Zepatier is a brand-name prescription drug. It’s FDA-approved to treat a chronic liver infection caused by certain types of the hepatitis C virus (HCV). “Chronic” means long-lasting.

In some cases, the infection can lead to liver failure or liver cancer.

Zepatier is used to treat an infection caused by HCV genotypes 1 and 4. In this situation, a genotype is a strain of a virus.

Drug details

Zepatier contains two active drug ingredients: elbasvir and grazoprevir. Zepatier belongs to a class of drugs called direct-acting antivirals. (A class of drugs is a group of medications that work together in a similar way.) Zepatier works directly on HCV cells to stop them from multiplying and growing.

Zepatier comes as a tablet that you swallow. Each tablet contains 50 milligrams (mg) of elbasvir and 100 mg of grazoprevir. You’ll likely take Zepatier once per day.

If you’d like to learn more about specific uses of the drug, see the “Zepatier for hepatitis C” section below.

Effectiveness

For information about the effectiveness of Zepatier, see the “Zepatier for hepatitis C” section below.

Zepatier contains two active drug ingredients: elbasvir and grazoprevir. Zepatier is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

As with all medications, the cost of Zepatier can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

It’s important to note that you may have to get Zepatier at a specialty pharmacy. This type of pharmacy is authorized to carry specialty medications. These are drugs that may be expensive or may require help from healthcare professionals to be used safely and effectively.

Before approving coverage for Zepatier, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Zepatier, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Zepatier, or if you need help understanding your insurance coverage, help is available.

Merck, the maker of Zepatier, offers a program called the Patient Assistance Program. For more information and to find out if you’re eligible for support, call 800-727-5400 or visit the program website.

Generic version

Zepatier isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

The following lists contain some of the key side effects that may occur while taking Zepatier alone or with ribavirin (Rebetol). These lists don’t include all possible side effects.

For more information about the possible side effects of Zepatier, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Zepatier, you can do so through MedWatch.

Mild side effects

Mild side effects* of Zepatier can include:

When used with ribavirin (Rebetol), common side effects of Zepatier can include:

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Zepatier. To learn about other mild side effects, talk with your doctor or pharmacist, or view Zepatier’s Patient Information.
† For more information about this side effect, see “Side effect details” below.

Serious side effects

Serious side effects from Zepatier aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

* For more information about this side effect, see “Side effect details” below.
Zepatier has a boxed warning for hepatitis B reactivation in people with the hepatitis B and C viruses. A boxed warning is the most serious warning from the FDA. For more information, see “Hepatitis B virus reactivation in people with the hepatitis B and C viruses” in “Side effect details” below.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Zepatier. But it isn’t known how often this side effect may have happened in adults who took Zepatier in clinical studies.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth, swelling, or redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Zepatier, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Hepatitis B virus reactivation in people with the hepatitis B and C viruses

Both the hepatitis C virus (HCV) and hepatitis B virus (HBV) can cause infections. If you have an HCV infection and have ever had an HBV infection, taking Zepatier can make the HBV infection active again.* This can also happen after you’ve stopped taking Zepatier. But it isn’t known how often this side effect may have happened in clinical studies of Zepatier.

In some cases, an active HBV infection can cause liver failure or hepatitis that’s sudden and severe. In rare cases, the infection can lead to death.

Symptoms of an active HBV infection can include:

Your doctor will likely give you a blood test before you start taking Zepatier. If the results show that you have an HBV infection that’s active, your doctor may treat it before or during your Zepatier treatment. If you have both active HBV and HCV infections, your doctor may check your liver function more often than usual while you’re taking Zepatier.

If you have an HCV infection and have ever had an HBV infection, ask your doctor if using Zepatier is right for you.

* Zepatier has a boxed warning for hepatitis B reactivation in people with the hepatitis B and C viruses. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Fatigue

Fatigue (lack of energy) can occur with Zepatier treatment. In clinical studies, the percentage of adults who had fatigue varied depending on:

  • whether they took Zepatier alone or with another medication to treat HCV called ribavirin (Rebetol)
  • whether they had taken other HCV treatments before
  • other medical conditions they had

In these studies, fatigue occurred in:

  • 5% to 11% of adults who took Zepatier alone
  • 3% to 4% of adults who took Zepatier with ribavirin (Rebetol)
  • 8% to 10% of adults who took a placebo (a treatment with no active drug)

The amount of time that fatigue lasted in these studies isn’t known.

