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Rifampin at steady state may induce CYP 3A4 and decrease the plasma concentration of Elbasvir / Grazoprevir.
Rifampin can inhibit OATP1B1 and increase the plasma concentration of Elbasvir / Grazoprevir.
Elbasvir : 3A4; P-gp (minor) / Grazoprevir : OATP1B1 and 3A4; P-gp (minor)
Elbasvir : BCRP; P-gp (weak at intestinal leveel) / Grazoprévir : BCRP; 3A4 (weak not clinically significant)
Possible decrease of clinical efficacy.
Possible significant increase of grazoprevir plasma levels.
Risk of increase in ALT levels.
Do not administer with potent CYP3A4 inducers.
Do not administer with OATP1B inhibitors.
1A2, 2C9, 2E1, P-gp
1A2, 2C9, 2C19, 3A4-7, UGT 1A1, P-gp
Avoid association. Choose an alternative.
|200 mg °||50/200* mg †|
|- 7% °||+ 10.7x/+ 1.2x †|
|+ 16% °||+ 1.4x/+ 10.9x †|
|- 90% °||+ 1.3x/+ 1.8x †|
|600 mg||600 mg IV|
Ref #3030 : ° Only the interaction between grazoprevir and rifampicine at steady state was studied.
Ref #3222 : † Elbasvir and grazoprevir were studied separately.
With a single dose of rifampin 600 mg orally, elbasvir increases were : AUC +1.2x, Cmax +1.3x and Cmin +1.2x; grazoprevir increases : AUC +8.4x, Cmax +6.5x and Cmin +1.6x.