When is Zepatier contraindicated? | Hepatitis Central

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Zepatier (elbasvir and grazoprevir)

When is Zepatier contraindicated?

Zepatier is contraindicated in patients with moderate or severe hepatic impairment (Child-Pugh B or C). Additionally, Zepatier is contraindicated with organic anion transporting polypeptides 1B1/3 inhibitors, strong inducers of cytochrome P450 3A, and efavirenz.

For those taking Zepatier in combination with ribavirin, this treatment is contraindicated in pregnant women or those that may become pregnant as well as men whose female partner is pregnant, due to the risks for birth defects and fetal death associated with ribavirin. For more specific information, refer to the prescribing information for ribavirin for a list of all contraindications.

The following chart provides information regarding additional medications that are contraindicated with Zepatier. This table is not all inclusive.


Drug Class Specific Drugs Within Class Contraindicated with Zepatier
Anticonvulsants Carbamazepine
Antimycobacterials Rifampin
HIV Medications Atazanavir
Herbal Supplements St. Johns’ wort (Hypericum perforatum)
Immunosuppressants Cyclosporine

Last Updated: February 2016

"Highlights of Prescribing Information." Merck.com. Merck Sharp & Dohme Corp., http://www.merck.com/product/usa/pi_circulars/z/zepatier/zepatier_pi.pdf. Retrieved February 1, 2016.

"Patient Information: Zepatier™." Merck.com. Merck Sharp & Dohme Corp., http://www.merck.com/product/usa/pi_circulars/z/zepatier/zepatier_ppi.pdf. Retrieved February 1, 2016.

"Zepatier Multiuse Savings Coupon." Activatethecard.com. Merck Sharp & Dohme Corp., https://www.activatethecard.com/7208/#. Retrieved February 1, 2016.

"Zepatier (Elbasvir and Grazoprevir) Official Website." Zepatier.com. Merck Sharp & Dohme Corp., https://www.zepatier.com/. Retrieved February 1, 2016.