Identification

Name
Ombitasvir
Accession Number
DB09296
Description

Ombitasvir is a direct acting antiviral medication used as part of combination therapy to treat chronic Hepatitis C, an infectious liver disease caused by infection with Hepatitis C Virus (HCV). HCV is a single-stranded RNA virus that is categorized into nine distinct genotypes, with genotype 1 being the most common in the United States, and affecting 72% of all chronic HCV patients 8. Treatment options for chronic Hepatitis C have advanced significantly since 2011, with the development of Direct Acting Antivirals (DAAs) such as Ombitasvir. Ombitasvir is an inhibitor of NS5A, a protein essential for viral replication and virion assembly Label. The barrier for develoment of resistance to NS5A inhibitors is lower than that of NS5B inhibitors, another class of DAAs 5.

In a joint recommendation published in 2016, the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) recommend Ombitasvir as a first line therapy option when used in combination with other antivirals for genotypes 1a, 1b, and 4 8. Depending on the genotype, Ombitasvir is often used in combination with other antivirals such as Dasabuvir, Paritaprevir, Ritonavir, and Ribavirin with the intent to cure, or achieve a sustained virologic response (SVR), after 12 weeks of daily therapy. SVR and eradication of HCV infection is associated with significant long-term health benefits including reduced liver-related damage, improved quality of life, reduced incidence of Hepatocellular Carcinoma, and reduced all-cause mortality 6. Treatment with direct acting antivirals such as Ombitasvir is associated with very minimal side effects, with the most common being headache and fatigue Label. Lack of significant side effects and short duration of therapy is a considerable advantage over older interferon-based regimens, which were limited by infusion site reactions, reduced blood count, and neuropsychiatric effects 7.

Ombutasvir first came on the market as a fixed-dose combination product with Dasabuvir, Paritaprevir, and Ritonavir as the FDA-approved product Viekira Pak. First approved in December 2014, Viekira Pak is indicated for the treatment of HCV genotype 1b without cirrhosis or with compensated cirrhosis, and when combined with Ribavirin for the treatment of HCV genotype 1a without cirrhosis or with compensated cirrhosis.

Ombutasvir is also available as a fixed-dose combination product with Paritaprevir and Ritonavir as the FDA- and Health Canada-approved product Technivie. First approved in July 2015, Technivie is indicated in combination with Ribavirin for the treatment of patients with genotype 4 chronic hepatitis C virus (HCV) infection without cirrhosis or with compensated cirrhosis.

In Canada, Ombutasvir is also available as a fixed-dose combination product with Dasabuvir, Paritaprevir, and Ritonavir as the Health Canada-approved, commercially available product Holkira Pak. First approved in January 2015, Holkira Pak is indicated for the treatment of HCV genotype 1b with or without cirrhosis, and when combined with Ribavirin for the treatment of HCV genotype 1a with or without cirrhosis.

Type
Small Molecule
Groups
Approved, Investigational
Structure
Thumb
Weight
Average: 894.127
Monoisotopic: 893.505112145
Chemical Formula
C50H67N7O8
Synonyms
  • dimethyl ([(2S,5S)-1-(4-tert-butylphenyl)pyrrolidine-2,5-diyl]bis{(4,1-phenylene)carbamoyl(2S)pyrrolidine-2,1-diyl[(2S)-3-methyl-1-oxobutane-1,2-diyl]})biscarbamate
  • Ombitasvir
External IDs
  • ABT 267
  • ABT-267
  • ABT267

Pharmacology

Indication

When used in combination with Paritaprevir and Ritonavir (as the fixed dose product Technivie), Ombitasvir is indicated in combination with Ribavirin for the treatment of patients with genotype 4 chronic hepatitis C virus (HCV) infection without cirrhosis 9.

When used in combination with Paritaprevir, Ritonavir, and Dasabuvir (as the fixed dose product Viekira Pak), Ombitasvir is indicated for the treatment of HCV genotype 1b and ,when combined with Ribavirin, for the treatment of HCV genotype 1a Label

Associated Conditions
Contraindications & Blackbox Warnings
Learn about our commercial Contraindications & Blackbox Warnings data.
Learn More
Pharmacodynamics

Ombitasvir is classified as a direct acting antiviral and acts against HCV to inhibit viral replication Label.

Mechanism of action

Ombitasvir is an inhibitor of the HCV non-structural protein 5A. While the precise role of this protein is unknown, it is essential to viral replication and virion assembly Label. Potential modes of action of NS5A inhibitors like Elbasvir include blocking signaling interactions, redistribution of NS5A from the endoplasmic reticulum to the surface of lipid droplets, and modification of the HCV replication complex 5.

TargetActionsOrganism
ANonstructural protein 5A
inhibitor
Hepatitis C Virus
Absorption

Ombitasvir reaches peak plasma concentration 5 hours after administration Label. It has an absolute bioavailability of 48%. Taking ombitasvir with high or normal fat meals increases exposure by 1.76 or 1.82 fold respectively.

Volume of distribution

Ombitasvir has a volume of distribution at steady state of 173 liters Label.

Protein binding

Ombitasvir is 99.9% bound to human plasma proteins Label.

Metabolism

Ombitasvir is mainly metabolized by amide hydrolysis followed by CYP2C8-mediated oxidative metabolism Label.

Route of elimination

Ombitasvir is mainly excreted in the feces (90.2%) with very little excreted in the urine (1.91%) Label. 87.8% and 0.03% of the dose excreted in the feces and urine respectively is present as the parent compound.

