Mavyret (Glecaprevir and Pibrentasvir)—Oral

Warning:

Before taking Mavyret, tell your healthcare provider if you have a hepatitis B virus infection. This combination drug of glecaprevir and pibrentasvir may reactivate a previous HBV infection which can be life-threatening. Your healthcare provider will order a blood test to see if you have had a hepatitis B infection.

Your healthcare provider will monitor HCV/HBV coinfected people for HBV reactivation during HCV treatment and post-treatment follow-up. 

What Is Mavyret?

Mavyret is a combination product containing two antiviral drugs, glecaprevir, and pibrentasvir. The Food and Drug Administration approved it to treat certain types of chronic (long-term) hepatitis C virus (HCV) infections. Glecaprevir and pibrentasvir belong to a class of medications called HCV NS3/4A protease inhibitors and HCV NS5A inhibitors, respectively. Both active drugs work together to decrease the amount of HCV by preventing its replication and spread in the body. 

Mavyret is a prescription drug available in two oral dosage forms: tablets and pellets.

Drug Facts

Generic Name: Glecaprevir and Pibrentasvir

Brand Name(s): Mavyret

Drug Availability: Prescription

Therapeutic Classification: Antiviral

Available Generically: Yes

Controlled Substance: No

Administration Route: Oral

Active Ingredient: Glecaprevir and Pibrentasvir

Dosage Form(s): Tablets, pellets

What Is Mavyret Used For?

Mavyret is indicated for the treatment of:

  • Chronic hepatitis C virus (HCV) with six types of genotype 1, 2, 3, 4, 5, or 6 infections without cirrhosis (liver scarring) or compensated cirrhosis (liver scarring without symptoms yet) in adults and children three years and older.
  • Hepatitis C (HCV genotype 1) infection in people treated with a different drug (containing an HCV NS5A inhibitor or an NS3/4A protease inhibitor) in adults and children three years and older.

Hepatitis C is a long-term asymptomatic infection, a significant cause of cirrhosis and liver cancer worldwide. It can spread through blood transfusion, injection drug use, sexual intercourse, and surgery. It is estimated that 130–150 million people globally have chronic hepatitis C infection. According to the World Health Organization (WHO), 350,000–500,000 people die yearly from hepatitis C-related liver diseases. 

How to Take Mavyret

Read the prescription label carefully and ask your healthcare provider if you have any questions. Mavyret is available as oral tablets or pellets. Suggestions for taking Mayvret include:

  • Take a tablet with food once a day or as prescribed.
  • Take Mavyret precisely as directed.
  • Do not take Mavyret more, less, or more often than prescribed.

When taking pellets:

  • Do not open the packet until you're ready to use it.
  • Take pellets with soft foods—take the pellets within five minutes after putting them in soft food because a bitter taste begins around then.
  • Do not chew the pellets to avoid a bitter taste.
  • Prepare your dose by spreading pellets precisely as instructed by your healthcare provider.
  • Do not mix the pellets with liquid to prevent the medicine from dissolving too fast.
  • Take the entire pellet mixture within 15 minutes of preparing it.
  • Mix the pellets with a small amount of recommended food and swallow.
  • Swirl the bowl or container with a small amount of liquid food and take it to get a full dose.
  • Do not store any leftover mixture (oral pellets mixed with food) for use at a later time. Throw away any unused portion.

Do not change your dose or stop taking the drug unless your healthcare provider advises it.

Storage

Store at or below 86 degrees Fahrenheit (30 degrees Celsius) in its original package. Keep out of the reach of children and pets, ideally locked in a cabinet or closet.

If you plan to travel with Mavyret, have a copy of your prescription. Keep Mavyret in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.

Discard all unused and expired drugs but do not pour them down the drain or in the toilet. Ask your pharmacist or healthcare provider about the best ways to dispose of this medicine. And check out drug take-back programs in your area.

Off-Label Uses

An “off-label” use is a technically unapproved use of a drug. Ask your healthcare provider about other (off-label) uses of this drug.

How Long Does Mavyret Take to Work?

