Description

Viekira Pak is a product that is composed of two different tablets. The first table comprises three medications which are paritaprevir, ombitasvir, and ritonavir. The second tablet contains dasabuvir.

Viekira Pak is given to treat chronic hepatitis C which is commonly known as a viral infection of the liver. The work of paritaprevir, ombitasvir, and dasabuvir is to reduce the amount of hepatitis C virus inside the body. This is helping your immune system with fighting the infection and recovering the health of your liver. Ritonavir helps with boosting the levels of paritaprevir so it can perform its work better. If chronic hepatitis C infection will be left untreated, it can cause various serious liver problems like liver cancer or scarring (cirrhosis).

No research has shown if the treatment can stop the passing of the virus to other patients. That's why it is highly recommended that you should never share the needles and do safe sex so the risk of passing the virus will be minimized.

Directions

For the common dosage of Viekira Pak and its 2-combination tablet is the following - the tablet which contains ombitasvir paritaprevir ritonavir must be taken once in the morning. While the other tablet with dasabuvir must be taken twice daily, every morning and evening. Before taking the medicine, you need to take a full meal. Viekira Pak can also be taken in combination with ribavirin.

The most recommended way to use Viekira Pak is to read the medication guide given by your pharmacist or doctor before you can begin taking the product and every time you ask for a refill. You need to follow every instruction because the product comes with two tablets that contain different drugs. Whenever you have any questions about Viekira Pak, feel free to ask your doctor or pharmacist.

Viekira Pak will work best if the drug's amount inside your body will be maintained at a consistent level that's why you need to take the tablets at equally spaced intervals. If you have a hard time with taking the medicine, start with taking it at the same time every day and never skip any doses.

When your symptoms start to disappear after a few days of taking the product, you need to continue taking it for the full length of time prescribed for you. If you stop the medication earlier as required for your condition, the infection may return.

If you miss your dose, you can take the drug after a full meal as soon as you remember it. When you remember it near the schedule of your next dose, you need to skip the missed dose. Your next dose must be taken at the regular time. You should never double dose your medication to catch up since it can affect its function inside your body.

This medication comes in different brands and they have different storage needs as well. To know the right storage instruction for your medicine, you need to check the product package or get some advice from your pharmacist.

Never flush the product down the toilet or pour it into a drain unless the instruction says so. For the best instruction about this concern, you can as your pharmacist or call your local waste disposal.

Ingredients

Active ingredients: ombitasvir, paritaprevir, and ritonavir Inactive ingredients: copovidone, K value 28, vitamin E polyethylene glycol succinate, propylene glycol monolaurate Type I, sorbitan monolaurate, colloidal silicon dioxide/colloidal anhydrous silica, sodium stearyl fumarate, polyvinyl alcohol, polyethylene 

Drug Interaction

The drug interaction of the product may affect the effectiveness of Viekira Pak or it may increase the different serious side effects that you may feel while taking the medication. We cannot include all the possible drug interactions with the product but this will give you a big help if you are using other medical products. As a patient, it is your responsibility to make a list of all the products that you are using and share the list with your pharmacist or doctor. The list must include prescribed drugs, non-prescribed drugs, and various herbal products that you take. Never stop, start, or change the dosage of your medicines without any instructions from your doctor.

Different products may interact with Viekira Pak like efavirenz and drugs that contain Ethinyl estradiol such as combined birth control pills, ring or patch. This means if you are taking hormonal birth control that contains a specific type of estrogen (Ethinyl estradiol), you need to stop using them before you begin your medication with Viekira Pak. During your medication, you can use other forms of birth control. This must be continued for an additional 2 weeks after you have stopped your Viekira Pak medication. At this time, you can resume the use of Ethinyl estradiol-containing birth control if you desire. If you want to know more details about this concern, it is highly recommended that you talk to your doctor.

