grazoprevir/elbasvir, or GZR/EBR
Treatment of patients with chronic hepatitis C virus (HCV).
FDA approved for HIV/HCV co-infection.
One tablet once daily with or without food. Each tablet contains 100 mg of grazoprevir and 50 mg of elbasvir. Ribavirin may be added in patients with certain baseline NS5A polymorphisms (mutations that may make the Zepatier less effective).
Zepatier can be used in severe renal impairment, including in patients on hemodialysis. NS3/4A protease inhibitors, such as grazoprevir, are contraindicated in patients with moderate or severe liver impairment (Child-Pugh B/C), which is also called decompensated cirrhosis. Using Zepatier in decompensated cirrhosis may cause significantly higher amounts of grazoprevir in the blood and may increase ALT (liver enzyme).
Take your missed dose as soon as possible, unless it is closer to the time of your next dose. Do not double up on your next dose.
BLACK BOX WARNING
Before starting treatment with any direct-acting antiviral (DAA), including Zepatier, patients should take a blood test to check for hepatitis B (HBV) infection. HBV infection could get worse or reactivate during or after DAA treatment, potentially leading to serious liver problems, including liver failure or death. Patients with current or past HBV infection should be monitored during HCV DAA treatment, and some may need to take HBV treatment.
Merck and Co.
Zepatier is very well tolerated with minimal side effects. In clinical trials, very few people —around 1%— discontinued treatment due to side effects. The most commonly reported side effects are fatigue and headaches. These side effects are considered mild and are comparable in patients with and without cirrhosis. Nausea, insomnia, and diarrhea have also been reported. Zepatier has not been studied in pregnant women or nursing mothers, so the impact it may have on fetal development or nursing babies is unknown.
Pregnant women or women who are trying to become pregnant should avoid use if the addition of ribavirin is required.
Before starting Zepatier, be sure to tell your medical provider or pharmacist about all of the medications, supplements, and herbal products you take, whether they are prescribed, over-the-counter, or illicit. It is also important to inform them of any changes as they happen during treatment. Zepatier should not be taken with HIV medications that require a booster (meaning they require another medication such as ritonavir or cobicistat to increase the drug levels in the body), such as atazanavir, darunavir, or elvitegravir. Zepatier should also not be taken with the HIV medications efavirenz or etravirine. Use with certain statins (cholesterol medicine) may cause increased risk of muscle pain (myopathy) or muscle breakdown (rhabdomyolysis). Your doctor should decide if your statin should be continued or changed during treatment with Zepatier. There are no interactions with methadone or other common medications used for opioid, alcohol, or nicotine dependency. Unlike several of the other HCV medications, Zepatier does not interact with acid reducing agents. It should not be taken with the rifamycin antimicrobials, such as rifabutin, rifampin, or rifapentine, nor should it be taken with the anticonvulsants carbamazepine, phenytoin, phenobarbital, or oxcarbazepine. It cannot be taken with St. John’s wort, and in general, herbal products should be avoided due to lack of information regarding potential for interaction.
Zepatier was an excellent medication upon its release, but it is not used much any longer as the other newer DAAs are preferred. Of particular importance: This regimen is especially effective in patients with kidney disease, including those on hemodialysis, with 99% achieving an SVR12.
Taking your Zepatier tablets exactly as your doctor prescribes is extremely important. That’s because following your treatment plan increases your chances of curing your hepatitis C (HCV). It also helps reduce your risk of long-term effects of HCV, such as cirrhosis and liver cancer.
Missing doses can interfere with how well Zepatier treats your hepatitis C. In some cases, if you miss doses, your HCV may not be cured.
So be sure to follow your doctor’s instructions and take your Zepatier tablet every day for the duration of your treatment. Using a reminder tool can be helpful in making sure you take Zepatier each day.
If you have any questions or concerns about your treatment, talk with your doctor or pharmacist. They can help resolve any issues for you and help you get the most out of your treatment.
Our pharmacists are experts in treating hepatitis C, medication therapy and finding valuable treatment resources. We keep Zepatier in stock for the duration of your treatment so you never have to wait to receive your medication. If you have any issues with your insurance plan or coverage, we’ll find a solution so you don’t miss a dose. You can rest assured that you have picked a partner who will work with you and your doctor to achieve your treatment goals.
Drug Mart offers free prescription delivery to any location (home or office) in New Jersey, New York or Pennsylvania.
Drug Mart is licensed in New Jersey, New York and Pennsylvania. If you live in one of these States, complete the form at Get Started, and our pharmacy team will handle the rest.