If you experience bothersome fatigue while taking Zepatier, talk with your doctor. They may suggest ways to ease this side effect.

Headache

Headache is a possible side effect of Zepatier. The percentage of adults who had headaches in clinical studies varied depending on:

  • whether they took Zepatier alone or with ribavirin (Rebetol)
  • whether they had taken other HCV treatments before
  • other medical conditions they had

In these studies, headaches occurred in:

  • 0% to 11% of adults who took Zepatier alone
  • 6% of adults who took Zepatier with ribavirin (Rebetol)
  • 5% to 9% of adults who took a placebo

The amount of time that headaches lasted in these studies isn’t known.

Talk with your doctor if you have headaches while taking Zepatier. They can recommend ways to lessen this side effect.

Increase in levels of liver enzymes

Zepatier treatment may cause an increase in transaminases, which are a type of liver enzyme. Enzymes are proteins that aid chemical changes in the body.

Clinical studies looked at adults who were given Zepatier alone or with ribavirin (Rebetol). Of these adults, 1% had an increase in the levels of liver enzymes. This increase usually occurred after 8 weeks of treatment. For many people in these studies, liver enzymes returned to normal levels after they finished taking Zepatier. Zepatier wasn’t compared with a different drug or a placebo.

You may have a higher risk for increased levels of liver enzymes after taking Zepatier if you are:

  • female
  • of Asian descent
  • age 65 years or older

Symptoms of liver disease

Unless you have more serious liver disease, you may not have any symptoms of increased liver enzymes. However, symptoms of liver disease can include:

Tell your doctor right away if you have any symptoms of liver disease while using Zepatier. They’ll likely give you blood tests to check your liver before you start treatment. Your doctor may also check your liver on a regular basis while you’re taking the drug.

If you have questions about your risk for increased liver enzymes while taking Zepatier, talk with your doctor.

The Zepatier dosage your doctor prescribes will depend on several factors. These include:

  • the genotype (strain) of hepatitis C virus (HCV) that you have
  • whether the type of HCV you have is typically resistant* to other treatments for HCV
  • whether you’ve taken other treatments for HCV

Your doctor will prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

* In this situation, “resistant” means that other treatments for HCV don’t work for the type of HCV you have.

Drug forms and strengths

Zepatier comes as a tablet that you swallow. Each tablet contains 50 milligrams (mg) of elbasvir and 100 mg of grazoprevir.

Dosage for chronic hepatitis C

Zepatier is approved to treat a chronic liver infection caused by certain types of the hepatitis C virus (HCV). “Chronic” means long-lasting. (For details, see the “Zepatier for hepatitis C” section below.)

For this use, the typical dosage of Zepatier is one tablet taken once per day. You may take your dose with or without food.

The recommended length of treatment with Zepatier is 12 to 16 weeks. The actual length of time that you’ll take Zepatier for depends on several factors. These include the three factors at the top of this “Zepatier dosage” section.

Your doctor may prescribe Zepatier alone or with ribavirin (Rebetol), which is another drug used to treat HCV. Whether you take Zepatier alone or with ribavirin depends on the same factors mentioned above.

If you have questions about the dosage of Zepatier that’s right for you, talk with your doctor.

Dosage questions

Below are answers to some questions you may have about taking Zepatier.

What if I miss a dose?

If you miss a dose of Zepatier, take your missed dose as soon as you remember. If it’s almost time for your next dose, skip your missed dose. Then take your next dose at its regular time. If you’re uncertain about whether you should take or skip a missed dose, ask your doctor or pharmacist.

However, don’t take an extra dose of Zepatier to make up for your missed dose. Taking extra doses can raise your risk for side effects. (For more information, see the “Zepatier side effects” section above.)

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app.

Will I need to use this drug long term?

No, you probably won’t take Zepatier as a long-term treatment. The recommended length of treatment with Zepatier is 12 to 16 weeks. Your doctor can recommend how long you’ll need to take the drug for. To learn more, see “Dosage for chronic hepatitis C” above.

The Food and Drug Administration (FDA) approves prescription drugs such as Zepatier to treat certain conditions. Zepatier may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is used for a purpose other than what it’s approved for.

