https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=19282

Glecaprevir / Pibrentasvir

Pravastatin

Use with caution.

Available pharmaceutical opinion

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

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Mechanism

Glecaprevir / Pibrentasvir may inhibit the transporters (OATP1B1 and OATP1B3) and increase the plasma concentration Pravastatin.

Glecaprevir / Pibrentasvir

Pharmacodynamic effects

–

Recommendations

–

Alternative solution(s)

–

Pravastatin

Pharmacodynamic effects

Possible increased risk of HMG CoA inhibitor toxicity.

Increased risk of myopathy and rhabdomyolysis.

Recommendations

Use this combination with caution.

Product monograph suggests to decrease the dose by 50%.

Monitor for adverse effects.

Alternative solution(s)

–

Monitor

Symptoms of toxicity associated with hypolipidemic agents : gastrointestinal effects, fatigue and muscular weaknesses, myalgias, muscular cramps, myopathies, rhabdomyolysis and myoglobinuria leading to renal insufficiency.

Tests

CK

Lipidic profile

Pharmacokinetic parameters
Parameters
Reference number
# patients
HCV
Dose
Frequency
Cmax
AUC
Glecaprevir / Pibrentasvir
3373
12
-
400/120 mg
QD
 
 
Pravastatin
3373
12
-
10 mg
QD
+ 123% (2.2x)
+ 130% (2.3 x)
Comment

Ref #3373 : No significant changes in glecaprevir or pibrentasvir concentrations.

Reference
  • 3373
    Glecaprevir/Pibrentasvir (Maviret), Abbvie, Québec, Canada, 30 octobre 2020.
  • 3419
    Kosloski M, Zhao W, Li H, Wang S, Valdes J et al. Drug-drug interactions of glecaprevir and pibrentasvir with pravastatin, rosuvastatin, or dabigatran etexilate. 18th International Workshop on Clinical Pharmacology of Antiviral Therapy. June 14-16, 2017, Chicago, USA, Abstract O_18.