https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=19245

Glecaprevir / Pibrentasvir

Carbamazepine

Not recommended association.

Available pharmaceutical opinion

Document made available to the pharmacist to communicate a drug interaction to the doctor.

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Mechanism

Carbamazepine may induce CYP 3A4 and P-gp and decrease the plasma concentration of Glecaprevir / Pibrentasvir.

Glecaprevir / Pibrentasvir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

–

Alternative solution(s)

–

Carbamazepine

Pharmacodynamic effects

–

Recommendations

Avoid association.

See comments.

Alternative solution(s)

Gabapentin, pregabalin, levetiracetam, brivaracetam, or valproic acid

Monitor

–

Tests

–

Pharmacokinetic parameters
Parameters
Reference number
# patients
HCV
Dose
Frequency
AUC
Cmax
Glecaprevir / Pibrentasvir
3373
10
-
300/120 mg
x 1
- 66%/- 51%
- 67%/- 50%
Carbamazepine
3373
10
-
200 mg
BID
 
 
Comment

Ref #3373 : No significant changes in carbamazepine concentrations.

Ref #3524 : Case report of five patients who received standard doses for the treatment of chronic hepatitis C infection while being maintained on first generation anticonvulsants (carbamazepine, phenobarbital, phenytoin). Four patients were treated with glecaprevir/pibrentasvir for 8 weeks and one patient with ledipasvir/sofosbuvir for 12 weeks. All five patients achieved a sustained virologic response (SVR) despite this drug interaction. The authors conclude that all efforts to prevent concomitant use with strong inducers should be made.

Reference
  • 3373
    Glecaprevir/Pibrentasvir (Maviret), Abbvie, Québec, Canada, 30 octobre 2020.
  • 3524
    Natali KM, Jimenez HR, and J Slim. When Coadministration Cannot Be Avoided: Real World Experience of Direct Acting Antivirals for the Treatment of Hepatitis C Virus Infection in Patients on First Generation Anticonvulsants. Journal of Pharmacy Practice. December 15, 2020; 897190020977762..