Identification
NameElbasvir
Accession NumberDB11574
TypeSmall Molecule
GroupsApproved
Description

Elbasvir is a direct acting antiviral medication used as part of combination therapy to treat chronic Hepatitis C, an infectious liver disease caused by infection with Hepatitis C Virus (HCV). HCV is a single-stranded RNA virus that is categorized into nine distinct genotypes, with genotype 1 being the most common in the United States, and affecting 72% of all chronic HCV patients [5]. Treatment options for chronic Hepatitis C have advanced significantly since 2011, with the development of Direct Acting Antivirals (DAAs) such as Elbasvir. Elbasvir is an inhibitor of NS5A, a protein essential for viral replication and virion assembly [Synthesis]. The barrier for develoment of resistance to NS5A inhibitors is lower than that of NS5B inhibitors, another class of DAAs [3]. Subtitutions at amino acid positions 28, 30, 31, or 93 are known to confer resistance to Elbasvir [FDA Label]. Despite this disadvantage Elbasvir is still effective against HCV particularly when paired with Grazoprevir.

In a joint recommendation published in 2016, the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) recommend Elbasvir as first line therapy in combination with Grazoprevir for genotypes 1a, 1b, and 4 of Hepatitis C [3]. Elbasvir and Grazoprevir are used with or without Ribavirin with the intent to cure, or achieve a sustained virologic response (SVR), after 12 weeks of daily therapy. SVR and eradication of HCV infection is associated with significant long-term health benefits including reduced liver-related damage, improved quality of life, reduced incidence of Hepatocellular Carcinoma, and reduced all-cause mortality [4].

Elbasvir is available as a fixed dose combination product with Grazoprevir (tradename Zepatier) used for the treatment of chronic Hepatitis C. Approved in January 2016 by the FDA, Zepatier is indicated for the treatment of HCV genotypes 1 and 4 with or without Ribavirin depending on the the presence of resistance associated amino acid substitutions in the NS5A protein and previous treatment failure with Ribavirin, Peginterferon alfa-2a, Peginterferon alfa-2b, or other NS3/4A inhibitors like Boceprevir, Simeprevir, or Telaprevir [FDA Label]. When combined together, Elbasvir and Grazoprevir as the combination product Zepatier have been shown to achieve a SVR between 94% and 97% for genotype 1 and 97% and 100% for genotype 4 after 12 weeks of treatment [5]. It can be used in patients with compensated cirrhosis, human immunodeficiency virus co-infection, or severe kidney disease.

Structure
Thumb
SynonymsNot Available
External IDs MK 8742 / MK-8742 / MK8742
Product Ingredients Not Available
Approved Prescription ProductsNot Available
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International BrandsNot Available
Brand mixtures
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
ZepatierTablet, film coatedOralMerck Sharp & Dohme Limited2016-07-22Not applicableEu
Categories
UNII632L571YDK
CAS number1370468-36-2
WeightAverage: 882.035
Monoisotopic: 881.422445147
Chemical FormulaC49H55N9O7
InChI KeyBVAZQCUMNICBAQ-PZHYSIFUSA-N
InChI
InChI=1S/C49H55N9O7/c1-27(2)41(54-48(61)63-5)45(59)56-20-10-14-37(56)43-50-25-34(52-43)30-17-19-36-32(22-30)23-39-33-18-16-31(24-40(33)65-47(58(36)39)29-12-8-7-9-13-29)35-26-51-44(53-35)38-15-11-21-57(38)46(60)42(28(3)4)55-49(62)64-6/h7-9,12-13,16-19,22-28,37-38,41-42,47H,10-11,14-15,20-21H2,1-6H3,(H,50,52)(H,51,53)(H,54,61)(H,55,62)/t37-,38-,41-,42-,47-/m0/s1
IUPAC Name
methyl N-[(2S)-1-[(2S)-2-{4-[(9S)-5-{2-[(2S)-1-[(2S)-2-[(methoxycarbonyl)amino]-3-methylbutanoyl]pyrrolidin-2-yl]-1H-imidazol-4-yl}-9-phenyl-8-oxa-10-azatetracyclo[8.7.0.0²,⁷.0¹¹,¹⁶]heptadeca-1(17),2(7),3,5,11(16),12,14-heptaen-14-yl]-1H-imidazol-2-yl}pyrrolidin-1-yl]-3-methyl-1-oxobutan-2-yl]carbamate
SMILES
COC(=O)N[C@@H](C(C)C)C(=O)N1CCC[[email protected]]1C1=NC(=CN1)C1=CC2=C(C=C1)N1[C@@H](OC3=C(C=CC(=C3)C3=CNC(=N3)[C@@H]3CCCN3C(=O)[C@@H](NC(=O)OC)C(C)C)C1=C2)C1=CC=CC=C1
Pharmacology
Indication

Elbasvir, when used in combination with Grazoprevir as the combination product Zepatier, is indicated for use with or without ribavirin for the treatment of chronic HCV genotypes 1 or 4 infection in adults [FDA Label].

