvastatin

Brand name: Flolipid, Zocor

Synonyms: n.a.

Mavyret

Generic Name: glecaprevir / pibrentasvir

Brand name: Mavyret

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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