Viekira Pak may also slow down the discharge of other medications from your body and it can affect the way they work. Some of the affected drugs are certain alpha-blockers (like silodosin and alfuzosin), cisapride, ergot alkaloids (like ergotamine and dihydroergotamine), colchicine, certain benzodiazepines (like midazolam and triazolam), certain heart drugs (like ranolazine and dronedarone), pimozide, lurasidone, salmeterol, rilpivirine, certain drugs used to treat pulmonary hypertension or erectile dysfunction-ED (like sildenafil and avanafil), certain drugs that weaken the immune system (like sirolimus, everolimus, temsirolimus, tacrolimus), certain "statin" cholesterol drugs (simvastatin, atorvastatin, lovastatin), among others.

Some medications may also affect the discharge of Viekira Pak from your body and this can affect the way the product works. Some examples of these drugs are those that are used to treat seizures (like carbamazepine, primidone, phenobarbital, phenytoin), clopidogrel, Apalutamide, cobicistat, mitotane, Elagolix, gemfibrozil, St. John's wort, thioridazine, rifampin, among others.

You should never take Viekira Pak with other drugs that contain ritonavir.

Cautions

Before you start taking Viekira Pak, or any other medications, you need to inform your pharmacist or doctor if you are allergic to a specific drug or any other allergic reaction that you have. This product may have inactive ingredients that can trigger allergic reactions in your body or other various problems.

Another important step that you should do is inform your medical provider about your medical history, especially if you have other diabetes, HIV infection, and other liver problems like hepatitis B.

Viekira Pak may lower your blood sugar if you start taking the medication. Because of this, you have a higher risk with low blood sugar which can be avoided through adjusting your diabetes medication plan. If you start experiencing symptoms of low blood sugar like fast heartbeat, sudden sweating, hunger, shaking, dizziness, blurred vision, or tingling hands/feet, tell your doctor immediately.

Pregnant patients should refrain using Viekira Pak unless it is clearly needed. To determine the various risks and benefits of the product while being pregnant, you can discuss it with your doctor.

Side Effects

If you are about to start taking this dasabuvir, ombitasvir, paritaprevir, and ritonavir, you need to know the possible side effects that you will experience while you are on the course of the Viekira Pak medication.

Commons Side Effects

If you experience these side effects while taking Viekira Pak, this indicates less severe expression:

• Skin Reactions - it is normal to find the visibility of skin reactions in various parts of your body since the product is fighting virus HCV.
• Difficulty with Sleeping - patients with cirrhosis who are taking the product may commonly experience difficulty with sleeping which can also lead to other side effects.
• Generalized Weakness - since you cannot get enough sleep while taking the medication, you will feel generally weak and you will lose interest in doing other things.
• Itching - your skin is getting more sensitive because of the product. If you feel itchiness in different parts of your body, don't panic and avoid too much scratching.
• Low Energy - it's very normal to feel out of energy because your body is working to fight for the virus HCV. Your lack of sleep also contributes to this side effect.
• Nausea - you will find yourself feeling distressed and sensitive to what you eat. You may also vomit now and then.

Infrequent Side Effects

If you experience these side effects, this indicates less severe expression:

• A High Alanine Transaminase Level
• Anemia
• A Type Of Bumpy Skin Rash Called A Maculopapular Rash
• Abnormal Liver Function Tests
• High Amount Of Bilirubin In The Blood
• Hives
• Erythema or Skin Redness
• Inflammation Of The Skin Due To An Allergy
• Increased Sensitivity Of The Skin To The Sun
• Psoriasis

Rare Side Effects

If you experience these side effects, this indicates less severe expression:

• A Significant Type Of Allergic Reaction Called Anaphylaxis
• A Hypersensitivity Reaction To A Drug
• A Type Of Significant Allergic Skin Reaction Called DRESS Syndrome
• A Type Of Allergic Reaction Called Angioedema
• Erythema Multiforme, A Type Of Allergic Skin Reaction
• Reactivation Of Hepatitis B Infection
• Liver Failure - you are not allowed to take this medication if you are one of the liver transplant recipients.
• A Skin Ulcer
• A Change In The Ability To Pay Attention
• Abnormal Dreams
• A Type Of Skin Condition With Redness And Itching Called Eczema
• Altered Interest In Having Sexual Intercourse
• Contact Dermatitis, A Type Of Skin Rash That Occurs From Contact With An Offending Substance
• Anxious Feelings
• Canker Sores
• Decreased Appetite, Diarrhea, Indigestion
• Head Pain, Memory Loss, Depression
• Muscle Spasm, Dry Skin, Nosebleed

Most of these side effects are manageable and may also stop after you have completed your Viekira Pak medication. In cases where you find any of these side effects are giving you more discomfort instead of making your condition better, you need to talk to your pharmacist or medical provider to discuss your situation.

If someone shows signs of overdose and serious symptoms like trouble breathing or passing out, it is necessary to call your local emergency hotline or the poison control center for immediate action.

Before using Viekira Pak with ribavirin, you or your partner should undergo a pregnancy test to make sure that there is no unborn baby that can be harmed during the medication. The use of Viekira Pak with ribavirin has a direct effect on the unborn child. If you or your partner is pregnant while on treatment, taking the product may be stopped depending on the advice of the doctor.

Risk Of Hepatitis B Virus Reactivation In Patients Also Infected With HCV And HBV

Hepatitis B virus (HBV) reactivation has been listed in HCV/HBV coinfected subjects who were undergoing or had finished medication with HCV HIV-1 direct-acting antivirals, and who were not taking HBV antiviral medication. Some cases have ended in hepatic failure, fulminant hepatitis, and death. Cases have been listed in patients who are positive with HBsAg as well as in patients with serologic evidence of resolved HBV infection (i.e., anti-HBc positive and HBsAg negative). HBV reactivation has also been known in patients getting certain chemotherapeutic or immunosuppressant agents; the chance of HBV reactivation linked with treatment with HCV direct-acting antivirals may be grown in these patients.

HBV reactivation is described as a sudden increase in HBV replication manifesting as a rapid rise in serum HBV DNA level. In a patient with resolved HBV infection, the reappearance of HBsAg can occur. Reactivation of HBV replication may be followed by hepatitis, i.e., increases in aminotransferase levels and, in severe cases, increases in liver failure, bilirubin levels, and death can occur.

The patients must be tested to find evidence of current or previous HBV infection through measuring hepatitis B surface antigen (or HBsAg) and hepatitis B (or anti-HBc) before starting with the HCV treatment with Viekira Pak. In patients with serologic indication of HBV infection, monitor for clinical and laboratory symptoms of hepatitis flare or HBV reactivation during HCV treatment with VIEKIRA PAK and post-medication follow-up. Initiate suitable patient management for HBV infection as clinically designated.

What are the different precautions you need to observe with Viekira Pak?

Before you start taking ombitasvir, dasabuvir, paritaprevir, and ritonavir, you need to inform your medical care provider if you have known allergies to ritonavir, ombitasvir, dasabuvir, and paritaprevir, any other types of medications, or to some of the ingredients in ritonavir, ombitasvir paritaprevir, and dasabuvir tablets. You need to be honest with your medical care provider to make sure that you are getting the right treatment for your condition. If you ever experienced a serious or life-threatening reaction to ritonavir like peeling your skin, the difficulty of breathing, or fainting, your doctor may not recommend taking dasabuvir, ombitasvir, paritaprevir, and ritonavir.