During clinical studies, 92–100% of people with HCV were cured within 8 to 16 weeks of taking Mavyret.

What Are the Side Effects of Mavyret?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at FDA.gov/MedWatch or 800-FDA-1088.

Common Side Effects

Some common side effects of Mavyret are:

Contact your healthcare provider if any of these are troublesome or worsen.

Severe Side Effects

Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Serious side effects and their symptoms include:

  • Bleeding or bruising more easily than normal
  • Confusion
  • Dark, black, or bloody stool
  • Dark or brown (tea-colored) urine
  • Loss of appetite
  • Lightheadedness
  • Swelling or pain in the upper right side of your stomach area (abdomen)
  • Sleepiness
  • Vomiting of blood
  • Yellowing of the skin or eyes
  • Light-colored stools

Report Side Effects

Mavyret may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone at 800-332-1088.

Dosage: How Much Mavyret Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For hepatitis C virus infection that has been previously treated with other medicines:
      • Adults and children 12 years of age and older or weighing 45 kilograms (kg) or more—3 tablets (total dose of 300 milligrams [mg] glecaprevir and 120 mg pibrentasvir) once a day for 8 to 16 weeks in patients without cirrhosis and 12 to 16 weeks for patients with cirrhosis. Each tablet contains 100 mg glecaprevir and 40 mg pibrentasvir.
      • Children 3 to younger than 12 years of age weighing less than 45 kg—Use of oral pellets is recommended.
      • Children younger than 3 years of age or weighing less than 45 kg—Use and dose must be determined by your doctor.
    • For hepatitis C virus infection that has not been treated with other medicines:
      • Adults and children 12 years of age and older or weighing 45 kilograms (kg) or more—3 tablets (total dose of 300 milligrams [mg] glecaprevir and 120 mg pibrentasvir) once a day for 8 weeks. Each tablet contains 100 mg glecaprevir and 40 mg pibrentasvir.
      • Children 3 to younger than 12 years of age weighing less than 45 kg—Use of oral pellets is recommended.
      • Children younger than 3 years of age or weighing less than 45 kg—Use and dose must be determined by your doctor.
    • For patients receiving a kidney or liver transplant:
      • Adults and children 12 years of age and older or weighing 45 kilograms (kg) or more—3 tablets (total dose of 300 milligrams [mg] glecaprevir and 120 mg pibrentasvir) once a day for 12 or 16 weeks. Each tablet contains 100 mg glecaprevir and 40 mg pibrentasvir.
      • Children 3 to younger than 12 years of age weighing less than 45 kg—Use of oral pellets is recommended.
      • Children younger than 3 years of age or weighing less than 45 kg—Use and dose must be determined by your doctor.
  • For oral dosage form (pellets):
    • For hepatitis C virus infection that has been previously treated with other medicines:
      • Children 3 to younger than 12 years of age weighing less than 45 kg—Dose is base on weight and must be determined by your doctor.
        • Weighing 30 to less than 45 kg—5 packets (total dose of 250 mg glecaprevir and 100 mg pibrentasvir once a day for 8 to 16 weeks in patients without cirrhosis and 12 to 16 weeks for patients with cirrhosis. Each packet contains 50 mg glecaprevir and 20 mg pibrentasvir.
        • Weighing 20 to less than 30 kg—4 packets (total dose of 200 mg glecaprevir and 80 mg pibrentasvir once a day for 8 to 16 weeks in patients without cirrhosis and 12 to 16 weeks for patients with cirrhosis. Each packet contains 50 mg glecaprevir and 20 mg pibrentasvir.
        • Weighing less than 20 kg—3 packets (total dose of 150 mg glecaprevir and 60 mg pibrentasvir once a day for 8 to 16 weeks in patients without cirrhosis and 12 to 16 weeks for patients with cirrhosis. Each packet contains 50 mg glecaprevir and 20 mg pibrentasvir.
      • Children younger than 3 years of age or weighing less than 45 kg—Use and dose must be determined by your doctor.
    • For hepatitis C virus infection that has not been treated with other medicines:
      • Children 3 to younger than 12 years of age weighing less than 45 kg—Dose is base on weight and must be determined by your doctor.
        • Weighing 30 to less than 45 kg—5 packets (total dose of 250 mg glecaprevir and 100 mg pibrentasvir once a day for 8 weeks. Each packet contains 50 mg glecaprevir and 20 mg pibrentasvir.
        • Weighing 20 to less than 30 kg—4 packets (total dose of 200 mg glecaprevir and 80 mg pibrentasvir once a day for 8 weeks. Each packet contains 50 mg glecaprevir and 20 mg pibrentasvir.
        • Weighing less than 20 kg—3 packets (total dose of 150 mg glecaprevir and 60 mg pibrentasvir once a day for 8 weeks. Each packet contains 50 mg glecaprevir and 20 mg pibrentasvir.
      • Children younger than 3 years of age or weighing less than 45 kg—Use and dose must be determined by your doctor.
    • For patients receiving a kidney or liver transplant:
      • Children 3 to younger than 12 years of age weighing less than 45 kg—Dose is base on weight and must be determined by your doctor.
        • Weighing 30 to less than 45 kg—5 packets (total dose of 250 mg glecaprevir and 100 mg pibrentasvir once a day for 12 to 16 weeks. Each packet contains 50 mg glecaprevir and 20 mg pibrentasvir.
        • Weighing 20 to less than 30 kg—4 packets (total dose of 200 mg glecaprevir and 80 mg pibrentasvir once a day for 12 to 16 weeks. Each packet contains 50 mg glecaprevir and 20 mg pibrentasvir.
        • Weighing less than 20 kg—3 packets (total dose of 150 mg glecaprevir and 60 mg pibrentasvir once a day for 12 to 16 weeks. Each packet contains 50 mg glecaprevir and 20 mg pibrentasvir.
      • Children younger than 3 years of age or weighing less than 45 kg—Use and dose must be determined by your doctor.

