Mavyret: Cost, side effects, dosage, use for hep C, and more Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe Mavyret glecaprevir pibrentasvir Medically reviewed by Victor Nguyen, PharmD, MBA — By Jennifer Mitri Williamson, Pharm.D. — Updated on July 12, 2022 What is Mavyret Mavyret is a brand-name prescription drug that’s used to treat chronic (long-term) hepatitis C virus (HCV). This virus infects your liver and causes inflammation. Mavyret can be used by people with any of the six types of HCV who either don’t have cirrhosis (liver scarring) or who have compensated (mild) cirrhosis. Mavyret can also be used to treat HCV type 1 in people who’ve been previously treated (but not cured) with a different type of medication. Mavyret is approved for use in adults and children ages 3 years and older. It’s taken by mouth once per day. Mavyret comes as oral tablets and oral pellets. Each form of the drug contains two antiviral medications, glecaprevir and pibrentasvir, in the following strengths:tablet: 100 milligrams (mg) glecaprevir/40 mg pibrentasvirpellets: 50 mg glecaprevir/20 mg pibrentasvir Effectiveness In clinical trials, adults with HCV (types 1, 2, 3, 4, 5, and 6) who had never been treated for the virus were given Mavyret. Of these people, 98% to 100% were cured after 8, 12, or 16 weeks of treatment. In these studies, being cured meant that people’s blood tests, which were done three months after treatment, showed no signs of HCV in their body. For more information on effectiveness, see the “Effectiveness” section under “Mavyret for hepatitis C” below. FDA approval Mavyret was approved by the Food and Drug Administration (FDA) in April 2017 to treat chronic hepatitis C virus (types 1, 2, 3, 4, 5, and 6) in adults. The FDA has since extended the drug’s approval to include its use in children ages 3 years and older. Mavyret generic Mavyret is available only as a brand-name medication. It’s not currently available in generic form. Mavyret contains two active drug ingredients: glecaprevir and pibrentasvir. Mavyret cost As with all medications, the cost of Mavyret can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use. Financial and insurance assistance If you need financial support to pay for Mavyret, or if you need help understanding your insurance coverage, help is available. A program called Mavyret Patient Support is available, which may help to lower your cost of the drug. For more information and to find out if you’re eligible for support, call 877-628-9738 or visit the program website. Mavyret side effects Mavyret can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Mavyret. These lists do not include all possible side effects. For more information on the possible side effects of Mavyret, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome. More common side effects The more common side effects of Mavyret include:headachefeeling tirednauseadiarrheaelevated bilirubin level Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist. Serious side effects Serious side effects from Mavyret aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects, which are discussed below in “Side effect details,” include the following:hepatitis B virus reactivation* (a flare-up of the virus, if it’s already inside your body)severe allergic reaction * Mavyret has a boxed warning from the Food and Drug Administration (FDA) for hepatitis B reactivation. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous. Side effect details You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on some of the side effects this drug may or may not cause. Allergic reaction As with most drugs, some people can have an allergic reaction after taking Mavyret. It’s not known for sure how often people taking this drug have an allergic reaction. This side effect wasn’t reported in clinical trials but it’s still possible. Symptoms of a mild allergic reaction can include:skin rashitchinessflushing A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:swelling under your skin, typically in your eyelids, lips, hands, or feetswelling of your tongue, mouth, or throattrouble breathing Call your doctor right away if you have a severe allergic reaction to Mavyret. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Itching You may experience itchy skin while you’re using Mavyret. In clinical trials, some people had itching while taking this drug. Itching most often occurred only in people taking the drug who had both chronic kidney disease and hepatitis C virus (HCV). In this group, about 17% of people reported itching as a side effect. Itchiness is also sometimes a symptom caused by HCV. Itching occurs in about 20% of people with HCV. This symptom is probably due to a buildup of a chemical called bilirubin in your body. Itching caused by HCV may be in one area or it may be all over your body. If you have concerns about having itchy skin while you’re taking Mavyret, talk with your doctor. They can recommend ways to help reduce this side effect while you’re taking the drug. Hepatitis B reactivation Mavyret treatment increases the risk of hepatitis B virus (HBV) reactivation in people with both HBV and HCV. In fact, Mavyret has a boxed warning from the Food and Drug Administration (FDA) about hepatitis B reactivation. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous. Symptoms of HBV reactivation can include:pain in the right side of your abdomenlight-colored stoolfeeling tiredyellowing of your skin or the whites of your eyes In serious cases, reactivation of HBV can cause liver failure or even death. Before starting Mavyret, your doctor will test you for HBV. If you have HBV, you may need to be treated for it before you start taking Mavyret. Or your doctor may recommend testing during your Mavyret treatment to monitor for HBV reactivation and treat the condition if needed. Weight changes (not a side effect) Weight loss and weight gain weren’t reported as side effects of Mavyret during clinical trials. However, Mavyret can cause nausea, which may lead to weight loss in some people. If you feel nauseous while taking this drug, you’re likely to eat less food, which may result in weight loss. If you have concerns about weight gain or weight loss while you’re taking Mavyret, talk with your doctor. They can help you manage your weight during your treatment. Skin rash (not a side effect) Skin rash wasn’t reported as a side effect of Mavyret during clinical trials. However, HCV itself can sometimes cause a skin rash. This may be mistaken for a side effect of the drug. The rash caused by HCV can be anywhere on your body, including your face, chest, or arms. It also might make you feel itchy. If you have a skin rash while taking Mavyret, talk with your doctor. They can suggest ways to reduce your symptoms and recommend treatment if needed. Side effects in children During clinical trials, side effects seen in children (ages 3 years and older) taking Mavyret were similar to side effects seen in adults taking the drug. In these studies, no children stopped treatment because of side effects. Common side effects seen in children included:feeling tirednauseaheadacheelevated bilirubin level If you’re concerned about side effects occurring in a child using Mavyret, talk with your doctor. They may be able to recommend ways to reduce these side effects during treatment. Mavyret dosage The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs. Drug forms and strengths Mavyret comes in the following forms and strengths:oral tablets that contain 100 milligrams (mg) glecaprevir/40 mg pibrentasviroral pellets that contain 50 mg glecaprevir/20 mg pibrentasvir The oral pellets are typically prescribed for children who weigh less than 45 kilograms (kg) (about 99 pounds [lb]). They may also be prescribed for people who have trouble swallowing tablets. The pellets should be sprinkled onto soft food and swallowed without chewing. See the “How to take Mavyret” section below for details. Dosage for hepatitis C The dosage of Mavyret for chronic hepatitis C virus (HCV) in adults is three tablets taken by mouth once each day. This is a total daily dose of 300 mg of glecaprevir and 120 mg of pibrentasvir. This drug should be taken with food. It should also be taken at about the same time each day. Your doctor will determine how long you need to take Mavyret. This depends on any previous HCV treatments you’ve used. Each person’s treatment length can differ, but most people take Mavyret for 8, 12, or 16 weeks. The typical length of Mavyret treatment is as follows:If you’ve never been treated for HCV, and you don’t have cirrhosis (liver scarring) or you have compensated (mild) cirrhosis, you’ll likely be treated for 8 weeks.If you’ve been previously treated for HCV, and your treatment wasn’t effective (didn’t cure your infection), your treatment length with Mavyret can vary. It might last 8, 12, or 16 weeks. The exact length of your treatment will depend on which HCV treatments you’ve used in the past. If you have any questions about how long you’ll need to take Mavyret, talk with your doctor. They can recommend the best treatment plan for you. Children s dosage Mavyret can be prescribed for children ages 3 years and older. Your child’s recommended dosage will depend on their age, and may also depend on their weight. Dosage for children 12 years and older For children ages 12 years and older, Mavyret’s recommended dosage is the same as that for adults: three tablets taken by mouth once per day. This is a total daily dose of 300 mg of glecaprevir and 120 mg of pibrentasvir. The dose should be taken with food. It should also be taken at about the same time each day. Dosage for children 3 years to less than 12 years old For children ages 3 years to less than 12 years, Mavyret’s recommended dosages are based on body weight in kilograms (kg). One kilogram equals about 2.2 pounds (lb). Oral pellets are prescribed for children who weigh less than 45 kg (about 99 lb).Child’s body weightRecommended Mavyret dosageRecommended total daily doseLess than 20 kg (less than about 44 lb)3 packets of pellets, taken once per day150 mg glecaprevir/60 mg pibrentasvir 20 kg to 30 kg (about 44 lb to 66 lb)4 packets of pellets, taken once per day200 mg glecaprevir/80 mg pibrentasvir30 kg to 45 kg (about 66 lb to 99 lb)5 packets of pellets, taken once per day250 mg glecaprevir/100 mg pibrentasvir45 kg or more (about 99 lb or more), or ages 12 years and older3 tablets taken once per day (or 6 packets of pellets taken once per day, for children who have trouble swallowing tablets)300 mg glecaprevir/120 mg pibrentasvir What if I miss a dose If you miss a dose of Mavyret, here’s what you should do:If it’s less than 18 hours from when you should’ve taken Mavyret, go ahead and take your dose as soon as you