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Direct-acting antiviral (NS5A + NS3/4A protease inhibitor)

Elbasvir with grazoprevir

Brand names: Zepatier

Elbasvir with grazoprevir is a fixed-dose direct-acting antiviral combination used to treat chronic hepatitis C virus infection of susceptible genotypes.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Elbasvir inhibits the HCV NS5A protein essential for viral replication and assembly, while grazoprevir inhibits the NS3/4A protease required for processing of the viral polyprotein.

Prescribing in practice

  • It can cause raised liver transaminases, particularly later in the course, so liver function should be assessed before and during treatment, and it is contraindicated in moderate to severe hepatic impairment.
  • Genotype and baseline resistance-associated substitutions can influence regimen choice and duration, so confirm these before starting.
  • Clinically important drug interactions occur, including with certain statins and other agents, so review concomitant medicines.

Monitoring

Monitor liver function during treatment and confirm cure with HCV RNA testing after completion of the course.

Counselling the patient

  • Take the tablets every day for the full course to give the best chance of clearing the virus.
  • A blood test some weeks after finishing treatment confirms whether the virus has been cleared.

Evidence & guidelines

Use is supported by NICE technology appraisal guidance for chronic hepatitis C and by the registrational direct-acting antiviral trials.

Reference: NICE TA413; EASL HCV; NHS England HCV ODN; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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