From the Guidelines
Mavyret (glecaprevir/pibrentasvir) can be safely coadministered with pravastatin without a significant interaction, as pravastatin is metabolized by glucuronidation, which is not affected by Mavyret 1. When considering the management of patients on Mavyret and pravastatin, it is essential to understand the metabolic pathways of both medications. Mavyret is known to inhibit certain transport proteins, but its impact on pravastatin is minimal due to pravastatin's unique metabolism. Key points to consider in the management of these patients include:
- Pravastatin's metabolism via glucuronidation reduces the risk of significant interactions with Mavyret 1.
- The lack of extensive metabolism of pravastatin by cytochrome P450 enzymes or transport proteins affected by Mavyret minimizes the potential for drug-drug interactions.
- Monitoring for statin-related side effects is still crucial, but the risk is not significantly increased by the coadministration of Mavyret and pravastatin.
- Healthcare providers should be informed about all medications a patient is taking before starting Mavyret, and patients should be monitored as usual for any signs of side effects during treatment. In clinical practice, the coadministration of Mavyret and pravastatin can be managed without significant dose adjustments, focusing instead on standard monitoring and patient care 1.
From the FDA Drug Label
HMG-CoA Reductase Inhibitors: ... Pravastatin↑ pravastatinCoadministration may increase the concentration of pravastatin. Increased statin concentrations may increase the risk of myopathy, including rhabdomyolysis. Reduce pravastatin dose by 50% when coadministered with MAVYRET.
- Mavyret Interaction with Pravastatin: Mavyret interacts with pravastatin by increasing its concentration, which may increase the risk of myopathy, including rhabdomyolysis.
- Recommended Action: Reduce pravastatin dose by 50% when coadministered with Mavyret 2.
From the Research
Mavyret and Pravastatin Interaction
- There are no direct studies on the interaction between Mavyret (glecaprevir/pibrentasvir) and pravastatin in the provided evidence.
- However, the studies suggest that glecaprevir/pibrentasvir is a well-tolerated and highly effective treatment for chronic hepatitis C infection, with minimal drug-related laboratory abnormalities 3, 4, 5, 6, 7.
- The pharmacokinetics of glecaprevir/pibrentasvir have been studied, and it has been found that the regimen can be safely used in individuals with severe chronic kidney disease (CKD), including those undergoing hemodialysis 4, 5.
- While there is no specific information on the interaction between Mavyret and pravastatin, it is known that glecaprevir/pibrentasvir is minimally excreted by the kidneys, which may reduce the potential for interactions with other medications 4.
- Further studies would be needed to determine the potential interaction between Mavyret and pravastatin, as the current evidence does not provide sufficient information to make a conclusion.