Zepatier is FDA-approved to treat a chronic liver infection caused by certain types of the hepatitis C virus (HCV). “Chronic” means long-lasting.

To be specific, Zepatier is used to treat HCV genotypes 1 and 4. In this situation, a genotype is a strain of a virus. (There are seven genotypes of HCV: 1a, 1b, 2, 3, 4, 5, and 6.) The type of HCV you have can be determined by a blood test. The virus doesn’t develop any differently based on the type of HCV you have. But by knowing your HCV type, your doctor can help determine the treatment that’s right for you.

Zepatier may be used alone or with ribavirin (Rebetol), which is another drug used to treat HCV. Zepatier is approved for use in adults.

Hepatitis C explained

HCV can cause a liver infection known as hepatitis C. Some people with HCV will have the hepatitis C for a short time. This is called acute hepatitis C. But most people who have HCV will have a lifelong infection if the infection isn’t treated. This is called chronic hepatitis C.

Chronic hepatitis C can lead to serious health problems, such as:

Some symptoms of a chronic hepatitis C infection are nausea and vomiting, as well as pain in the abdomen (belly). Other symptoms may include fever and jaundice (yellow coloring of your skin or the white of your eyes).

HCV is usually transmitted through the blood of a person who has the virus. You might be exposed to blood that has HCV by:

  • sharing used syringes or needles with someone who has the virus
  • being born to a female* who has the virus
  • having sexual intercourse with a person who has the virus
  • getting tattoos or body piercings with instruments that haven’t been properly cleaned
  • receiving an organ transplant or donor blood from a person who has the virus
  • accidently getting stuck by a needle that has the virus, which may occur in a healthcare setting

HCV can’t be transmitted through coughing, sneezing, kissing, or sharing food or water.

* Use of the term “female” within this article refers to a person’s gender assigned at birth.

Effectiveness for chronic hepatitis C

Zepatier has been found effective for treating types 1 and 4 of chronic HCV. Treatment is considered effective when the virus is no longer detected in your blood 12 weeks after you’ve stopped taking Zepatier. This is known as a sustained virologic response (SVR).

In clinical studies, SVR was compared in adults who received one of the following treatments:

  • Zepatier alone
  • Zepatier with ribavirin (Rebetol)
  • a placebo (a treatment without active drug)

Effectiveness for type 1 HCV

Five clinical studies were completed in people with genotype 1 HCV* who had achieved an SVR after finishing Zepatier treatment. The study looked at the percentage of adults who achieved an SVR after either 12 weeks or 16 weeks of treatment. An SVR was achieved in:

  • 94% to 95% of adults who were given Zepatier alone
  • 96% to 97% who took Zepatier with ribavirin (Rebetol)

* In this situation, a genotype is a strain of a virus. For more information on HCV genotypes, see “Zepatier for hepatitis C” above.

Effectiveness for type 4 HCV

In four clinical studies, an SVR was achieved in 97% to 100% of adults with genotype 4 HCV. They were given the following treatments:

  • Zepatier alone
  • Zepatier with ribavirin (Rebetol)

It isn’t known how many people in these studies had an SVR after taking a placebo.

Zepatier and children

Zepatier isn’t approved for use in children. The drug hasn’t been studied in anyone younger than age 18 years.

There aren’t any known interactions between Zepatier and alcohol.

Zepatier is used to treat a chronic liver infection caused by certain types of the hepatitis C virus (HCV). “Chronic” means long-lasting.

Keep in mind that drinking alcohol while you have HCV can cause liver problems. (These problems include a type of liver scarring called cirrhosis.) Therefore, you may need to be careful about drinking alcohol while taking Zepatier.

Drinking large amounts of alcohol can put you at risk for cirrhosis or worsen cirrhosis if you already have it.

Talk with your doctor about whether it’s safe to drink alcohol while taking Zepatier.

Zepatier can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Zepatier and other medications

Below are examples of medications that can interact with Zepatier. This section doesn’t contain all drugs that may interact with Zepatier.

Before taking Zepatier, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Zepatier and certain medications that affect how your body breaks down Zepatier

You shouldn’t take Zepatier with certain drugs that affect how your body metabolizes (breaks down) Zepatier.

Zepatier and OATP1B1/3 inhibitors

You shouldn’t take Zepatier with a type of drug called an OATP1B1/3 inhibitor. This type of drug works by blocking the action of an enzyme in the body called OATP1B1/3. This is one of the enzymes your body uses to break down Zepatier. (Enzymes are proteins that aid chemical changes to produce a specific effect in your body.)