Modifications

The following modifications (changes) should be kept in mind when using Mavyret:

Severe allergic reaction: Avoid using Mavyret if you have a known allergy to glecaprevir, pibrentasvir, or other product ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: In animal studies, glecaprevir and pibrentasvir were found to have no effects on the fetus. No adequate human data is available to determine how Mavyret affects the pregnancy. Discuss it with your healthcare provider if you plan to become pregnant or are pregnant, and weigh the benefits and risks of taking Mavyret during the pregnancy.

Breastfeeding: The drug components were present in the milk of the study's lactating rodents without any effect on the growth and development observed in the nursing pups.

It is not known whether Mavyret components are present in the milk of breastfeeding humans and how that may affect a breastfeeding infant. The drug should be prescribed considering the clinical need of the breastfeeding individual and the risk to the breastfed child.

Adults over 65: No overall differences in the safety and effectiveness of Mavyret were observed between participants over 65 and younger participants.

Children: The safety and effectiveness of Mavyret have not been studied in children younger than three years of age.

Other modifications: People with renal impairment, including those undergoing dialysis, do not require any dose adjustment when taking Mavyret.

Mavyret does not require a dose adjustment in people with mild hepatic impairment, but it is contraindicated in moderate or severe hepatic impairment or with any history of hepatic decompensation.

Missed Dose

In case of a missed dose of Mavyret:

  • Take it as soon as you remember if it's less than 18 hours from the usual time of taking your scheduled dose. Take your next dose of Mavyret at the normal time.
  • Skip the missed dose if more than 18 hours have passed since your usual time. Take your next dose of Mavyret at the scheduled time.

Try to find ways that work for you to help yourself remember to keep your appointments and take your medication routinely. If you miss too many doses, Mavyret might be less effective in controlling HCV.

Overdose: What Happens if I Take Too Much Mavyret?

In case of an overdose, monitor the individual for any signs and symptoms of toxicities. However, if you think you're experiencing life-threatening symptoms, seek immediate medical attention.

What Happens if I Overdose on Mavyret?