remember. Then, take your next dose at the usual time.If it’s more than 18 hours from when you should’ve taken Mavyret, just skip that dose. You can take your next dose at the usual time. To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too. Will I need to use this drug long term The length of time that you’ll need to take Mavyret depends on a couple of things. These include whether you’ve ever been treated for HCV before, and if you have any liver scarring (cirrhosis). Typically, treatment with Mavyret lasts for 8, 12, or 16 weeks. It usually doesn’t last longer than 16 weeks. Mavyret for hepatitis C The Food and Drug Administration (FDA) approves prescription drugs such as Mavyret to treat certain conditions. Mavyret is FDA-approved to treat chronic infections caused by hepatitis C virus (HCV). This virus infects your liver and causes inflammation, which can sometimes lead to liver scarring (called cirrhosis). HCV infection can cause symptoms such as:jaundice (yellowing of your skin and the whites of your eyes)fluid buildup in your abdomenfeverlong-term problems, such as liver failure HCV is spread through blood that’s infected with the virus. Transmission (spreading) happens most commonly through people sharing used needles with each other. Mavyret is approved to treat HCV in adults. It’s also approved for use in children ages 3 years and older. It’s used to treat all HCV types (1, 2, 3, 4, 5, and 6) in people:with no liver scarring (cirrhosis), or in those who have cirrhosis without any symptoms of the condition (called compensated cirrhosis)who have received a liver or kidney transplantwho have HIV Mavyret can also be used to treat HCV type 1 in people who’ve been previously treated (but not cured) with a different type of medication. Effectiveness In clinical trials, adults with HCV (types 1, 2, 3, 4, 5, and 6) who had never been treated for the virus were given Mavyret. Of these people, 93% to 100% were cured within 8 to 12 weeks of treatment. In these studies, being cured meant that people’s blood tests, which were done three months after treatment, showed no signs of HCV infection in their body. Of all people in the studies (both those who had been previously treated for HCV and those who had not been), between 92% and 100% were cured of HCV. The results varied depending on whether the people had been previously treated and on the type of HCV they had. Clinical trials also compared Mavyret to the combination of two other antiviral drugs called sofosbuvir (Sovaldi) and daclatasvir (Daklinza). One study looked at people with HCV type 3, who’d never been treated before. These people didn’t have any liver scaring (cirrhosis). After 12 weeks, 95% of people taking Mavyret were considered cured (they had no HCV detectable in their blood tests). Of those taking sofosbuvir and daclatasvir, 97% had the same result. Mavyret for children Mavyret is approved to treat HCV in children ages 3 years and older. The drug is considered to be as effective in children as it is in adults. Mavyret and alcohol Mavyret doesn’t have any known interactions with alcohol. However, you shouldn’t drink alcohol if you have hepatitis C virus (HCV). Alcohol makes HCV worse, which can lead to severe scarring (cirrhosis) in your liver. If you drink alcohol, and you’re concerned about how to stop drinking, talk with your doctor. Alternatives to Mavyret Other drugs are available that can treat chronic hepatitis C virus (HCV). Some may be better options for your condition than others. If you’re interested in finding an alternative to Mavyret, talk with your doctor. They can tell you about other medications that may work well for you. Alternative medications, which contain a combination of antiviral drugs to treat HCV, include the following:ledipasvir/sofosbuvir (Harvoni)sofosbuvir/velpatasvir (Epclusa)velpatasvir/sofosbuvir/voxilaprevir (Vosevi)elbasvir/grazoprevir (Zepatier)simeprevir (Olysio) and sofosbuvir (Sovaldi)* * Although they don’t come as a combination drug, simeprevir (Olysio) and sofosbuvir (Sovaldi) may also be taken together to treat HCV. Mavyret vs Harvoni You may wonder how Mavyret compares to other medications that are prescribed for similar uses. Here we look at how Mavyret and Harvoni are alike and different. About Mavyret contains the drugs glecaprevir and pibrentasvir. Harvoni contains the drugs ledipasvir and sofosbuvir. Both Mavyret and Harvoni contain a combination of antivirals, and they belong to the same class of medications. Uses Mavyret is approved to treat chronic hepatitis C virus (HCV) in adults. It’s also approved for use in children ages 3 years and older. Mavyret is used to treat all types (1, 2, 3, 4, 5, and 6) of HCV in people:with no liver scarring (cirrhosis), or in those who have cirrhosis without any symptoms of the conditionwho have received a liver or kidney transplantwho have HIV Mavyret can also be used to treat HCV type 1 in people who’ve been previously treated (but not cured) with a different type of medication. Harvoni is approved to treat the following types of HCV in adults and in children ages 3 years and older:types 1, 4, 5, or 6 in people with no liver scarring (cirrhosis), or in those who have cirrhosis without any symptoms of the conditiontype 1 in people who have cirrhosis with symptoms of the condition (in these people, Harvoni should be combined with ribavirin)type 1 or 4 in people who