Glecaprevir / Pibrentasvir

Rifampicin

Contraindicated.

Available pharmaceutical opinion

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

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Mechanism

Rifampicin at steady state may induce P-gp, BCRP and CYP 3A4 and decrease plasma concentration of Glecaprevir / Pibrentasvir.

Glecaprevir / Pibrentasvir

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

Avoid association.

Alternative solution(s)

Rifampicin

Pharmacodynamic effects

Recommendations

Alternative solution(s)

Monitor

Tests

Pharmacokinetic parameters
Parameters
Reference number
# patients
HCV
Dose
Frequency
AUC
Cmax
Glecaprevir / Pibrentasvir
3373
12
-
300/120 mg
QD
- 88%/- 87%
- 86%/- 83%
Rifampicin
3373
12
-
600 mg
QD
 
 
Comment

Ref #3373 : The first dose of rifampin increased the AUC and Cmax of glecaprevir by 8.55 and 6.52-fold, respectively. Concentrations of pibrentasvir remained unchanged. This increase is due to OATP1B1/3 inhibition by rifampin.

Reference
  • 3373
    Glecaprevir/Pibrentasvir (Maviret), Abbvie, Québec, Canada, 30 octobre 2020.
  • 3709
    Kosloski MP, Li H, Wang S, Mensa F, Kort J et al. Characterizing complex and competing drug-drug interactions between the antiviral regimen of glecaprevir and pibrentasvir with rifampin or carbamazepine. Clin Transl Sci . 2023 Apr; 16(4): 593-605.