If you think you or someone else may have overdosed on Mavyret, call a healthcare provider or the Poison Control Center at 800-222-1222.

If someone collapses or isn't breathing after taking Mavyret, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your or your child's progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Do not use this medicine together with atazanavir (eg, Evotaz®, Reyataz®) or rifampin (eg, Rifadin®, Rifamate®, Rifater®, Rimactane®).

If you have ever had a hepatitis B infection, the virus could become active again during treatment with glecaprevir and pibrentasvir combination. You should be tested for hepatitis B infection before starting treatment with this medicine. Talk with your doctor if you have concerns.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

What Are the Reasons I Shouldn’t Take Mavyret?

Mavyret is contraindicated in people with:

  • Moderate or severe hepatic impairment
  • Any history of prior hepatic decompensation
  • Concomitant use of drugs, including atazanavir or rifampin

What Other Medications Interact With Mavyret?

Use caution when taking Mavyret with the following drugs:

These drugs may affect the way Mavyret works. If you're taking them, you may need a different dose of your medicines. Ask your healthcare provider before taking any other drugs while on Mavyret.

What Medications Are Similar?

The FDA approved other combination drugs to treat chronic HCV. If you’re interested in finding an alternative to Mavyret, talk with your healthcare provider. Other options include:

  • Harvoni (ledipasvir and sofosbuvir)
  • Epclusa (sofosbuvir and velpatasvir)
  • Vosevi (velpatasvir, sofosbuvir, and voxilaprevir)
  • Zepatier (elbasvir and grazoprevir)
  • Olysio (simeprevir)
  • Sovaldi (sofosbuvir)

Frequently Asked Questions

  • What is Mavyret?

    Mavyret is a combination product containing two antiviral drugs, glecapravir, and pibrentasvir, in a fixed combination. It is approved to treat chronic hepatitis C (HCV) infection in adults and children over three years old.

  • How does Mavyret work?

    Glecaprevir belongs to the class of drugs called HCV NS3/4A protease inhibitors, decreasing the amount of hepatitis C virus (HCV) in the body. Pibrentasvir is in a class of HCV NS5A inhibitor drugs stopping the virus that causes hepatitis C to spread in the body. Glecaprevir and pibrentasvir work by reducing the amount of the hepatitis C virus in the body, which helps the immune system fight the infection and may help the liver recover. 

  • What is the most important information I should know about Mavyret?

    Mavyret should be used cautiously in people with hepatitis B and hepatitis C. The hepatitis B virus (HBV) may reactivate during or right after treatment. Stop the treatment immediately. Reactivation could lead to liver failure and even death if the treatment with Mavyret continues. Before starting treatment, your healthcare provider will do blood tests to check for hepatitis B virus infection.

  • How can I avoid getting hepatitis C?

    The primary cause of the spread of this infection is blood transfusions, unprotected sexual intercourse, injection drug use, surgery, and other personal belongings like razors becoming infected with blood. Avoid direct contact with an infected person's blood and body fluids. Always have safer sexual intercourse.

How Can I Stay Healthy While Taking Mavyret?

Hepatitis C virus (HCV) infection is an important global health issue. It can lead to liver cancer or cirrhosis in a significant number of the infected populations. Several new treatment options are emerging and available to many affected people. However, the best you can do is to avoid this infection. The primary cause of the spread of this infection is blood transfusions, unprotected sexual intercourse, injection drug use, surgery, and personal belongings like razors becoming infected with blood. The outcomes of hepatitis C depend on various factors such as host, virus, and environmental factors, which can be modified to protect and cope with the disease. Refer to the section below for some general tips to support your health:

  • Take hepatitis C-related medications as recommended by your healthcare provider.
  • Consider avoiding infected blood transfusions and unhygienic practices regarding injections.
  • Achieve a healthy lifestyle to prevent the spreading of disease.
  • Use latex condoms or other effective methods during sexual intercourse to avoid transmission of infection.
  • Keep regular laboratory appointments.
  • Keep a close check on hepatitis B symptoms and report to your healthcare provider if you have any.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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