have received a liver transplant, and either don’t have liver scarring, or have liver scarring without symptoms (in these people, Harvoni should also be combined with ribavirin) Drug forms and administration Mavyret comes as tablets and as pellets, which are taken by mouth (with food) once each day. It’s usually given for a period of 8, 12, or 16 weeks depending on your treatment history and how severe your liver disease is. Harvoni also comes as tablets and as pellets, which are taken by mouth (with or without food) once each day. It’s usually given over a period of 8, 12, or 24 weeks depending on your treatment history and the condition of your liver. Side effects and risks Mavyret and Harvoni do not contain the same drugs, but they are part of the same class of medications. These medications can cause some similar side effects and some different side effects. Below are examples of these side effects. More common side effects These lists contain examples of more common side effects that can occur with Mavyret, with Harvoni, or with both drugs (when taken individually).Can occur with Mavyret:diarrheaelevated bilirubin levelCan occur with Harvoni:feeling weakinsomnia (trouble sleeping)coughfeeling irritableCan occur with both Mavyret and Harvoni:headachefeeling tirednausea Serious side effects Serious side effects that can occur with both Mavyret and Harvoni (when taken individually) include the following:hepatitis B virus reactivation (a flare-up of the virus, if it’s already inside your body)*severe allergic reaction * Mavyret and Harvoni both have a boxed warning from the Food and Drug Administration (FDA) for hepatitis B reactivation. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous. Effectiveness Both Mavyret and Harvoni are approved to treat chronic hepatitis C virus (HCV). However, one medication may be more effective for you than the other, depending on the type of HCV you have and whether you have any liver scarring (cirrhosis). These drugs haven’t been directly compared in clinical studies. But separate studies have found that both Mavyret and Harvoni are effective in treating HCV. Costs Mavyret and Harvoni are both brand-name drugs. Mavyret is not available as a generic. However, Harvoni is available as the generic medication ledipasvir/sofosbuvir. Brand-name medications usually cost more than generics. According to estimates on GoodRx.com, brand-name Mavyret and Harvoni generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use. Mavyret vs Epclusa You may wonder how Mavyret compares to other medications that are prescribed for similar uses. Here we look at how Mavyret and Epclusa are alike and different. About Mavyret contains the drugs glecaprevir and pibrentasvir. Epclusa contains the drugs velpatasvir and sofosbuvir. Both Mavyret and Epclusa contain a combination of antiviral drugs, and they belong to the same class of medications. Uses Mavyret is approved to treat chronic hepatitis C virus (HCV) in adults. It’s also approved for use in children ages 3 years and older. Mavyret is used to treat all types (1, 2, 3, 4, 5, and 6) of HCV in people:with no liver scarring (cirrhosis), or in those who have cirrhosis without any symptoms of the conditionwho have received a liver or kidney transplantwho have HIV Mavyret can also be used to treat HCV type 1 in people who’ve been previously treated (but not cured) with a different type of medication. Much like Mavyret, Epclusa is also approved to treat chronic HCV caused by all types of the virus (types 1, 2, 3, 4, 5, and 6) in adults and in children ages 3 years and older. It’s used in people who don’t have liver scarring (cirrhosis), or in those with liver scarring who don’t have any symptoms of the condition. Epclusa can also be used in adults with cirrhosis who have symptoms of the condition. Drug forms and administration Mavyret comes as tablets and as pellets, which are taken by mouth (with food) once each day. It’s usually given for a period of 8, 12, or 16 weeks depending on your treatment history and how severe your liver disease is. Epclusa also comes as tablets and as pellets, which are taken by mouth once each day. Epclusa can be taken with or without food. It’s usually given for a period of 12 weeks. Side effects and risks Mavyret and Epclusa do not have the same drugs in them. However, they belong to the same class of medications. Therefore, both medications can cause similar side effects. Below are examples of these side effects. More common side effects These lists contain examples of more common side effects that can occur with Mavyret, with Epclusa, or with both drugs (when taken individually).Can occur with Mavyret:diarrheaelevated bilirubin levelCan occur with Epclusa:feeling weakinsomnia (trouble sleeping)Can occur with both Mavyret and Epclusa:headachefeeling tirednausea Serious side effects Serious side effects that can occur with both Mavyret and Epclusa (when taken individually) include the following:hepatitis B virus reactivation (a flare-up of the virus, if it’s already inside your body)*severe allergic reaction * Mavyret and Epclusa both have a boxed warning from the Food and Drug Administration (FDA) for hepatitis B reactivation. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous. Effectiveness Mavyret and Epclusa are both used to treat all six types of chronic HCV. Your doctor may recommend that you take either Epclusa or Mavyret depending on the type of HCV you have and the condition of your liver. These drugs haven’t been directly compared in clinical studies. But separate studies have found that both Mavyret and Epclusa are effective in treating HCV. Costs Mavyret and Epclusa are both brand-name drugs. Mavyret is not available as a generic. However, Epclusa is available as the generic medication velpatasvir/sofosbuvir. Brand-name medications usually cost more than generics. According to estimates on GoodRx.com, brand-name Mavyret and Epclusa generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use. Mavyret interactions Mavyret can interact with several other medications. It can also interact with certain supplements. Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe. Mavyret and other medications Below are lists of medications that can interact with Mavyret. These lists do not contain all the drugs that may interact with Mavyret. Before taking Mavyret, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist. Mavyret and carbamazepine Tegretol Taking carbamazepine with Mavyret could decrease the amount of Mavyret in your body. This could cause the medication to not work as well, which may lead to your hepatitis C virus (HCV) not being fully treated. It’s important to avoid taking carbamazepine and Mavyret together. Mavyret and warfarin Jantoven Taking warfarin with Mavyret can change the level of warfarin in your body. This may lead to changes in the thickness of your blood, causing it to become either too thin or too thick. If this happens, you may be at risk for certain complications, such as bleeding or having blood clots. If you’re taking Mavyret with warfarin, it’s important to get certain blood tests done frequently to check the thickness of your blood. If you need to take these medications together, your doctor will recommend ways to help ensure your safety during treatment. Mavyret and digoxin Lanoxin Taking Mavyret with digoxin can increase levels of digoxin in your body. This can cause symptoms such as:nauseavomitingdiarrheairregular heart rhythm If you’re taking digoxin while you’re using Mavyret, your doctor may need to lower your dose of digoxin. This will help prevent your digoxin levels from getting too high and causing side effects. Your doctor may check your digoxin levels on blood tests more often than usual while you’re taking Mavyret. Mavyret and dabigatran Pradaxa Taking Mavyret with dabigatran increases the levels of dabigatran in your body. If this level gets too high, you’ll have an increased risk of bleeding or bruising. You may also feel weak. These symptoms can sometimes be serious. If you’re taking dabigatran while you’re using Mavyret, your doctor may need to lower your dosage of dabigatran. This will help to prevent these symptoms from happening. Mavyret and rifampin Rifadin Taking Mavyret with rifampin lowers the levels of Mavyret in your body. If the level of Mavyret in your body is lowered, the drug may not work as well to treat HCV. You should avoid taking Mavyret and rifampin at the same time. Mavyret and certain birth control medications Some birth control medications contain a drug called ethinyl estradiol. Taking this drug in combination with Mavyret can increase your body’s levels of a certain liver enzyme called alanine aminotransferase (ALT). Increased ALT levels can make your hepatitis symptoms worse. It’s recommended that you don’t use birth control containing ethinyl estradiol while you’re taking Mavyret. Examples of birth control pills that contain ethinyl estradiol include:levonorgestrel/ethinyl estradiol (Lessina, Levora, Seasonique)desogestrel/ethinyl estradiol (Apri, Kariva)norethindrone/ethinyl estradiol (Balziva, Junel, Loestrin/Loestrin Fe, Microgestin/Microgestin Fe)norgestrel/ethinyl estradiol (Cryselle, Lo/Ovral)drospirenone/ethinyl estradiol (Loryna, Yaz)norgestimate/ethinyl estradiol (Ortho Tri-Cyclen/Ortho Tri-Cyclen Lo, Sprintec, Tri-Sprintec, TriNessa) This is not a complete list of birth control pills that contain ethinyl estradiol. If you aren’t sure if your birth control has ethinyl estradiol in it, be sure to ask your doctor or pharmacist. Some other methods of birth control besides pills also contain ethinyl estradiol. These methods include the contraceptive patch (Ortho Evra) and the vaginal ring (NuvaRing). If you’re using birth control that contains ethinyl estradiol, talk with your doctor about other options to prevent pregnancy while you’re taking Mavyret. Mavyret and certain HIV antiviral medications Certain HIV medications (called antivirals) can affect the amount of Mavyret in your body. Examples of antiviral drugs that may alter the amount of Mavyret in your body include:atazanavir (Reyataz)darunavir (Prezista)lopinavir/ritonavir (Kaletra)ritonavir (Norvir)efavirenz (Sustiva) Atazanavir should never be taken with Mavyret. Taking these drugs together increases your body’s level of a certain liver enzyme called alanine aminotransferase (ALT). Increased ALT levels can make your hepatitis symptoms worse. Taking Mavyret with darunavir, lopinavir, or ritonavir is also not recommended. This is because these antiviral drugs can increase the levels of Mavyret in your body. This can lead to increased side effects from Mavyret. Taking Mavyret with efavirenz decreases the levels of Mavyret in your body. This may cause Mavyret to not work as well. You