Structured Indications
Pharmacodynamics

Elbasvir is classified as a direct-acting antiviral (DAA) and prevents viral replication in HCV genotypes 1a, 1b, and 4 [FDA Label].

Mechanism of action

Elbasvir is an inhibitor of the HCV non-structural protein 5A. While the precise role of this protein is unknown, it is essential to viral replication and virion assembly [Synthesis]. Potential modes of action of NS5A inhibitors like Elbasvir include blocking signaling interactions, redistribution of NS5A from the endoplasmic reticulum to the surface of lipid droplets, and modification of the HCV replication complex [3].

TargetKindPharmacological actionActionsOrganismUniProt ID
Nonstructural Protein 5A (NS5A)Proteinyes
inhibitor
Hepatitis C Virus (HCV)not applicabledetails
Related Articles
Absorption

Elbasvir reaches peak plasma concentration 3-6 hours after administration [FDA Label]. Elbasvir has an absolute bioavailability of 32%. When taken with food the peak concentration of Elbasvir increases 1.5 fold but this increase in exposure has not been deemed clinically relevant.

Volume of distribution

Elbasvir has an estimated apparent volume of distribution of 680 liters [FDA Label]. It is thought to distribute into most tissues including the liver.

Protein binding

Elbasvir is more than 99.9% bound to plasma proteins [FDA Label]. It binds both human serum albumin and α1-acid glycoprotein.

Metabolism

Elbasvir is partially eliminated by oxidative metabolism meditated by CYP3A [FDA Label]. No circulating metabolites of have been detected in human plasma.

Route of elimination

Elbasvir is mainly eliminated in the feces (90%) with very little eliminated in the urine (<1%) [FDA Label].

Half life

The geometric mean apparent terminal half-life for Grazoprevir is 24 hours in HCV-infected subjects [FDA Label].

Clearance

The clearance of Elbasvir has not been determined [FDA Label].

Toxicity

The most commonly reported adverse reactions of all intensity (greater than or equal to 5% in placebo-controlled trials) were fatigue, headache, and nausea [FDA Label].

