سعر مبيفيروباك بلس 90/400مجم 28 قرص 2022

Mpiviropack Plus 90/400 mg tablets (Marcyrl Co., Egypt): fixed-dose combination of ledipasvir 90 mg (NS5A inhibitor) and sofosbuvir 400 mg (NS5B inhibitor) for chronic hepatitis C; pack of 28 tablets.

• Chronic hepatitis C genotype 1, 4, 5 or 6 without cirrhosis or with compensated cirrhosis; genotype 1 with decompensated cirrhosis (with ribavirin); genotype 1 or 4 liver-transplant recipients (with ribavirin). Adults and children 3 years and older.Population: Adults and children 3 years and olderDailyMed (U.S. National Library of Medicine)

• Most common (at least 10%, all grades): fatigue, headache and asthenia.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• If given with ribavirin, all contraindications to ribavirin apply to the combination regimen.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Boxed warning: risk of hepatitis B virus reactivation in HCV/HBV coinfected patients (fulminant hepatitis, hepatic failure, death reported); test all patients for HBV before starting.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Serious symptomatic bradycardia, including fatal cardiac arrest, has been reported when amiodarone is co-administered; risk higher with beta-blockers, cardiac comorbidities or advanced liver disease.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• P-gp inducers (e.g. rifampicin, St John's wort) may significantly decrease ledipasvir and sofosbuvir concentrations; co-administration not recommended.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Acid-reducing agents (antacids, H2-receptor antagonists, proton-pump inhibitors)Ledipasvir solubility decreases as gastric pH rises, lowering its concentration; separate antacids (e.g. aluminium/magnesium hydroxide) from the tablet by 4 hours; see label for H2-antagonist and PPI timing.DailyMed (U.S. National Library of Medicine)
• AmiodaroneSerious symptomatic bradycardia with co-administration.DailyMed (U.S. National Library of Medicine)
• P-gp inducers (rifampicin, St John's wort)Decrease ledipasvir and sofosbuvir concentrations; not recommended.DailyMed (U.S. National Library of Medicine)

• No adequate human data; no adverse developmental outcomes in animal studies with ledipasvir or sofosbuvir at exposures above human exposure. With ribavirin, the regimen is contraindicated in pregnant women and in men whose female partners are pregnant.International label, same formulation · DailyMed (U.S. National Library of Medicine)
• Unknown whether ledipasvir, sofosbuvir or metabolites are present in human milk; in rats ledipasvir was detected in nursing pups' plasma and GS-331007 in milk without clear effects. Weigh benefits against maternal need.International label, same formulation · DailyMed (U.S. National Library of Medicine)

• Ledipasvir: Inhibitor of the HCV NS5A protein, which is required for viral replication (US Harvoni label, section 12.4).
• Sofosbuvir: Nucleotide prodrug converted intracellularly to the active uridine analogue triphosphate (GS-461203), which is incorporated into HCV RNA by the NS5B RNA-dependent RNA polymerase and acts as a chain terminator (US label, section 12.4).