Blocking OATP1B1/3 can raise the level of Zepatier in your blood. This can increase your risk for side effects. (For more information, see the “Zepatier side effects” section above.)

The following drugs are examples of OATP1B1/3 inhibitors:

  • cyclosporine (Sandimmune, Gengraf)
  • darunavir (Prezista)
  • saquinavir (Invirase)

Talk with your doctor about any medications you take before starting Zepatier. They can tell you whether any of your medications are OATP1B1/3 inhibitors. Then your doctor can adjust your treatment plan as needed.

Zepatier and CYP3A inducers

Taking Zepatier with a type of drug called a strong CYP3A inducer isn’t recommended. CYP3A inducers can increase how quickly the CYP3A enzyme breaks down Zepatier. This can lower the level of Zepatier in your blood, which may prevent the drug from working to treat your condition.

The following drugs are examples of CYP3A inducers.

If you use any of these drugs, talk with your doctor before taking Zepatier.

Zepatier and strong CYP3A inhibitors

You shouldn’t take Zepatier with a type of drug called a strong CYP3A inhibitor. These drugs block the action of an enzyme in the body called CYP3A. This is one of the enzymes your body uses to break down Zepatier.

Blocking the action of this enzyme can raise the level of Zepatier in your blood. This can increase your risk for side effects, such as diarrhea, fatigue, or increased levels of liver enzymes. (For more information, see the “Zepatier side effects” section above.)

The following drugs are examples of strong CYP3A inhibitors:

  • cobicistat (Tybost)
  • itraconazole (Sporanox, Tolsura)
  • ketoconazole
  • lopinavir/ritonavir (Kaletra)
  • ritonavir (Norvir)
  • voriconazole (Vfend)

If you use any of these medications, talk with your doctor before taking Zepatier.

Zepatier and herbs and supplements

You shouldn’t take St. John’s wort during your Zepatier treatment. St. John’s wort is an herb that is sometimes used to help ease the symptoms of depression. Taking Zepatier with this supplement can make Zepatier less effective for you.

Talk with your doctor or pharmacist before using any herbs or supplements while taking Zepatier.

Zepatier and foods

No foods have been specifically reported to interact with Zepatier. If you have any questions about eating certain foods while taking Zepatier, talk with your doctor.

Other drugs are available that can treat your condition. Some of these drugs may be a better fit for you than others. If you’re interested in finding an alternative to Zepatier, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for chronic hepatitis C

Zepatier is used to treat a chronic liver infection caused by certain types of the hepatitis C virus (HCV). “Chronic” means long-lasting. Examples of other drugs that may be used for this purpose include:

  • glecaprevir/pibrentasvir (Mavyret)
  • ledipasvir/sofosbuvir (Harvoni)
  • peginterferon alfa-2a (Pegasys)
  • ribavirin (Rebetol)
  • sofosbuvir (Sovaldi)
  • sofosbuvir/velpatasvir (Epclusa)
  • sofosbuvir/velpatasvir/voxilaprevir (Vosevi)

Zepatier is used to treat a chronic liver infection caused by certain types of the hepatitis C virus (HCV). “Chronic” means long-lasting.

Zepatier is used to treat HCV genotypes (strains) 1 and 4.

For this purpose, Zepatier may be used with another drug, ribavirin (Rebetol), which also treats HCV infection. Ribavirin may be used with Zepatier to make treatment more effective in people who have:

  • HCV with a genetic mutation* called NS5A polymorphism. This genetic mutation can cause drug resistance to Zepatier. So if you have NS5A polymorphism, Zepatier may not work to treat your HCV infection when it’s used on its own.
  • Tried treatment with a combination of the following medications, but it didn’t work for them:
    • peginterferon alfa
    • ribavirin

Talk with your doctor if you have questions about your treatment options for HCV.

* A genetic mutation is an abnormal change in a gene.

Zepatier comes as a tablet that you swallow.

You should take Zepatier according to your doctor’s or healthcare provider’s instructions.

When to take

You’ll likely take Zepatier once per day. You can take the drug any time of day. But you should try to take your dose around the same time each day.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm on your phone or downloading a reminder app.

