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Interactions update for glecaprevir/pibrentasvir and ethinylestradiol doses of 20 µg or less

Friday 08 December 2023

We have downgraded interactions between glecaprevir/pibrentasvir (Mavyret/Maviret®) and ethinylestradiol dosed at 20 µg or less from red to amber. This is thanks to new data demonstrating a lack of adverse events in 66 volunteers who were coadministered glecaprevir/pibrentasvir and ethinylestradiol/levonorgestrel (20/100 µg). Accordingly, the US Prescribing Information now permits coadministration of Mayvret and ethinylestradiol, if the dose is 20 µg or less. At >20 µg, coadministration is still not recommended. Contraceptives which can be prescribed at this lower dose now have a separate entry in the database for 20 µg or less.


Note for European prescribers, the combination of Maviret and ethinylestradiol at any dose is still contraindicated in the Summary of Product Characteristics.


Safety and tolerability of an oral contraceptive containing low-dose ethinyl estradiol combined with glecaprevir/pibrentasvir treatment in healthy premenopausal women: results of a phase 1 study. Shiller D-D,  Yao B-B, Chen M-J et al. Hepatology. 2023; 78 (suppl. 1):S1-S2154.  

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