Affected organisms
  • Hepatitis C Virus
PathwaysNot Available
Pharmacogenomic Effects/ADRs Not Available
Interactions
Drug Interactions
DrugInteractionDrug group
AcebutololThe serum concentration of Acebutolol can be increased when it is combined with Elbasvir.Approved
AcetaminophenThe serum concentration of Acetaminophen can be increased when it is combined with Elbasvir.Approved
Acetylsalicylic acidThe serum concentration of Acetylsalicylic acid can be increased when it is combined with Elbasvir.Approved, Vet Approved
AfatinibThe serum concentration of Afatinib can be increased when it is combined with Elbasvir.Approved
AldosteroneThe serum concentration of Aldosterone can be increased when it is combined with Elbasvir.Experimental
AlitretinoinThe serum concentration of Alitretinoin can be increased when it is combined with Elbasvir.Approved, Investigational
AmbrisentanThe serum concentration of Ambrisentan can be increased when it is combined with Elbasvir.Approved, Investigational
AmitriptylineThe serum concentration of Amitriptyline can be increased when it is combined with Elbasvir.Approved
ApixabanThe serum concentration of Apixaban can be increased when it is combined with Elbasvir.Approved
Arsenic trioxideThe serum concentration of Arsenic trioxide can be increased when it is combined with Elbasvir.Approved, Investigational
AtazanavirThe serum concentration of Atazanavir can be increased when it is combined with Elbasvir.Approved, Investigational
AtenololThe serum concentration of Atenolol can be increased when it is combined with Elbasvir.Approved
AxitinibThe serum concentration of Axitinib can be increased when it is combined with Elbasvir.Approved, Investigational
BetamethasoneThe serum concentration of Betamethasone can be increased when it is combined with Elbasvir.Approved, Vet Approved
BoceprevirThe serum concentration of Boceprevir can be increased when it is combined with Elbasvir.Withdrawn
BosutinibThe serum concentration of Bosutinib can be increased when it is combined with Elbasvir.Approved
Brentuximab vedotinThe serum concentration of Brentuximab vedotin can be increased when it is combined with Elbasvir.Approved
BromocriptineThe serum concentration of Bromocriptine can be increased when it is combined with Elbasvir.Approved, Investigational
CabazitaxelThe serum concentration of Cabazitaxel can be increased when it is combined with Elbasvir.Approved
CaffeineThe serum concentration of Caffeine can be increased when it is combined with Elbasvir.Approved
CamptothecinThe serum concentration of Camptothecin can be increased when it is combined with Elbasvir.Experimental
CanagliflozinThe serum concentration of Canagliflozin can be increased when it is combined with Elbasvir.Approved
CarbamazepineThe serum concentration of Carbamazepine can be increased when it is combined with Elbasvir.Approved, Investigational
CarfilzomibThe serum concentration of Carfilzomib can be increased when it is combined with Elbasvir.Approved
CeritinibThe serum concentration of Ceritinib can be increased when it is combined with Elbasvir.Approved
CerivastatinThe serum concentration of Cerivastatin can be increased when it is combined with Elbasvir.Withdrawn
ChlorpromazineThe serum concentration of Chlorpromazine can be increased when it is combined with Elbasvir.Approved, Vet Approved
CimetidineThe serum concentration of Cimetidine can be increased when it is combined with Elbasvir.Approved
CiprofloxacinThe serum concentration of Ciprofloxacin can be increased when it is combined with Elbasvir.Approved, Investigational
CisplatinThe serum concentration of Cisplatin can be increased when it is combined with Elbasvir.Approved
CitalopramThe serum concentration of Citalopram can be increased when it is combined with Elbasvir.Approved
ClarithromycinThe serum concentration of Clarithromycin can be increased when it is combined with Elbasvir.Approved
ClobazamThe serum concentration of Clobazam can be increased when it is combined with Elbasvir.Approved, Illicit
ClomifeneThe serum concentration of Clomifene can be increased when it is combined with Elbasvir.Approved, Investigational
ClonidineThe serum concentration of Clonidine can be increased when it is combined with Elbasvir.Approved
ClopidogrelThe serum concentration of Clopidogrel can be increased when it is combined with Elbasvir.Approved, Nutraceutical
ClozapineThe serum concentration of Clozapine can be increased when it is combined with Elbasvir.Approved
CobimetinibThe serum concentration of Cobimetinib can be increased when it is combined with Elbasvir.Approved
ColchicineThe serum concentration of Colchicine can be increased when it is combined with Elbasvir.Approved
Conjugated estrogensThe serum concentration of Conjugated Equine Estrogens can be increased when it is combined with Elbasvir.Approved
CrizotinibThe serum concentration of Crizotinib can be increased when it is combined with Elbasvir.Approved
CyclosporineThe serum concentration of Cyclosporine can be increased when it is combined with Elbasvir.Approved, Investigational, Vet Approved
Dabigatran etexilateThe serum concentration of the active metabolites of Dabigatran etexilate can be increased when Dabigatran etexilate is used in combination with Elbasvir.Approved
DabrafenibThe serum concentration of Dabrafenib can be increased when it is combined with Elbasvir.Approved
DactinomycinThe serum concentration of Dactinomycin can be increased when it is combined with Elbasvir.Approved
