Zepatier

Zepatier is a prescription medication used with or without ribavirin to treat chronic (long-lasting) hepatitis C virus (HCV) genotypes 1 or 4 infection in adults. It is a single product containing 2 medications elbasvir and grazoprevir. Zepatier belongs to a group of drugs called antiviral medications. These work by targeting certain proteins in the HCV to keep it from reproducing in the body.

This medication comes in tablet form and is typically taken once a day with or without food.

Common side effects of Zepatier include headache, nausea, and diarrhea.

Zepatier can also cause you to feel tired. Do not drive or operate heavy machinery until you know how Zepatier affects you.

Zepatier is a prescription medication used with or without ribavirin to treat chronic (long-lasting) hepatitis C virus (HCV) genotypes 1 or 4 infection in adults.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Merck & Co., Inc.

Serious side effects have been reported with Zepatier. See the "Zepatier Precautions" section.

Common side effects of Zepatier when used without ribavirin include the following:

• fatigue
• headache
• nausea
• trouble sleeping
• diarrhea

Common side effects of Zepatier when used with ribavirin include the following:

• low red blood cell counts (anemia)
• headache
• fatigue
• shortness of breath
• rash or itching
• feeling irritable
• stomach pain
• depression
• joint pain

This is not a complete list of Zepatier side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• Anticonvulsants
  • phenytoin (Dilantin)
  • carbamazepine (Tegretol)
• Antimycobacterials
  • rifampin (Rifadin)
• Herbal Products
  • St. John's wort (Hypericum perforatum)
• HIV Medications
  • efavirenz (Sustiva, Stocrin)
  • atazanavir (Reyataz)
  • darunavir (Prezista)
  • lopinavir/ritonavir (Kaletra)
  • saquinavir (Invirase, Fortovase)
  • tipranavir (Aptivus)
• Immunosuppressants
  • cyclosporine (Neoral, Sandimmune)
• Statins used to lower cholesterol such as atorvastatin and rosuvastatin (Monitor for statin-related adverse reactions such as myopathy (issues with the muscles that can lead to muscle weakness) and rhabdomyolysis (a rare but serious side effect in which the muscle tissue breaks down)
• warfarin (International normalized ratio (INR) values may rise and fall irregularly in those taking warfarin. As a result, frequent monitoring of INR values is recommended in patients taking warfarin)

This is not a complete list of Zepatier drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with Zepatier including the following:

• ALT Elevations (a rise in liver enzymes in the blood which indicates liver damage). Tell your healthcare provider right away if you have some or all of the following symptoms of ALT Elevations
  • fatigue
  • weakness
  • lack of appetite
  • nausea and vomiting
  • jaundice (yellow skin or whites of the eyes)
  • discolored feces
• Risks Associated with Ribavirin Combination Treatment
  • see Drug Precautions for ribavirin

Contact your healthcare provider immediately if you develop weakness, fatigue, nausea, vomiting, yellow eyes or skin, loss of appetite, or light-colored stools. These may be signs and symptoms of a serious liver problem. 

Do not take Zepatier if you:

• are allergic to Zepatier (elbasvir and grazoprevir) or to any of its ingredients
• have moderate or severe hepatic impairment (Child-Pugh B or C)
• are taking certain medications such as OATP1B1/3 inhibitors, strong CYP3A inducers, or efavirenz (tell your doctor about all the medicines you take)

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of Zepatier, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking Zepatier, tell your doctor about all of your medical conditions. Especially tell your doctor if you have liver problems other than hepatitis C/ 

• are allergic to Zepatier or to any of its ingredients 
• if you have a history of hepatitis B infection
• have ever taken any medicine for hepatitis C
• have HIV
• have had or are waiting for a liver transplant
• have any other medical conditions
• are pregnant or trying to get pregnant. Zepatier has not been studied in pregnant women. It is not known if Zepatier will harm your baby while you are pregnant.
• are breastfeeding or plan to breastfeed. It is not known if Zepatier gets in your breast milk and gets passed to your baby. Talk to your healthcare provider about the best way to feed your baby during treatment with Zepatier.

Males and females who take Zepatier and ribavirin should also read the ribavirin drug precautions for important pregnancy, contraception, and infertility information.
 

Tell your doctor if you are pregnant or plan to become pregnant.

There are no well-done studies that have been done in pregnant women with Zepatier. It is not known if Zepatier will harm your baby while you are pregnant.

Males and females who take this medication and ribavirin should also read the ribavirin medication guide for important pregnancy, contraception, and infertility information.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Zepatier crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with the use of this medication, talk to your healthcare provider about the best way to feed your baby during treatment with Zepatier. 

Take Zepatier exactly as prescribed.

Zepatier comes in a blister package of individually-packaged tablets. Keep the tablets in the blister package until you are ready to take your dose.

Take Zepatier tablets once a day, with or without food.

Do not stop taking this medication without first talking with your healthcare provider.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The recommended dosage of Zepatier is one tablet (50 mg elbasvir and 100 mg grazoprevir) once a day.

If you take too much Zepatier, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store Zepatier in the original blister package until use to protect from moisture.
• Store Zepatier at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (between 59°F to 86°F).
• Keep Zepatier and all medicines out of the reach of children

There is a risk of hepatitis B virus (HBV) becoming an active infection in those who have a current or previous infection with HBV and is treated with a certain antiviral medication (a direct-acting antiviral) to treat hepatitis C virus. Your healthcare provider will screen and monitor for HBV in those taking a direct-acting antiviral. Tell your healthcare provider if you have a history of hepatitis B infection or other liver problems before you are treated for hepatitis C.