Taking Zepatier with food

You can take Zepatier with or without food.

Can Zepatier be crushed, split, or chewed?

It isn’t known whether Zepatier tablets can be crushed, split, or chewed. The maker of Zepatier hasn’t specifically stated this information.

However, if you have trouble swallowing Zepatier tablets, talk with your doctor or pharmacist. They can suggest ways to make it easier to take your medication.

Zepatier is approved to treat a chronic liver infection caused by certain types of the hepatitis C virus (HCV). “Chronic” means long-lasting.

Hepatitis is a kind of liver inflammation that’s caused by different viruses. The common ones are A, B, and C. Zepatier works to treat hepatitis caused by the hepatitis C virus (HCV).

HCV infects liver cells, which can cause them to swell and not work properly. This can lead to liver damage over time. In some cases, the infection can lead to cirrhosis (liver scarring) and liver cancer. The infection is known as hepatitis C.

For more information on hepatitis C, see the “Zepatier for hepatitis C” section above.

What Zepatier does

Zepatier belongs to a class of drugs called direct-acting antiviral medications. (A drug class is a group of medications that work in a similar way.)

Zepatier works by stopping HCV from making copies of itself. This keeps HCV from multiplying and spreading through your body. The way a drug works is also called its mechanism of action.

How long does it take to work?

Zepatier starts working right away to treat your HCV. You might not notice Zepatier working in your body. But you may start to notice fewer symptoms of HCV within a few weeks after starting the drug.

It isn’t known whether Zepatier is safe to take while pregnant. The drug hasn’t been studied in pregnancy.

When Zepatier was taken by pregnant females in animal studies, no harm was seen in the fetus. But animal studies don’t always predict what will happen in humans.

If you’re pregnant or planning to become pregnant, talk with your doctor before using Zepatier. They can answer your questions about using Zepatier during pregnancy.

It’s not known if Zepatier is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Zepatier.

For more information about taking Zepatier during pregnancy, see the “Zepatier and pregnancy” section above.

It isn’t known whether Zepatier can pass into breast milk. This drug hasn’t been studied in breastfeeding females.

If you’re breastfeeding or planning to breastfeed your child, talk with your doctor. They can answer your questions about the pros and cons of breastfeeding while taking Zepatier.

Here are answers to some frequently asked questions about Zepatier.

Will Zepatier cure my hepatitis C?

It’s likely Zepatier can cure your hepatitis C.

Clinical studies have found Zepatier effective for curing certain types of chronic infections caused by the hepatitis C virus (HCV). “Curing” means the virus isn’t detected in your blood for at least 12 weeks after you stop taking the drug. And an HCV infection is known as hepatitis C.

Even if your hepatitis C is cured with Zepatier, you can still get the virus again if you’re exposed to it later. It’s important to keep protecting yourself from the transmission of HCV. (For information on ways that HCV can be transmitted, see the “Zepatier for hepatitis C” section above.)

If you have questions about using Zepatier to cure your HCV, talk with your doctor.

Can I transmit hepatitis C to another person while I’m taking Zepatier?

You can transmit the hepatitis C virus (HCV) to someone while you’re taking Zepatier. “Hepatitis C” refers to an infection caused by HCV. If the level of HCV in your blood is high enough to be measured, you can still transmit the virus. HCV is usually transmitted through the blood of a person who has the virus. For information about how HCV may be transmitted, see the “Zepatier for hepatitis C” section above.

If you have questions about transmitting HCV to another person while taking Zepatier, talk with your doctor.

Can I take Zepatier if I have hepatitis B?

Possibly. Zepatier is used to treat infections caused by certain types of the hepatitis C virus(HCV). The hepatitis B virus (HBV) can also cause infections. If you have an HCV infection and have ever had an HBV infection, which is known as hepatitis B, taking Zepatier can make the HBV infection active again. This can also happen after you’ve stopped taking Zepatier.

In fact, Zepatier has a boxed warning for hepatitis B reactivation in people with the hepatitis B and C viruses. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous.

For more information about this side effect, see “Hepatitis B virus reactivation in people with the hepatitis B and C viruses” in the “Zepatier side effects” section above.

If you’ve ever had HBV, talk with your doctor before taking Zepatier.

If I have HIV, can I take Zepatier?

Yes, you can take Zepatier if you have HIV and an infection caused by the hepatitis C virus (HCV).