DapagliflozinThe serum concentration of Dapagliflozin can be increased when it is combined with Elbasvir.Approved
DasatinibThe serum concentration of Dasatinib can be increased when it is combined with Elbasvir.Approved, Investigational
DaunorubicinThe serum concentration of Daunorubicin can be increased when it is combined with Elbasvir.Approved
DebrisoquinThe serum concentration of Debrisoquin can be increased when it is combined with Elbasvir.Approved
DexamethasoneThe serum concentration of Dexamethasone can be increased when it is combined with Elbasvir.Approved, Investigational, Vet Approved
DiazepamThe serum concentration of Diazepam can be increased when it is combined with Elbasvir.Approved, Illicit, Vet Approved
DiethylstilbestrolThe serum concentration of Diethylstilbestrol can be increased when it is combined with Elbasvir.Approved
DigitoxinThe serum concentration of Digitoxin can be increased when it is combined with Elbasvir.Approved
DigoxinThe serum concentration of Digoxin can be increased when it is combined with Elbasvir.Approved
DihydrotestosteroneThe serum concentration of Dihydrotestosterone can be increased when it is combined with Elbasvir.Illicit
DiltiazemThe serum concentration of Diltiazem can be increased when it is combined with Elbasvir.Approved
DipyridamoleThe serum concentration of Dipyridamole can be increased when it is combined with Elbasvir.Approved
DocetaxelThe serum concentration of Docetaxel can be increased when it is combined with Elbasvir.Approved, Investigational
DomperidoneThe serum concentration of Domperidone can be increased when it is combined with Elbasvir.Approved, Investigational, Vet Approved
DoxorubicinThe serum concentration of Doxorubicin can be increased when it is combined with Elbasvir.Approved, Investigational
EdoxabanThe serum concentration of Edoxaban can be increased when it is combined with Elbasvir.Approved
EletriptanThe serum concentration of Eletriptan can be increased when it is combined with Elbasvir.Approved, Investigational
EpinastineThe serum concentration of Epinastine can be increased when it is combined with Elbasvir.Approved, Investigational
ErlotinibThe serum concentration of Erlotinib can be increased when it is combined with Elbasvir.Approved, Investigational
ErythromycinThe serum concentration of Erythromycin can be increased when it is combined with Elbasvir.Approved, Vet Approved
EstradiolThe serum concentration of Estradiol can be increased when it is combined with Elbasvir.Approved, Investigational, Vet Approved
EstriolThe serum concentration of Estriol can be increased when it is combined with Elbasvir.Approved, Vet Approved
EstroneThe serum concentration of Estrone can be increased when it is combined with Elbasvir.Approved
Ethinyl EstradiolThe serum concentration of Ethinyl Estradiol can be increased when it is combined with Elbasvir.Approved
EtoposideThe serum concentration of Etoposide can be increased when it is combined with Elbasvir.Approved
EverolimusThe serum concentration of Everolimus can be increased when it is combined with Elbasvir.Approved
EzetimibeThe serum concentration of Ezetimibe can be increased when it is combined with Elbasvir.Approved
FesoterodineThe serum concentration of Fesoterodine can be increased when it is combined with Elbasvir.Approved
FexofenadineThe serum concentration of Fexofenadine can be increased when it is combined with Elbasvir.Approved
FidaxomicinThe serum concentration of Fidaxomicin can be increased when it is combined with Elbasvir.Approved
Fluticasone furoateThe serum concentration of Fluticasone furoate can be increased when it is combined with Elbasvir.Approved
GefitinibThe serum concentration of Gefitinib can be increased when it is combined with Elbasvir.Approved, Investigational
GemcitabineThe serum concentration of Gemcitabine can be increased when it is combined with Elbasvir.Approved
GrazoprevirThe serum concentration of Grazoprevir can be increased when it is combined with Elbasvir.Approved
GrepafloxacinThe serum concentration of Grepafloxacin can be increased when it is combined with Elbasvir.Withdrawn
HaloperidolThe serum concentration of Haloperidol can be increased when it is combined with Elbasvir.Approved
HydrocortisoneThe serum concentration of Hydrocortisone can be increased when it is combined with Elbasvir.Approved, Vet Approved
IbuprofenThe serum concentration of Ibuprofen can be increased when it is combined with Elbasvir.Approved
IdelalisibThe serum concentration of Idelalisib can be increased when it is combined with Elbasvir.Approved
ImatinibThe serum concentration of Imatinib can be increased when it is combined with Elbasvir.Approved
ImipramineThe serum concentration of Imipramine can be increased when it is combined with Elbasvir.Approved
IndacaterolThe serum concentration of Indacaterol can be increased when it is combined with Elbasvir.Approved
IndinavirThe serum concentration of Indinavir can be increased when it is combined with Elbasvir.Approved
IndomethacinThe serum concentration of Indomethacin can be increased when it is combined with Elbasvir.Approved, Investigational
IrinotecanThe serum concentration of Irinotecan can be increased when it is combined with Elbasvir.Approved, Investigational
IvermectinThe serum concentration of Ivermectin can be increased when it is combined with Elbasvir.Approved, Vet Approved
