Hepatitis C treatment factsheet: Maviret (glecaprevir + pibrentasvir)

Maviret is a medication used to treat hepatitis C. It is a combination pill containing glecaprevir and pibrentasvir. It was approved in the European Union in August 2017 for treatment of all genotypes of hepatitis C for adults and children aged 3 years and over.

How does Maviret work?

Maviret contains two direct-acting antiviral drugs that target different steps of the hepatitis C virus (HCV) lifecycle. Glecaprevir blocks the NS3/4A protease that HCV uses to reproduce. Pibrentasvir is an HCV NS5A replication complex inhibitor that interferes with another protein HCV uses to reproduce. Blocking two steps in the lifecycle of the virus stops it from reproducing and clears the virus from the body rapidly.

The aim of treatment is to achieve a sustained virologic response 12 weeks after completing treatment. If the hepatitis C virus remains undetectable at this point, it means the virus has been cleared from the body and a person is cured of hepatitis C.

Who can use Maviret?

Maviret is approved for the treatment of all genotypes of hepatitis C. It is approved for use in previously untreated people and for the treatment of people who have been previously treated with older forms of hepatitis C medication but remained uncured.

Maviret is not suitable for people who have taken a previous regimen containing any direct-acting antiviral apart from sofosbuvir alone. People who have taken sofosbuvir and ledipasvir (Harvoni), grazoprevir and elbasvir (Zepatier) or sofosbuvir and velpatasvir (Epclusa) or paritaprevir and ombitasvir (Viekirax) should not take Maviret.

How is Maviret taken?

Maviret is taken once a day with or without food. Previously untreated people take Maviret for 8 weeks.

People who have previously been treated with pegylated interferon with or without ribavirin, or sofosbuvir with or without ribavirin will take Maviret for 8 weeks unless they have genotype 3 or liver cirrhosis. People with cirrhosis and previous treatment experience will take Maviret for 12 weeks.

People with genotype 3 hepatitis C and previous treatment experience take Maviret for 16 weeks.

A granular form of Maviret is available for children aged 3 to 12 years. This formulation is dosed according to weight. Children weighing 45kg or more should take the adult dose.

How effective is Maviret?

Clinical trials of Maviret showed that between 95 and 100% of people were cured of hepatitis C, depending on genotype. The cure rate was slightly lower in the small group of people with genotype 6 (92%). Cirrhosis did not affect the outcome of treatment.

What are the side effects of Maviret?

The most common side effects (affecting more than one in ten people) are headache and tiredness.

Does Maviret interact with other drugs?

Maviret should not be used with the following medicines:

  • atorvastatin, simvastatin (medicines for lowering cholesterol levels in the blood);
  • dabigatran etexilate (a medicine for preventing blood clots);
  • ethinyl estradiol-containing products (such as contraceptive medicines);
  • rifampicin (antibiotic usually used to treat tuberculosis);
  • carbamazepine, phenobarbital, phenytoin, primidone (medicines for epilepsy);
  • St John’s wort (a herbal remedy used for depression and anxiety).

Maviret should not be used with several antiretroviral drugs used to treat HIV, including HIV protease inhibitors or efavirenz.

Factsheet published April 2022.