should avoid using efavirenz while taking Mavyret. Mavyret and certain cholesterol medications Taking Mavyret along with certain cholesterol medications called statins may increase the level of the statin in your body. Having increased levels of statins increases your risk of side effects (such as muscle pain) from the statin. Examples of statins include:atorvastatin (Lipitor)lovastatin (Mevacor)simvastatin (Zocor)pravastatin (Pravachol)rosuvastatin (Crestor)fluvastatin (Lescol)pitavastatin (Livalo) It’s recommended that you don’t take Mavyret in combination with atorvastatin, lovastatin, or simvastatin. These statins have the highest risk of increased side effects when they’re taken with Mavyret. Pravastatin can be taken with Mavyret if your doctor recommends that you need a cholesterol medication. Your dosage of pravastatin will need to be lowered before you start taking Mavyret. This will help to reduce your risk of side effects from the statin. If fluvastatin and pitavastatin are taken with Mavyret, they should be given at the lowest possible dosage. This helps reduce your risk of having increased side effects from the statins. Mavyret and cyclosporine Sandimmune Mavyret is not recommended for use in people who are taking more than 100 milligrams (mg) per day of cyclosporine. This drug increases the levels of Mavyret in your body, which can increase your risk of side effects from Mavyret. If you’re taking cyclosporine, talk with your doctor about what dosage of cyclosporine is safest for you. Mavyret and omeprazole (not an interaction) There aren’t any known interactions between omeprazole and Mavyret. Omeprazole is sometimes given to people taking Mavyret if they’re having nausea during treatment. Sometimes, nausea is caused by acid buildup in your stomach. Taking omeprazole will help lower the amount of acid in your stomach, which can help reduce this side effect. Mavyret and ibuprofen (not an interaction) There aren’t any known interactions between ibuprofen (Advil, Motrin, others) and Mavyret. Ibuprofen can be used to treat headaches in people taking Mavyret. Headaches are a common side effect that may occur when you’re taking Mavyret. Ibuprofen can help reduce the pain and discomfort of a headache. Mavyret and herbs and supplements Mavyret can interact with some herbs and supplements, including St. John’s wort (which is detailed below). These interactions may affect how Mavyret works in your body. You should review all of the medications you take (including any herbs and supplements) with your doctor or pharmacist before you start taking Mavyret. Mavyret and St John s wort Taking St. John’s wort with Mavyret can greatly decrease the levels of Mavyret in your body. This can cause Mavyret to not work as well in treating your hepatitis C infection. It’s recommended that you don’t take St. John’s wort while you’re using Mavyret. Mavyret and pregnancy There haven’t been any studies in humans looking at whether or not Mavyret is safe to take during pregnancy. In animal trials, no harm was seen in fetuses exposed to Mavyret. However, the results of animal studies don’t always predict what will happen in humans. If you’re pregnant or may become pregnant while using Mavyret, talk with your doctor. They can discuss with you the risks and benefits of using this drug during pregnancy. Mavyret and breastfeeding There haven’t been any studies in humans to know whether or not Mavyret passes into breast milk, or if it has any effect on a breastfeeding child. In animal trials, Mavyret passed into the milk of lactating animals. However, this milk did not cause harm to the animals who consumed it. Keep in mind that these results may be different in humans. If you’re breastfeeding, or planning to breastfeed while taking Mavyret, talk with your doctor about whether this is a safe option. They may recommend other healthy ways to feed your child. How to take Mavyret You should take Mavyret according to your doctor or healthcare professional’s instructions. It’s important to take Mavyret for as long as your doctor prescribes, in order to get the most effective treatment. When to take It doesn’t matter what time of day you choose to take Mavyret, but you should take it at about the same time each day. This helps the medication work the right way inside your body. To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too. Taking Mavyret with food Mavyret should be taken with food. This helps your body to better absorb the medication. Mavyret oral pellets should be sprinkled onto a small amount of food. The pellets should be swallowed (without chewing) within 15 minutes after mixing with food. The food should be soft and able to be swallowed without chewing. Avoid using a liquid or food that might slide off a spoon. Examples of foods to mix with Mavyret pellets include yogurt, peanut butter, and cream cheese. Can Mavyret be crushed split or chewed No, Mavyret should not be split, crushed, or chewed. The tablets and pellets are meant to be swallowed whole. If you have trouble swallowing tablets, your doctor may prescribe Mavyret pellets instead. Splitting, crushing, or chewing Mavyret tablets or pellets can decrease the amount of drug that gets into your body. This can cause Mavyret to not work as well as usual at treating your hepatitis C infection. How Mavyret works Mavyret is approved to treat chronic hepatitis C virus (HCV). This