KetazolamThe serum concentration of Ketazolam can be increased when it is combined with Elbasvir.Approved
KetoconazoleThe serum concentration of Ketoconazole can be increased when it is combined with Elbasvir.Approved, Investigational
LamivudineThe serum concentration of Lamivudine can be increased when it is combined with Elbasvir.Approved, Investigational
LamotrigineThe serum concentration of Lamotrigine can be increased when it is combined with Elbasvir.Approved, Investigational
LansoprazoleThe serum concentration of Lansoprazole can be increased when it is combined with Elbasvir.Approved, Investigational
LedipasvirThe serum concentration of Ledipasvir can be increased when it is combined with Elbasvir.Approved
LenalidomideThe serum concentration of Lenalidomide can be increased when it is combined with Elbasvir.Approved
LenvatinibThe serum concentration of Lenvatinib can be increased when it is combined with Elbasvir.Approved
LevetiracetamThe serum concentration of Levetiracetam can be increased when it is combined with Elbasvir.Approved, Investigational
LevofloxacinThe serum concentration of Levofloxacin can be increased when it is combined with Elbasvir.Approved, Investigational
LevomilnacipranThe serum concentration of Levomilnacipran can be increased when it is combined with Elbasvir.Approved
LinagliptinThe serum concentration of Linagliptin can be increased when it is combined with Elbasvir.Approved
LoperamideThe serum concentration of Loperamide can be increased when it is combined with Elbasvir.Approved
LosartanThe serum concentration of Losartan can be increased when it is combined with Elbasvir.Approved
MannitolThe serum concentration of Mannitol can be increased when it is combined with Elbasvir.Approved, Investigational
MethotrexateThe serum concentration of Methotrexate can be increased when it is combined with Elbasvir.Approved
MethylprednisoloneThe serum concentration of Methylprednisolone can be increased when it is combined with Elbasvir.Approved, Vet Approved
MetoprololThe serum concentration of Metoprolol can be increased when it is combined with Elbasvir.Approved, Investigational
MidazolamThe serum concentration of Midazolam can be increased when it is combined with Elbasvir.Approved, Illicit
MirabegronThe serum concentration of Mirabegron can be increased when it is combined with Elbasvir.Approved
MitoxantroneThe serum concentration of Mitoxantrone can be increased when it is combined with Elbasvir.Approved, Investigational
MorphineThe serum concentration of Morphine can be increased when it is combined with Elbasvir.Approved, Investigational
Mycophenolate mofetilThe serum concentration of Mycophenolate mofetil can be increased when it is combined with Elbasvir.Approved, Investigational
NadololThe serum concentration of Nadolol can be increased when it is combined with Elbasvir.Approved
NaloxegolThe serum concentration of Naloxegol can be increased when it is combined with Elbasvir.Approved
NaloxoneThe serum concentration of Naloxone can be increased when it is combined with Elbasvir.Approved, Vet Approved
NelfinavirThe serum concentration of Nelfinavir can be increased when it is combined with Elbasvir.Approved
NicardipineThe serum concentration of Nicardipine can be increased when it is combined with Elbasvir.Approved
NifedipineThe serum concentration of Nifedipine can be increased when it is combined with Elbasvir.Approved
NilotinibThe serum concentration of Nilotinib can be increased when it is combined with Elbasvir.Approved, Investigational
NintedanibThe serum concentration of Nintedanib can be increased when it is combined with Elbasvir.Approved
NizatidineThe serum concentration of Nizatidine can be increased when it is combined with Elbasvir.Approved
OlanzapineThe serum concentration of Olanzapine can be increased when it is combined with Elbasvir.Approved, Investigational
OmbitasvirThe serum concentration of Ombitasvir can be increased when it is combined with Elbasvir.Approved
OsimertinibThe serum concentration of Osimertinib can be increased when it is combined with Elbasvir.Approved
PaclitaxelThe serum concentration of Paclitaxel can be increased when it is combined with Elbasvir.Approved, Vet Approved
PanobinostatThe serum concentration of Panobinostat can be increased when it is combined with Elbasvir.Approved, Investigational
PazopanibThe serum concentration of Pazopanib can be increased when it is combined with Elbasvir.Approved
PhenobarbitalThe serum concentration of Phenobarbital can be increased when it is combined with Elbasvir.Approved
PhenytoinThe serum concentration of Phenytoin can be increased when it is combined with Elbasvir.Approved, Vet Approved
PitavastatinThe serum concentration of Pitavastatin can be increased when it is combined with Elbasvir.Approved
PomalidomideThe serum concentration of Pomalidomide can be increased when it is combined with Elbasvir.Approved
PonatinibThe serum concentration of Ponatinib can be increased when it is combined with Elbasvir.Approved
PravastatinThe serum concentration of Pravastatin can be increased when it is combined with Elbasvir.Approved
PrazosinThe serum concentration of Prazosin can be increased when it is combined with Elbasvir.Approved
PrednisoloneThe serum concentration of Prednisolone can be increased when it is combined with Elbasvir.Approved, Vet Approved
PrednisoneThe serum concentration of Prednisone can be increased when it is combined with Elbasvir.Approved, Vet Approved
