Liverpool HEP Interactions

Interaction Checker

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Potential Interaction

Glecaprevir/Pibrentasvir

Rosuvastatin

Summary:

Coadministration of glecaprevir/pibrentasvir and rosuvastatin (5 mg) increased rosuvastatin Cmax and AUC by 5.62-fold and 2.15-fold. Use with caution. The European SPC recommends that the rosuvastatin dose should not exceed 5 mg/day, whereas the US Prescribing Information recommends that rosuvastatin should not exceed 10 mg/day. Note, rosuvastatin is contraindicated in patients with active liver disease and should be used with caution in patients who consume excessive quantities of alcohol and/or have a history of liver disease.

Description:

Co-administration with Maviret may increase plasma concentrations of medicinal products that are substrates of OATP1B1/3 (e.g. rosuvastatin). Coadministration of rosuvastatin (5 mg once daily) and glecaprevir/pibrentasvir increased rosuvastatin Cmax and AUC by 5.62-fold and 2.15-fold due to inhibition of OATP1B1/3 and BCRP. Caution is recommended. Rosuvastatin dose should not exceed 5 mg per day.

Maviret Summary of Product Characteristics, AbbVie Ltd., June 2021.

Coadministration of rosuvastatin (5 mg once daily) and glecaprevir/pibrentasvir (400/120 mg once daily) increased rosuvastatin Cmax and AUC by 5.62-fold and 2.15-fold (n=11). Increased statin concentrations may increase the risk of myopathy, including rhabdomyolysis. Rosuvastatin may be administered with Mavyret at a dose that does not exceed 10 mg.

Mavyret Prescribing Information, AbbVie Inc., June 2021.

Coadministration of rosuvastatin (5 mg, once daily) was studied with glecaprevir/pibrentasvir (400/120 mg, once daily) in healthy volunteers. Rosuvastatin Cmax and AUC increased by 5.62-fold and 2.15-fold, respectively. Glecaprevir and pibrentasvir exposures were not clinically different (≤25% change). The increase in rosuvastatin exposure is likely due to inhibition of both OATP1B1/B3 and BCRP. Refer to prescribing information.

Translation of In Vitro Transport Inhibition Studies to Clinical Drug-Drug Interactions for Glecaprevir and Pibrentasvir. MP Kosloski, DAJ Bow, R Kikuchi et al. J Pharmacol Exp Ther, 2019 Aug;370(2):278-287.

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