Zepatier is effective for treating HCV infections in people who have both conditions. Clinical studies looked at adults who had HIV and HCV. Treatment was considered effective when HCV was no longer detected in their blood 12 weeks after they stopped taking Zepatier. This is known as a sustained virologic response (SVR). Zepatier produced a 95% to 97% SVR.

However, certain medications used to treat HIV may interact with Zepatier. These include:

  • darunavir (Prezista)
  • saquinavir (Invirase)
  • lopinavir/ritonavir (Kaletra)
  • ritonavir (Norvir)
  • efavirenz (Sustiva)

For more information, see “Zepatier and other medications” in the “Zepatier interactions” section above.

If you have HCV and HIV, talk with your doctor about the best treatment options for your conditions.

Can I take Zepatier if I’ve had a liver transplant?

It isn’t known if Zepatier is effective for treating infections caused by the hepatitis C virus (HCV) in adults who’ve had a liver transplant. If you’ve had a liver transplant, talk with your doctor about the best treatment options for your HCV infection.

Can I use Zepatier if I’ve used other hepatitis C treatments in the past?

Probably. If other treatments for hepatitis C virus (HCV) infection haven’t worked for you, your doctor may try to treat it with Zepatier. In some cases, your doctor may have you take Zepatier with a drug called ribavirin (Rebetol). To learn more, see the “Zepatier use with other drugs” section above.

Zepatier is used to treat an infection caused by HCV genotypes 1 and 4. In this situation, a genotype is a strain of a virus.

Genotype 1 HCV is the most common form in the United States. Genotype 4 HCV is more common in the Middle East and Africa. The kind of HCV you have can be determined by a blood test. The virus doesn’t develop any differently based on the genotype of HCV you have. But by knowing your HCV genotype, your doctor can help determine the treatment that’s right for you.

If you have questions about your Zepatier treatment, talk with your doctor.

This drug comes with several precautions.

FDA warning: Hepatitis B reactivation in people with the hepatitis B and C viruses

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Both the hepatitis C virus (HCV) and hepatitis B virus (HBV) can cause infections. If you have an HCV infection and have ever had an HBV infection, taking Zepatier can make the HBV infection active again. This can also happen after you’ve stopped taking Zepatier.

In some cases, an active HBV infection can cause liver failure or hepatitis that’s sudden and severe. In rare cases, the infection can lead to death.

For more information, see “Hepatitis B virus reactivation in people with the hepatitis B and C viruses” in the “Zepatier side effects” section above.

Other precautions

Before taking Zepatier, talk with your doctor about your health history. Zepatier may not be right for you if you have certain medical conditions or other factors affecting your health. These include the ones mentioned below.

Note: For more information about the potential negative effects of Zepatier, see the “Zepatier side effects” section above.

Liver problems. Before starting Zepatier treatment, tell your doctor if you have any liver problems other than the hepatitis C virus (HCV). These problems may include liver disease that’s moderate, severe, or decompensated.

Having liver problems other than HCV can prevent your body from breaking down Zepatier. This could increase your risk for certain side effects from the drug, such as increased liver enzymes. (For more information, see “Increase in levels of liver enzymes” in the “Zepatier side effects” section above.)

Your doctor may perform regular liver enzyme tests to monitor you. If your liver disease worsens, your doctor may have you stop taking Zepatier and recommend a different treatment for your HCV.

Allergic reaction. If you’ve had an allergic reaction to Zepatier or any of its ingredients, you shouldn’t take Zepatier. Ask your doctor what other medications are better options for you.

Pregnancy. It isn’t known whether Zepatier is safe to use during pregnancy. For more information, see the “Zepatier and pregnancy” section above.

Breastfeeding. It isn’t known whether Zepatier can pass into breast milk during breastfeeding. For more information, see the “Zepatier and breastfeeding” section above.

Note: For more information about the potential negative effects of Zepatier, see the “Zepatier side effects” section above.

Do not use more Zepatier than your doctor recommends. With some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Zepatier

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Zepatier from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Zepatier tablets should be stored at room temperature (68°F to 77°F/20°C to 25°C). For short periods of time, such as when traveling, you can keep Zepatier at temperatures of 59°F to 86°F (15°C to 30°C). The tablets should be stored in their original package and away from light. Avoid keeping this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Zepatier and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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