ProgesteroneThe serum concentration of Progesterone can be increased when it is combined with Elbasvir.Approved, Vet Approved
PropranololThe serum concentration of Propranolol can be increased when it is combined with Elbasvir.Approved, Investigational
PrucaloprideThe serum concentration of Prucalopride can be increased when it is combined with Elbasvir.Approved
QuetiapineThe serum concentration of Quetiapine can be increased when it is combined with Elbasvir.Approved
QuinidineThe serum concentration of Quinidine can be increased when it is combined with Elbasvir.Approved
QuinineThe serum concentration of Quinine can be increased when it is combined with Elbasvir.Approved
RanitidineThe serum concentration of Ranitidine can be increased when it is combined with Elbasvir.Approved
RanolazineThe serum concentration of Ranolazine can be increased when it is combined with Elbasvir.Approved, Investigational
ReserpineThe serum concentration of Reserpine can be increased when it is combined with Elbasvir.Approved
RifampicinThe serum concentration of Rifampicin can be increased when it is combined with Elbasvir.Approved
RifaximinThe serum concentration of Rifaximin can be increased when it is combined with Elbasvir.Approved, Investigational
RisperidoneThe serum concentration of Risperidone can be increased when it is combined with Elbasvir.Approved, Investigational
RitonavirThe serum concentration of Ritonavir can be increased when it is combined with Elbasvir.Approved, Investigational
RivaroxabanThe serum concentration of Rivaroxaban can be increased when it is combined with Elbasvir.Approved
RomidepsinThe serum concentration of Romidepsin can be increased when it is combined with Elbasvir.Approved, Investigational
Salicylic acidThe serum concentration of Salicylic acid can be increased when it is combined with Elbasvir.Approved, Vet Approved
SaquinavirThe serum concentration of Saquinavir can be increased when it is combined with Elbasvir.Approved, Investigational
SelexipagThe serum concentration of Selexipag can be increased when it is combined with Elbasvir.Approved
SilodosinThe serum concentration of Silodosin can be increased when it is combined with Elbasvir.Approved
SimeprevirThe serum concentration of Simeprevir can be increased when it is combined with Elbasvir.Approved
SitagliptinThe serum concentration of Sitagliptin can be increased when it is combined with Elbasvir.Approved, Investigational
SofosbuvirThe serum concentration of Sofosbuvir can be increased when it is combined with Elbasvir.Approved
SorafenibThe serum concentration of Sorafenib can be increased when it is combined with Elbasvir.Approved, Investigational
SparfloxacinThe serum concentration of Sparfloxacin can be increased when it is combined with Elbasvir.Approved
SphingosineThe serum concentration of Sphingosine can be increased when it is combined with Elbasvir.Experimental
TacrolimusThe serum concentration of Tacrolimus can be increased when it is combined with Elbasvir.Approved, Investigational
TamoxifenThe serum concentration of Tamoxifen can be increased when it is combined with Elbasvir.Approved
Taurocholic AcidThe serum concentration of Taurocholic Acid can be increased when it is combined with Elbasvir.Experimental
Technetium Tc-99m sestamibiThe serum concentration of Technetium Tc-99m sestamibi can be increased when it is combined with Elbasvir.Approved
TelaprevirThe serum concentration of Telaprevir can be increased when it is combined with Elbasvir.Withdrawn
TemsirolimusThe serum concentration of Temsirolimus can be increased when it is combined with Elbasvir.Approved
TicagrelorThe serum concentration of Ticagrelor can be increased when it is combined with Elbasvir.Approved
TimololThe serum concentration of Timolol can be increased when it is combined with Elbasvir.Approved
TolvaptanThe serum concentration of Tolvaptan can be increased when it is combined with Elbasvir.Approved
TopotecanThe serum concentration of Topotecan can be increased when it is combined with Elbasvir.Approved, Investigational
ToremifeneThe serum concentration of Toremifene can be increased when it is combined with Elbasvir.Approved, Investigational
Trastuzumab emtansineThe serum concentration of Trastuzumab emtansine can be increased when it is combined with Elbasvir.Approved
UlipristalThe serum concentration of Ulipristal can be increased when it is combined with Elbasvir.Approved
UmeclidiniumThe serum concentration of Umeclidinium can be increased when it is combined with Elbasvir.Approved
VecuroniumThe serum concentration of Vecuronium can be increased when it is combined with Elbasvir.Approved
VenetoclaxThe serum concentration of Venetoclax can be increased when it is combined with Elbasvir.Approved
VenlafaxineThe serum concentration of Venlafaxine can be increased when it is combined with Elbasvir.Approved
VerapamilThe serum concentration of Verapamil can be increased when it is combined with Elbasvir.Approved
VinblastineThe serum concentration of Vinblastine can be increased when it is combined with Elbasvir.Approved
VincristineThe serum concentration of Vincristine can be increased when it is combined with Elbasvir.Approved, Investigational
VismodegibThe serum concentration of Vismodegib can be increased when it is combined with Elbasvir.Approved
ZidovudineThe serum concentration of Zidovudine can be increased when it is combined with Elbasvir.Approved
Food InteractionsNot Available
References
Synthesis Reference

