| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Darunavir EBR/GZR 920 | Red: Avoid combination | Do not coadminister: Increased levels of grazoprevir | Potential for increased risk of ALT elevations due to a significant increase in grazoprevir plasma concentrations caused by OATP1B1 / 3 inhibition |
No significant change |
50 / 100 mg once daily | Elbasvir AUC increase 66%; Grazoprevir AUC increase 7.5 fold |
Contraindicated. Use alternative agents. |
| Atazanavir EBR/GZR 823 | Red: Avoid combination | Do not coadminister: Potential for increased levels of grazoprevir | May increase risk of ALT elevations due to a significant increase in grazoprevir plasma concentrations caused by OATP1B1 / 3 inhibition |
ATV AUC increased 43% by grazoprevir |
Elbasvir 50 mg daily with grazoprevir 200 mg daily | Elbasvir AUC increased by 4.76-fold, Grazoprevir AUC increased by 10.58-fold |
Contraindicated. Use alternative agents. |
| Nevirapine EBR/GZR 606 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of elbasvir / grazoprevir | Decreased elbasvir, grazoprevir levels expected |
Nevirapine AUC decreased 31%; Cmax decreased 36%; Cmin decreased 21% |
Not studied (may decrease grazprevir levels) |
Contraindicated. Use alternative agents. |
|
| Nevirapine EBR/GZR 605 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of elbasvir / grazoprevir | Potentially decreased elbasvir, grazoprevir levels expected |
Not studied (may decrease grazprevir levels) |
Avoid combination. Use alternative agents |
||
| Etravirine EBR/GZR 542 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of elbasvir / grazoprevir | Potentially decreased elbasvir, grazoprevir levels expected |
Not studied |
Not studied (may decrease grazprevir levels) |
Avoid combination. Use alternative agents |
|
| Efavirenz EBR/GZR 447 | Red: Avoid combination | Do not coadminister: Reduced levels of elbasvir / grazoprevir | Elbasvir 50 mg daily with grazoprevir 100 mg daily | Elbasvir AUC decreased 54% Grazoprevir AUC decreased 83% |
Contraindicated. Use alternative agents. |
||
| Efavirenz EBR/GZR 446 | Red: Avoid combination | Do not coadminister: Reduced levels of elbasvir / grazoprevir | decreased of elbasvir / grazoprevir effects |
Contraindicated. Use alternative agents. |
|||
| Efavirenz EBR/GZR 445 | Red: Avoid combination | Do not coadminister: Reduced levels of elbasvir / grazoprevir | decreased of elbasvir / grazoprevir effects |
Elbasvir 50 mg daily with grazoprevir 100 mg daily | Elbasvir AUC decreased 54% Grazoprevir AUC decreased 83% |
Contraindicated. Use alternative agents. |
|
| Raltegravir EBR/GZR 306 | Green: Administer standard doses | Administer standard doses | Increase RAL AUC 43% with grazoprevir |
Elbasvir 50 mg daily with grazoprevir 100 mg daily | No significant change |
||
| Elvitegravir EBR/GZR 187 | Red: Avoid combination | Do not coadminister: Potential for increased levels of antivirals | Potential for increased AUC of HCV agents |
No significant change |
Elbasvir Cmax increased 91%, AUC increased 118%; Grazoprevir Cmax increased 359%, AUC increased436% |
Use alternative agents |
|
| Dolutegravir EBR/GZR 105 | Green: Administer standard doses | Administer standard doses | Cmax increased 22%, AUC increased 16%, Cmin increased 14% |
elbasvir 50 mg + grazoprevir 200 mg once daily | No significant change in elbasvir. Grazoprevir Cmax decreased 36%, AUC decreased 19%, Cmin decreased 14% |
||
| Fostemsavir Elbasvir / grazoprevir 27 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits benefit | Potentially increased exposure of grazoprevir and risk of ALT elevations |
Avoid combination; use alternative HCV regimen |
