Moderate Or Strong Cyp3a Inducers
Contraindicated
Textbook
Potential for reduced plasma levels and loss of efficacy of elbasvir.
Coadministration with moderate or strong CYP3A inducers is not recommended.
Source: Harrison 22e · unknown
Drug reference
elbasvir
NS5A inhibitor · Antiviral, Hepatitis C agent
NS5A inhibitorAntiviral, Hepatitis C agent
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
8 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactionssee all 8 →
- Moderate Or Strong Cyp3a InducersContraindicatedTextbookHarrison 22e · unknown
- Strong Cyp3a InhibitorsContraindicatedTextbookHarrison 22e · unknown
- Moderate Cyp3a InducersSevereTextbookG&G 14e · p1241, p1242
- Moderate P Gp InducersSevereTextbookG&G 14e · p1241, p1242
Mechanism
Elbasvir is an inhibitor of the non-structural protein 5A (NS5A) of the hepatitis C virus, which plays a critical role in viral RNA replication and virion assembly.
Indications
HCV genotypes 1 and 4 (as part of fixed-dose combination with grazoprevir)Patients with renal impairment (as part of fixed-dose combination with grazoprevir, preferred treatment)Genotype 1a patients with preexisting NS5A RASs (as part of fixed-dose combination with grazoprevir and ribavirin, extended duration)
Dosing
- Adult
- 50 mg (as part of fixed-dose combination with grazoprevir) once daily
- Renal adjustment
- No specific adjustment needed, preferred treatment in renal impairment
Pharmacokinetics
Half-life
23 h
Bioavailability
30%
Protein binding
Extensively (~99%) bound
Metabolism
Substrate for CYP3A4
Excretion
Less than 1% renally eliminated
Contraindications
- Advanced liver disease
- Concomitant use with moderate or strong CYP3A and P-gp inducers (including efavirenz)
- Concomitant use with HIV protease inhibitors
Side effects
Common
HeadacheFatigueNausea
Drug interactions
Strong Cyp3a Inhibitors
Contraindicated
Textbook
Potential for increased plasma levels and adverse effects of elbasvir.
Coadministration with strong CYP3A inhibitors is not recommended.
Source: Harrison 22e · unknown
Moderate Cyp3a Inducers
Severe
Textbook
Reduced elbasvir concentrations and efficacy.
Not recommended for coadministration with GZR/EBR. Should not be used with moderate CYP3A inducers.
Source: G&G 14e · p1241, p1242
Moderate P Gp Inducers
Severe
Textbook
Reduced elbasvir concentrations and efficacy.
Not recommended for coadministration with GZR/EBR. Should not be used with moderate P-gp inducers.
Source: G&G 14e · p1241, p1242
Strong Cyp3a Inducers
Severe
Textbook
Significantly reduced elbasvir concentrations and efficacy.
Not recommended for coadministration with GZR/EBR. Should not be used with strong CYP3A inducers.
Source: G&G 14e · p1241, p1242
Strong P Gp Inducers
Severe
Textbook
Significantly reduced elbasvir concentrations and efficacy.
Not recommended for coadministration with GZR/EBR. Should not be used with strong P-gp inducers.
Source: G&G 14e · p1241, p1242
Berotralstat
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Ozanimod
Severe
Database
Clinical effect not specified
Source: DDInter
4 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.
Related guidelines
Hepatitis B — chronic infection
INASL · Gastroenterology · 2023
Hepatitis B — chronic infection
EASL · Gastroenterology · 2025
Hepatitis B — chronic infection
WHO · Hepatology · 2025
Hepatitis C — chronic infection
EASL · Gastroenterology · 2020
Coronary angiography with renal dysfunction
CSI · Cardiology · 2020
Other NS5A inhibitor drugs
Ask House about elbasvir
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Harrison 22e·Verified: 2026-05-10 · House clinical team