Coburn CA, Meinke PT, Chang W, Fandozzi CM, Graham DJ, Hu B, Huang Q, Kargman S, Kozlowski J, Liu R, McCauley JA, Nomeir AA, Soll RM, Vacca JP, Wang D, Wu H, Zhong B, Olsen DB, Ludmerer SW: Discovery of MK-8742: an HCV NS5A inhibitor with broad genotype activity. ChemMedChem. 2013 Dec;8(12):1930-40. doi: 10.1002/cmdc.201300343. Epub 2013 Oct 14.

General References
  1. Bell AM, Wagner JL, Barber KE, Stover KR: Elbasvir/Grazoprevir: A Review of the Latest Agent in the Fight against Hepatitis C. Int J Hepatol. 2016;2016:3852126. doi: 10.1155/2016/3852126. Epub 2016 Jun 15. [PubMed:27403342 ]
  2. Coburn CA, Meinke PT, Chang W, Fandozzi CM, Graham DJ, Hu B, Huang Q, Kargman S, Kozlowski J, Liu R, McCauley JA, Nomeir AA, Soll RM, Vacca JP, Wang D, Wu H, Zhong B, Olsen DB, Ludmerer SW: Discovery of MK-8742: an HCV NS5A inhibitor with broad genotype activity. ChemMedChem. 2013 Dec;8(12):1930-40. doi: 10.1002/cmdc.201300343. Epub 2013 Oct 14. [PubMed:24127258 ]
  3. Bagaglio S, Uberti-Foppa C, Morsica G: Resistance Mechanisms in Hepatitis C Virus: implications for Direct-Acting Antiviral Use. Drugs. 2017 May 12. doi: 10.1007/s40265-017-0753-x. [PubMed:28497432 ]
  4. Myers RP, Shah H, Burak KW, Cooper C, Feld JJ: An update on the management of chronic hepatitis C: 2015 Consensus guidelines from the Canadian Association for the Study of the Liver. Can J Gastroenterol Hepatol. 2015 Jan-Feb;29(1):19-34. Epub 2015 Jan 13. [PubMed:25585348 ]
  5. American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance. http://hcvguidelines.org. Accessed June 12, 2017. [Link]
External Links
ATC CodesNot Available
AHFS CodesNot Available
PDB EntriesNot Available
FDA labelDownload (441 KB)
MSDSNot Available
Clinical Trials
Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedTreatmentChronic Hepatitis C Virus (HCV) Infection / Impaired Renal Function1
1CompletedTreatmentHepatic Insufficiency1
1CompletedTreatmentHepatitis, Viral, Human1
1, 2RecruitingTreatmentEnd Stage Renal Disease (ESRD)1
1, 2RecruitingTreatmentHeart Failure, Unspecified1
2CompletedTreatmentChronic Hepatitis C Infection7
2CompletedTreatmentHepatitis C Virus (HCV)1
2RecruitingTreatmentAcute Hepatitis C / HIV Disease1
2, 3CompletedTreatmentChronic Hepatitis C Infection1
2, 3CompletedTreatmentChronic Hepatitis C Virus (HCV) Infection1
2, 3CompletedTreatmentHepatitis C Virus (HCV)1
3CompletedTreatmentChronic Hepatitis C Infection2
3CompletedTreatmentChronic Hepatitis C Virus (HCV) Infection1
3CompletedTreatmentHepatitis C Infection1
3Not Yet RecruitingTreatmentChronic HCV Infection1
3Not Yet RecruitingTreatmentChronic Hepatitis C Infection / HIV Disease1
3Not Yet RecruitingTreatmentChronic Hepatitis C Infection / Transplantation, Liver1
3Not Yet RecruitingTreatmentChronic Hepatitis C Infection / Compensated liver disease1
3Not Yet RecruitingTreatmentChronic hepatitis C genotype 1b / Cirrhoses, Liver / Fibrosis, Liver / Metabolic Syndromes1
3RecruitingTreatmentAcute Hepatitis C / Chronic Hepatitis C Infection / Human Immunodeficiency Virus (HIV)1
3RecruitingTreatmentHepatitis C, Chronic1
3WithdrawnTreatmentChronic Hepatitis C Infection1
4Active Not RecruitingTreatmentChronic Hepatitis C Infection / End-Stage Renal Disease (ESRD)1
4Enrolling by InvitationTreatmentChronic Hepatitis C Infection / Substance Abuse, Intravenous / Substance Use Disorder (SUD)1
4Not Yet RecruitingPreventionCardiac Transplant Disorder / Chronic Hepatitis C Infection1
4Not Yet RecruitingPreventionChronic Hepatitis C Infection / Renal Failure Chronic1
4Not Yet RecruitingTreatmentChronic Hepatitis C Infection2
