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FDA Warns Viekira Pak and Technivie for Hepatitis C Can Cause Serious Liver Injury


The U.S. Food and Drug Administration (FDA) issued a warning this week that recently approved interferon-free therapy for hepatitis C virus (HCV) infection can produce serious liver damage, mainly in people who already have advanced liver disease. The warning applies to AbbVie's paritaprevir/ritonavir/ombitasvir coformulation, which is sold alone as Technivie for the treatment of HCV genotype 4, and as part of the Viekira Pak regimen for HCV genotype 1; in Europe the latter regimen is sold as separate components, Viekirax and Exviera.

The FDA cautions that people should not stop taking these medications on their own, as this can lead to drug resistance. Healthcare providers are urged to carefully monitor patients taking this treatment for signs of worsening liver disease.

AbbVie has announced that it has changed the product labels for Viekira Pak and Technivie to reflect this new information.

Below is an edited excerpt from an FDA Drug Safety Communication issued this week describing risk and safety measures in more detail.

FDA Drug Safety Communication: FDA warns of serious liver injury risk with hepatitis C treatments Viekira Pak and Technivie

October 22, 2015 -- The U.S. Food and Drug Administration (FDA) is warning that hepatitis C treatments Viekira Pak and Technivie can cause serious liver injury mostly in patients with underlying advanced liver disease. As a result, we are requiring the manufacturer to add new information about this safety risk to the drug labels.

Patients taking these medicines should contact their health care professional immediately if they develop fatigue, weakness, loss of appetite, nausea and vomiting, yellow eyes or skin, or light-colored stools, as these may be signs of liver injury. Patients should not stop taking these medicines without first talking to their health care professionals. Stopping treatment early could result in drug resistance to other hepatitis C medicines. Health care professionals should closely monitor for signs and symptoms of worsening liver disease, such as ascites, hepatic encephalopathy, variceal hemorrhage, and/or increases in direct bilirubin in the blood.

Viekira Pak and Technivie are used to treat chronic hepatitis C, a viral infection that can last a lifetime and lead to serious liver and other health problems, including cirrhosis, liver cancer, and death. These medicines reduce the amount of hepatitis C virus in the body by preventing it from multiplying and may slow down the disease.

Our review of adverse events reported to the FDA Adverse Event Reporting System (FAERS) database and to the manufacturer of these medicines, AbbVie, identified cases of hepatic decompensation and liver failure in patients with underlying liver cirrhosis who were taking these medicines. Some of these events resulted in liver transplantation or death. These serious outcomes were reported mostly in patients taking Viekira Pak who had evidence of advanced cirrhosis even before starting treatment with it.

Since the approvals of Viekira Pak in December 2014 and Technivie in July 2015, at least 26 worldwide cases submitted to FAERS were considered to be possibly or probably related to Viekira Pak or Technivie. In most of the cases, liver injury occurred within 1 to 4 weeks of starting treatment. Some of the cases occurred in patients for whom these medicines were contraindicated or not recommended (see Data Summary). FAERS includes only reports submitted to FDA, so there are likely additional cases about which we are unaware.

We are requiring AbbVie to include information about serious liver injury adverse events to the Contraindications, Warnings and Precautions, Postmarketing Experience, and Hepatic Impairment sections of the Viekira Pak and Technivie drug labels.

We urge health care professionals and patients to report side effects involving Viekira Pak or Technivie to the FDA MedWatch program, using the information in the "Contact FDA" box at the bottom of the page.



Food and Drug Administration. FDA Drug Safety Communication: FDA warns of serious liver injury risk with hepatitis C treatments Viekira Pak and Technivie. October 22, 2015.


AbbVie. AbbVie Updated U.S. Labels for Viekira Pak and Technivie. Media release. October 22, 2015.