virus causes an infection in your body that affects your liver. HCV can lead to severe liver damage if it’s not treated the right way. Mavyret contains two drugs: glecaprevir and pibrentasvir. It works by stopping the hepatitis C virus from multiplying (making more virus) inside your body. Because the virus isn’t able to multiply, it will eventually die off. Once all of the virus has died, and it’s no longer inside your body, your liver can begin to heal. Mavyret works to treat all six types (1, 2, 3, 4, 5, and 6) of HCV. How long does it take to work During clinical trials, 92% to 100% people with HCV were cured after taking Mavyret for their prescribed length of time. This length of time ranged from 8 to 16 weeks. In these studies, being cured meant that people’s blood tests, which were done three months after treatment, showed no detectable signs of HCV in their body. Common questions about Mavyret Here are answers to some frequently asked questions about Mavyret. Can I take Mavyret if I have HIV and hepatitis C Yes, you can take Mavyret if you have both HIV and hepatitis C virus (HCV). Having HIV doesn’t change the way that Mavyret works in your body to treat HCV. How successful is Mavyret at curing hepatitis C Mavyret has been shown to be very effective in curing HCV infections. In clinical trials, between 92% and 100% of people taking Mavyret were cured of HCV. In these studies, being cured meant that people’s blood tests, which were done three months after treatment, showed no signs of HCV infection. The percentage of people who were cured depended on the type of HCV they had, and what kind of treatments they’d used in the past. If I ve taken other hepatitis C treatments can I use Mavyret If you’ve tried other medications for your hepatitis C that haven’t worked (cured your infection), you can likely still use Mavyret. Depending on what drugs you’ve used in the past, your treatment length with Mavyret could be 8, 12, or 16 weeks. If you have questions about whether you can use Mavyret, talk with your doctor. Will I need any tests before or during Mavyret treatment Before you start treatment with Mavyret, your doctor will test your blood for hepatitis B virus (HBV). If you have HBV, it can reactivate (flare up) during Mavyret treatment. Reactivation of HBV can cause severe liver problems, including liver failure and death. If you have HBV, your doctor will recommend blood tests during your Mavyret treatment to check for HBV reactivation. You may need to be treated for HBV before you start taking Mavyret. Can I use Mavyret if I have cirrhosis You may be able to, but it depends on how severe your cirrhosis (liver scarring) is. Mavyret can be used if you have compensated (mild) cirrhosis. With this condition, your liver has scarring, but you don’t have any symptoms of the condition and your liver is still working normally. Mavyret is not yet approved for use in people with decompensated cirrhosis. With this condition, your liver has scarring and you have symptoms of the condition. Symptoms can include:yellowing of your skin or the whites of your eyesextra fluid in your abdomenenlarged blood vessels in your throat, which may cause bleeding If you have cirrhosis but aren’t sure what kind, talk with your doctor. Mavyret precautions This drug comes with several precautions. FDA warning Hepatitis B virus reactivation This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. Mavyret treatment increases the risk of hepatitis B virus (HBV) reactivation (flare-up) in people with both HBV and hepatitis C virus (HCV). In serious cases, reactivation of HBV can cause liver failure or even death. Before starting Mavyret, your doctor will test you for HBV. If you have HBV, you may need to be treated for it before you start taking Mavyret. Or your doctor may recommend testing during your Mavyret treatment to check for HBV reactivation. Other warnings Before taking Mavyret, talk with your doctor about your health history. Mavyret may not be right for you if you have certain medical conditions. These include:Liver failure. If you have liver failure, taking Mavyret may worsen your condition. Talk with your doctor if you have any history of liver disease or liver failure before starting treatment with Mavyret.Current use of atazanavir or rifampin. Mavyret should never be used in people taking either atazanavir or rifampin. Taking Mavyret and rifampin together may decrease Mavyret levels in your body. This can make Mavyret less effective for you. Taking atazanavir with Mavyret can increase in the amount of Mavyret in your body. This can increase levels of a liver enzyme (called alanine aminotransferase), which can become dangerous. See the “Mavyret interactions” section for more information. Always talk with your doctor about any medications that you’re taking before you start Mavyret.Pregnancy. It’s not known whether Mavyret can affect a pregnancy. In animal trials, Mavyret did not cause harm when used during pregnancy. However this result may be different in humans. For more information, please see the “Mavyret and pregnancy” section above.Breastfeeding. It’s not known if Mavyret passes into human breast milk, or if it harms a breastfeeding child. In animal trials, Mavyret passed into breast milk, but it did not cause harm to animals who consumed the breast milk. However, this result may be different in humans. For more