Mavyret is a prescription antiviral medication used to treat all major types (genotypes 1 through 6) of chronic hepatitis C in adults and children. It combines two active ingredients that attack the hepatitis C virus at different points in its life cycle, and it cures the infection in roughly 95% to 99% of patients depending on the genotype. For many people, treatment lasts just 8 weeks.
How Mavyret Treats Hepatitis C
Hepatitis C is a viral infection that damages the liver over years or decades. Left untreated, it can lead to cirrhosis, liver failure, and liver cancer. Mavyret works by combining two drugs that each block a different protein the virus needs to survive. One ingredient stops a protein the virus uses to copy its genetic material and assemble new viral particles. The other blocks a protein the virus needs to break apart a large molecule into the smaller pieces required for replication.
By hitting the virus from two angles simultaneously, Mavyret makes it extremely difficult for hepatitis C to develop resistance during treatment. This dual approach is why the cure rates are so high across all six genotypes of the virus, something earlier hepatitis C treatments couldn’t achieve.
Cure Rates by Genotype
The goal of Mavyret treatment is what doctors call a sustained virologic response at 12 weeks, meaning the virus is undetectable in the blood three months after finishing the medication. This is considered a cure. In clinical trials submitted to the FDA, Mavyret achieved the following cure rates in patients without cirrhosis who hadn’t been treated before:
- Genotype 1: 99% (348 of 351 patients) with 8 weeks of treatment
- Genotype 2: 98% (193 of 197 patients) with 8 weeks
- Genotype 3: 95% (149 of 157 patients) with 8 weeks
- Genotype 4: 93% (43 of 46 patients) with 8 weeks
- Genotypes 5 and 6: 100% with 12 weeks
For patients with compensated cirrhosis (early-stage scarring where the liver still functions), cure rates were similarly impressive. In the EXPEDITION-1 trial, 99% of patients across genotypes 1, 2, 4, 5, and 6 were cured after 12 weeks. Patients with genotype 3 and cirrhosis achieved cure rates of 96% to 98% with 12 to 16 weeks of treatment.
Treatment Duration
Most patients without cirrhosis who are being treated for hepatitis C for the first time qualify for an 8-week course. This is one of the shortest treatment durations available for hepatitis C, which made Mavyret a significant advance when it was approved. Patients with compensated cirrhosis, or those who have tried other hepatitis C treatments before, typically need 12 or 16 weeks depending on their specific situation and genotype.
How to Take It
The standard adult dose is three tablets taken together, once a day, with food. Food matters here: it helps your body absorb the medication properly. A pellet form is also available for children or anyone who has difficulty swallowing tablets.
If you miss a dose and it’s been less than 18 hours since you were supposed to take it, take it as soon as you remember and then continue your regular schedule. If more than 18 hours have passed, skip the missed dose entirely and just take the next one at your usual time. Don’t double up.
Common Side Effects
Mavyret is generally well tolerated. The most frequently reported side effects across clinical trials were headache (13%), fatigue (11%), and nausea (8%). These numbers were consistent across different patient groups, including people co-infected with HIV, organ transplant recipients, and people who inject drugs. Most side effects were mild and didn’t require stopping treatment.
In the genotype 3 trial, side effects were similar whether patients took the 8-week or 12-week course. Headache occurred in about 16% to 17% of patients in both groups, fatigue in 11% to 14%, and nausea in 9% to 12%. The slightly higher rates with 12 weeks likely reflect the longer exposure rather than a difference in tolerability.
Who Should Not Take Mavyret
Mavyret is not safe for people with moderate or severe liver damage, classified as Child-Pugh B or C. These categories describe how well the liver is functioning based on blood tests and symptoms like fluid buildup and confusion. People with any history of hepatic decompensation, where the liver has previously lost its ability to function adequately, are also ineligible. Mavyret is designed for people whose livers are still working reasonably well, even if some scarring is present.
There’s also an important interaction with certain birth control pills. Hormonal contraceptives containing more than 20 micrograms of ethinyl estradiol should not be taken with Mavyret. Lower-dose formulations (20 micrograms or less) are now permitted in the U.S., though European guidelines are more restrictive. If you’re on hormonal birth control, this is something to sort out before starting treatment.
All patients starting Mavyret need to be screened for hepatitis B first. Treating hepatitis C with any direct-acting antiviral can cause a dormant hepatitis B infection to reactivate, which can lead to serious liver damage. This screening is standard practice before beginning treatment.
Special Populations
Mavyret has been studied in several groups that were historically harder to treat. In the EXPEDITION-2 trial, patients co-infected with both hepatitis C and HIV tolerated the medication well, with side effect rates comparable to the general population. Liver and kidney transplant recipients were studied in the MAGELLAN-2 trial, where headache (17%), fatigue (16%), and nausea (8%) were the most common complaints. People who inject drugs and those on medication-assisted treatment for opioid use disorder also showed strong results in dedicated trials, with similar cure and side effect profiles.
Mavyret is also approved for pediatric patients, with an oral pellet formulation available for children who can’t take the adult tablets. The specific dosing depends on the child’s weight.