Merck, the maker of Zepatier has a prescription copay assistance program. Our staff is trained to find these savings and help lower the price you pay for your prescription. In most cases, patients pay zero dollar out-of-pocket for their Zepatier prescription.
Zepatier is FDA-approved to treat hepatitis C virus in adults with genotypes 1 or 4.
Zepatier is FDA-approved for use in people with genotypes 1 and 4 who have a condition called polymorphism. With this condition, a person has certain genetic variations (mutations) that make the virus resistant to certain medications. When a virus is resistant, it’s difficult to treat with certain drugs.
Your doctor will perform a blood test see if you have one of these variations. If you do, you may need to take ribavirin with Zepatier.
Zepatier isn’t approved for use in children.
Zepatier isn’t approved for use in people with moderate or severe liver disease, decompensated cirrhosis, or after a liver transplant.
Zepatier treatment lasts for 12 or 16 weeks. The duration of treatment your doctor prescribes will be based on your genotype, liver function, and history of past hepatitis C treatments.
It doesn’t matter what time of day you choose to take Zepatier, but you should take it at about the same time each day. This helps the medication work the right way inside your body.
You may take Zepatier with or without food.
It’s important that you don’t miss or skip doses of Zepatier and that you take the full course of treatment. Missing doses or not completing the course will make Zepatier less effective against the hepatitis C virus. This could mean that your hepatitis C won’t be cured.
To help make sure you don’t miss a dose, try setting a reminder on your phone.
If you forget to take a dose at your usual time, take it as soon as you remember that day. But if you don’t remember until the following day, just take your regular dose. Never take two doses to make up for a missed dose. This could raise your risk for getting side effects.
You shouldn’t crush, split, or chew Zepatier tablets. The effect of crushing, chewing, or breaking Zepatier hasn’t been studied.
It could affect the way your body absorbs the medication. It’s not known if this would change how safe or effective the drug is.
If you have trouble swallowing Zepatier tablets whole, talk with your doctor about your options for other treatments.
Zepatier is a type of drug called a direct-acting antiviral. It contains two active drugs: grazoprevir and elbasvir. Each of these drugs works in a slightly different way to stop the hepatitis C virus from making copies of itself.
The hepatitis C virus uses certain proteins within the virus to make copies of itself. Each of the drugs in Zepatier stops a different protein from working. This means the virus can’t multiply.
Viruses that can’t make copies of themselves eventually die or are removed by your immune system. This clears up the infection and prevents further damage to your liver.
Zepatier will start working right away, but you’ll need to take the full 12 or 16-week course of treatment to cure the infection.
Your doctor will test your blood for the virus during treatment and 12 to 16 weeks after you finish treatment. If the virus is not detected in your blood after your treatment ends, you’re considered cured of hepatitis C.
Yes. Zepatier is FDA approved to be used as a treatment in HIV and HCV co-infection. Your doctor will choose the treatment plan based on your clinical situation.
Yes, your doctor will do blood tests to check for the hepatitis B virus before you start treatment.
If these tests show you have the hepatitis B virus, you may need to take medication to treat it. This is because taking Zepatier can make the hepatitis B virus become active in your body again, which can lead to liver failure and death.
It’s not known if Zepatier is safe to take during pregnancy. It hasn’t been studied in pregnant women.
If you’re pregnant or considering becoming pregnant, talk with your doctor about your treatment options.
It’s not known if Zepatier is safe to take while breastfeeding. It’s unknown if the active drugs in Zepatier pass into human breast milk.
Zepatier was highly effective in participants with compensated cirrhosis, with cure rates between 97% and 100%.
There are six different types, or strains, of hepatitis C viruses that infect people. These strains are called genotypes.
Genotypes are identified by differences in the genetic code of the viruses. Genotype 1 is the most common hepatitis C strain in the United States, but other strains are also seen in this country.
Your doctor will do a blood test to figure out which genotype you have. Your hepatitis C genotype will help your doctor choose the right medication for you.
You should avoid drinking alcohol while you’re taking Zepatier to treat hepatitis C. Drinking alcohol could cause further damage to your liver. It can also increase your risk for getting Zepatier side effects such as headaches, diarrhea, nausea, and fatigue (lack of energy).
Talk with your doctor if you’re concerned about avoiding alcohol during your Zepatier treatment.
Do not use more Zepatier than your doctor recommends.
If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool.
If your symptoms are severe, call 911 or go to the nearest emergency room right away.
Call us at the pharmacy and we’ll be glad to answer any questions. You can reach us at (800) 877-0337.