information, please see the “Mavyret and breastfeeding” section above.Allergic reaction. If you’ve had an allergic reaction to Mavyret or any of its ingredients, doctors won’t prescribe Mavyret for your condition. Talk with your doctor about other treatment options. Note: For more information about the potential negative effects of Mavyret, see the “Mavyret side effects” section above. Mavyret overdose Using more than the recommended dosage of Mavyret can lead to serious side effects. Never take more than the dosage your doctor prescribes for you. What to do in case of overdose 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 its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away. Mavyret expiration storage and disposal When you get Mavyret from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically one year from the date they dispensed the medication. The expiration date helps guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it. Storage How long a medication remains good can depend on many factors, including how and where you store the medication. Mavyret tablets should be stored at room temperature (below 86°F/30°C) in a tightly sealed container. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms. Disposal If you no longer need to take Mavyret and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment. The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication. Professional information for Mavyret The following information is provided for clinicians and other healthcare professionals. Indications Mavyret is indicated for the treatment of chronic hepatitis C virus (HCV) genotypes 1, 2, 3, 4, 5, and 6. Mavyret is approved for use in adults and children ages 3 years and older. It should only be used in patients without cirrhosis, or in those with compensated cirrhosis. Mavyret is also indicated to treat genotype 1 hepatitis C virus infection in people whose previous treatments were unsuccessful. These prior treatments should include either an HCV NS5A inhibitor or an NS3/4A protease inhibitor. Mavyret is not indicated for use in patients whose prior treatment failed using both an HCV NS5A inhibitor and an NS3/4A protease inhibitor. Mechanism of action Mavyret contains glecaprevir and pibrentasvir. These drugs are direct-acting antiviral medications that fight HCV. Glecaprevir is an NS3/4A protease inhibitor. It works by targeting NS3/4A protease, which is necessary for the development of hepatitis C virus. Pibrentasvir is an NS5A inhibitor. By blocking NS5A, pibrentasvir essentially stops hepatitis C viral replication. Mavyret is effective against hepatitis C virus genotypes 1, 2, 3, 4, 5, and 6. Pharmacokinetics and metabolism In a clinical study involving non-HCV-infected people who were considered healthy, absorption of Mavyret was greatly affected by the presence of food. When taken with a meal, glecaprevir absorption increased by 83% to 163%. Absorption of pibrentasvir was increased by 40% to 53%. Therefore, Mavyret is recommended to be taken with food to enhance its absorption. Maximum plasma concentration of Mavyret occurs at about 5 hours post-dose. The half-life of glecaprevir is 6 hours, while the half-life of pibrentasvir is 13 hours. Mavyret is mainly excreted via the biliary-fecal route. The majority of both glecaprevir and pibrentasvir is plasma protein bound. Contraindications Mavyret is contraindicated in patients with severe hepatic disease, defined as Child-Pugh C score. Mavyret is also contraindicated in patients that are taking either atazanavir or rifampin. The concentration of Mavyret is greatly decreased by rifampin, which may reduce or inhibit the therapeutic effect of Mavyret. Mavyret should not be taken with atazanavir because the combination of drugs can increase alanine aminotransferase (ALT) levels, leading to increased risk of liver failure. Storage Mavyret should be stored at or below 86°F (30°C) in a sealed, dry container. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.Liver Disease / HepatitisPharmacy / PharmacistDrugsMedically reviewed by Victor Nguyen, PharmD, MBA — By Jennifer Mitri Williamson, Pharm.D. — Updated on July 12, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat are the best hepatitis C medications?Medically reviewed by Alan Carter, Pharm.D. Hepatitis C medications include Epclusa and Mavyret. Medications may vary depending on the type of hepatitis C virus a person has. Learn more here.READ MOREWhat is the prognosis for hepatitis C?Medically reviewed by Cameron White, MD, MPH Hepatitis C (HCV) is a viral infection. Prognosis tends to depend on how soon a person receives a diagnosis and whether or not complications develop…READ MOREHow does hepatitis C affect a person?Medically reviewed by Cameron White, MD, MPH Hepatitis C is a viral infection of the liver. The hepatitis C virus (HCV) can cause permanent liver damage and a range of other adverse health…READ MOREWhat to eat if you have hepatitis CMedically reviewed by Natalie Olsen, R.D., L.D., ACSM EP-C Hepatitis C can damage the liver and lead to cirrhosis, or scarring of the liver. Damage to the liver may mean that a person needs to modify their…READ MOREHepatitis C and HIV coinfectionMedically reviewed by Joseph Vinetz, MD HIV and hepatitis C are bloodborne viruses that people acquire in similar ways. Learn about the symptoms, prevention, and treatment of HCV in people…READ MORE