4Not Yet RecruitingTreatmentTo Assess the Efficacy of Grazoprevir 100mg and Elbasvir 50mg by Determining the Proportion of Sustained Virological Response 12 Weeks After the End of Therapy1
4RecruitingPreventionRenal Failure1
4RecruitingTreatmentChronic Hepatitis C Infection1
4RecruitingTreatmentChronic Hepatitis C Infection / Disorder of Transplanted Kidney / Renal Insufficiency,Chronic1
4RecruitingTreatmentChronic Hepatitis C Virus (HCV) Infection2
4WithdrawnTreatmentHCV1
Not AvailableNot Yet RecruitingTreatmentHCV, HCC1
Not AvailableRecruitingNot AvailableChronic Hepatitis C Infection1
Not AvailableRecruitingNot AvailableHepatitis C, Chronic / Human Immunodeficiency Virus (HIV)1
Pharmacoeconomics
ManufacturersNot Available
PackagersNot Available
Dosage forms
FormRouteStrength
TabletOral
Tablet, film coatedOral
PricesNot Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US8871759 No2011-05-042031-05-04Us
US7973040 No2009-07-242029-07-24Us
Properties
StateSolid
Experimental PropertiesNot Available
Predicted Properties
PropertyValueSource
Water Solubility0.0044 mg/mLALOGPS
logP6.17ALOGPS
logP7.07ChemAxon
logS-5.3ALOGPS
pKa (Strongest Acidic)12.42ChemAxon
pKa (Strongest Basic)5.39ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count7ChemAxon
Hydrogen Donor Count4ChemAxon
Polar Surface Area188.8 Å2ChemAxon
Rotatable Bond Count13ChemAxon
Refractivity241.02 m3·mol-1ChemAxon
Polarizability98.71 Å3ChemAxon
Number of Rings9ChemAxon
Bioavailability0ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET featuresNot Available
Spectra
Mass Spec (NIST)Not Available
Spectra
Spectrum TypeDescriptionSplash Key
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, PositiveNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 10V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 20V, NegativeNot Available
Predicted LC-MS/MSPredicted LC-MS/MS Spectrum - 40V, NegativeNot Available
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as valine and derivatives. These are compounds containing valine or a derivative thereof resulting from reaction of valine at the amino group or the carboxy group, or from the replacement of any hydrogen of glycine by a heteroatom.
KingdomOrganic compounds
Super ClassOrganic acids and derivatives
ClassCarboxylic acids and derivatives
Sub ClassAmino acids, peptides, and analogues
Direct ParentValine and derivatives
Alternative ParentsAlpha amino acid amides / Indoles / N-acylpyrrolidines / Benzene and substituted derivatives / Tertiary carboxylic acid amides / Pyrroles / Methylcarbamates / Imidazoles / Heteroaromatic compounds / Oxacyclic compounds
SubstituentsValine or derivatives / Alpha-amino acid amide / Indole / Indole or derivatives / N-acylpyrrolidine / Monocyclic benzene moiety / Benzenoid / Methylcarbamate / Azole / Imidazole
Molecular FrameworkAromatic heteropolycyclic compounds
External DescriptorsNot Available

Targets

1. Nonstructural Protein 5A (NS5A)
Kind
Protein
Organism
Hepatitis C Virus (HCV)
Pharmacological action
yes
Actions
inhibitor

Enzymes

1. Cytochrome p450 3A subfamily
Kind
Protein group
Organism
Human
Pharmacological action
no
Actions
substrate

Transporters

Kind
Protein
Organism
Human
Pharmacological action
no
Actions
substrate
General Function:
Xenobiotic-transporting atpase activity
Specific Function:
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name:
ABCB1
Uniprot ID:
P08183
Uniprot Name:
Multidrug resistance protein 1
Molecular Weight:
141477.255 Da
Drug created on April 07, 2016 10:37 / Updated on August 08, 2017 11:11