https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=19283

Glecaprevir / Pibrentasvir

Rosuvastatin

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 hepatic transports OATP1B1/B3 and BCRP and increase plasma concentration of Rosuvastatin.

Glecaprevir / Pibrentasvir

Pharmacodynamic effects

–

Recommendations

–

Alternative solution(s)

–

Rosuvastatin

Pharmacodynamic effects

Possible increased risk of HMG CoA inhibitor toxicity.

Increased risk of myopathy and rhabdomyolysis.

Recommendations

Use this combination with caution.

Start with a small dosage. Monitor closely for signs and symptoms of toxicity and adjust dosage as a function of efficacy and tolerance.

Canadian product monograph does not recommend more than 5 mg per day.

The US product monograph recommends instead a maximum dose of 10 mg daily.

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
11
-
400/120 mg
QD
 
 
Rosuvastatin
3373
11
-
5 mg
QD
+ 462% (5.6x)
+ 115% (2.2x)
Comment

–

Comment
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.
  • 3377
    Glecaprevir/Pibrentasvir (Mavyret), Prescribing Information, Abbvie, IL USA, may 2020.