You should also inform your medical care provider if you are taking atorvastatin (Lipitor, in Caduet); alfuzosin (Uroxatral); carbamazepine (Carbatrol, Equetro, Epitol, Tegretol); dronedarone (Multaq); efavirenz (Sustiva, in Atripla); ergot-containing medicines like dihydroergotamine mesylate (D.H.E. 45, Migranal), methylergonovine (Methergine), and ergotamine (Ergomar, in Cafergot, in Migergot); ethinyl estradiol oral contraceptives like certain tablets ('birth control pills'), hormonal vaginal rings, patches, and other esthinyl estradiol products; gemfibrozil (Lopid); everolimus (Afinitor, Zortress); lovastatin (Altoprev); phenobarbital; lurasidone (Latuda); pimozide (Orap); midazolam (by mouth); phenytoin (Dilantin, Phenytek); ranolazine (Ranexa); sildenafil (Revatio) for treatment of pulmonary arterial hypertension; rifampin (Rifadin, Rimactane, in Rifamate, in Rifater); simvastatin (Zocor, in Vytorin); St. John's wort; sirolimus (Rapamune); tacrolimus (Astagraf XL, Envarsus XR, Prograf); or triazolam (Halcion). You should inform your medical care provider if you are taking colchicine (Mitigare, Colcrys) and you have a kidney or liver disease. Your doctor may not recommend taking dasabuvir, ombitasvir, paritaprevir, and ritonavir while you are taking any of these medications since they can contraindicate with each other.

You need to inform your medical care provider if you are taking other prescribed and non-prescribed drugs, nutritional supplements, and any herbal products. If you are taking any of the following, you need to mention it to your doctor: alprazolam (Xanax); acetaminophen and hydrocodone (Anexsia, Zyfrel); buprenorphine and naloxone (Suboxone, Zubsolv); angiotensin receptor blocker (ARB) such as losartan (Cozaar, in Hyzaar), candesartan (Atacand, in Atacand HCT), and valsartan (Diovan, in Diovan HCT, Exforge); calcium channel blockers such as amlodipine diltiazem (Cartia and Cardizem), (Norvasc, in Caduet), verapamil (Calan, Verelan), and nifedipine (Afeditab and Adalat); carisoprodol (Soma); cyclobenzaprine (Amrix); diazepam (Valium); cyclosporine (Gengraf, Neoral, Sandimmune); furosemide (Lasix); fluticasone (Flonase, Flovent, in Advair); medications for irregular heartbeat such as amiodarone (Nexterone, Pacerone), disopyramide (Norpace), mexiletine, flecainide, lidocaine (Xylocaine), propafenone (Rythmol), or quinidine (in Nuedexta); metformin (Riomet and Glucophage); ketoconazole; omeprazole (Prilosec); pravastatin (Pravachol); quetiapine (Seroquel); ritonavir (Norvir, in Kaletra) used in combination with other HIV protease inhibitors such as darunavir (Prezista), atazanavir (Reyataz), and lopinavir (in Kaletra); rilpivirine (Edurant); salmeterol (Serevent, in Advair); in Complera, in Odefsey); rosuvastatin (Crestor); and voriconazole (Vfend). Your medical care provider may change your medication dose and closely monitor your condition for possible side effects.

You need to inform your medical provider if you have any type of liver disease aside from hepatitis C since a patient who has this diagnosis should not take ritonavir, ombitasvir, dasabuvir, and paritaprevir. You will not also be prescribed with Viekira Pak if you are one of the liver transplant recipients.

You need to inform your medical provider if you or your partner is pregnant, or you or your partner is planning to become pregnant, or you are breastfeeding since the combination of dasabuvir, ombitasvir, paritaprevir, and ritonavir can affect the unborn baby. If you or your partner become pregnant during the treatment of ritonavir, ombitasvir, dasabuvir, and paritaprevir, you need to inform your doctor right away.

You need to know that ritonavir, ombitasvir, dasabuvir, and paritaprevir can lower the effectiveness of different hormonal contraceptives such as birth control pills, rings, patches, implants, intrauterine devices, and injections. If you are taking ritonavir, ombitasvir, dasabuvir, and paritaprevir, you should consider using another form of birth control throughout your medication and an additional 2 weeks after you have completed your final dose. You can talk to your medical care provider to know which type of birth control will work best during an after your treatment of ritonavir, ombitasvir, dasabuvir, and paritaprevir.