Half-life

Ombitasvir has a half life of elimination of 21-25 hours Label

Clearance

Clearance of Ombitasvir has not been determined.

Adverse Effects
Learn about our commercial Adverse Effects data.
Learn More
Toxicity

The most common adverse effects of Viekira Pak either in combination with or without Ribavirin were pruritus, nausea, insomnia, and asthenia Label. The most common adverse effects of Technivie with or without Ribavirin were asthenia, fatigue, nausea, insomnia and pruritus 9.

Affected organisms
Not Available
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbacavirThe metabolism of Abacavir can be decreased when combined with Ombitasvir.
AbataceptThe metabolism of Ombitasvir can be increased when combined with Abatacept.
AbemaciclibAbemaciclib may decrease the excretion rate of Ombitasvir which could result in a higher serum level.
AbirateroneThe metabolism of Ombitasvir can be decreased when combined with Abiraterone.
AcetaminophenThe metabolism of Acetaminophen can be decreased when combined with Ombitasvir.
AdalimumabThe metabolism of Ombitasvir can be increased when combined with Adalimumab.
Adenovirus type 7 vaccine liveThe therapeutic efficacy of Adenovirus type 7 vaccine live can be decreased when used in combination with Ombitasvir.
AfatinibThe serum concentration of Ombitasvir can be increased when it is combined with Afatinib.
AlectinibAlectinib may decrease the excretion rate of Ombitasvir which could result in a higher serum level.
AlmotriptanThe metabolism of Ombitasvir can be decreased when combined with Almotriptan.
Additional Data Available
  • Extended Description
    Extended Description

    Extended description of the mechanism of action and particular properties of each drug interaction.

    Learn more
  • Severity
    Severity

    A severity rating for each drug interaction, from minor to major.

    Learn more
  • Evidence Level
    Evidence Level

    A rating for the strength of the evidence supporting each drug interaction.

    Learn more
  • Action
    Action

    An effect category for each drug interaction. Know how this interaction affects the subject drug.

    Learn more
Food Interactions
  • Avoid St. John's Wort.
  • Take with food.

Products

Product Ingredients
IngredientUNIICASInChI Key
Ombitasvir heminonahydrateEQE3I70J3W1456607-70-7AWMWWEBJJCSJHI-MVJJBPFMSA-N
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
Holkira PakOmbitasvir (12.5 mg) + Dasabuvir (250 mg) + Paritaprevir (75 mg) + Ritonavir (50 mg)Kit; TabletOralAbbvie2015-01-062018-08-15Canada flag
TechnivieOmbitasvir (12.5 mg) + Paritaprevir (75 mg) + Ritonavir (50 mg)TabletOralAbbvie2015-11-242018-07-30Canada flag
TechnivieOmbitasvir heminonahydrate (12.5 mg/1) + Paritaprevir dihydrate (75 mg/1) + Ritonavir (50 mg/1)OralAbbVie Inc.2015-07-242019-03-14US flag
Viekira PakOmbitasvir heminonahydrate (12.5 mg/1) + Dasabuvir sodium monohydrate (250 mg/1) + Paritaprevir dihydrate (75 mg/1) + Ritonavir (50 mg/1)OralAbbVie Inc.2014-12-19Not applicableUS flag
Viekira XROmbitasvir heminonahydrate (8.33 mg/1) + Dasabuvir sodium monohydrate (200 mg/1) + Paritaprevir dihydrate (50 mg/1) + Ritonavir (33.33 mg/1)OralAbbVie Inc.2016-07-222019-01-17US flag

Categories

ATC Codes
J05AP53 — Ombitasvir, paritaprevir and ritonavirJ05AP52 — Dasabuvir, ombitasvir, paritaprevir and ritonavir
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as dipeptides. These are organic compounds containing a sequence of exactly two alpha-amino acids joined by a peptide bond.
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Carboxylic acids and derivatives
Sub Class
Amino acids, peptides, and analogues
Direct Parent
Dipeptides
Alternative Parents
Valine and derivatives / Proline and derivatives / Alpha amino acid amides / Phenylpyrrolidines / Phenylpropanes / Anilides / Pyrrolidinecarboxamides / Aniline and substituted anilines / N-arylamides / N-acylpyrrolidines
show 12 more
Substituents
1-phenylpyrrolidine / 2-phenylpyrrolidine / Alpha-amino acid amide / Alpha-amino acid or derivatives / Alpha-dipeptide / Amine / Amino acid or derivatives / Anilide / Aniline or substituted anilines / Aralkylamine
show 31 more
Molecular Framework
Aromatic heteromonocyclic compounds
External Descriptors
carbamate ester, dipeptide, pyrrolidines, ring assembly, aromatic amide (CHEBI:85183)

Chemical Identifiers

UNII
2302768XJ8
CAS number
1258226-87-7
InChI Key
PIDFDZJZLOTZTM-KHVQSSSXSA-N
InChI
InChI=1S/C50H67N7O8/c1-30(2)42(53-48(62)64-8)46(60)55-28-10-12-40(55)44(58)51-35-20-14-32(15-21-35)38-26-27-39(57(38)37-24-18-34(19-25-37)50(5,6)7)33-16-22-36(23-17-33)52-45(59)41-13-11-29-56(41)47(61)43(31(3)4)54-49(63)65-9/h14-25,30-31,38-43H,10-13,26-29H2,1-9H3,(H,51,58)(H,52,59)(H,53,62)(H,54,63)/t38-,39-,40-,41-,42-,43-/m0/s1
IUPAC Name
methyl N-[(2S)-1-[(2S)-2-({4-[(2S,5S)-1-(4-tert-butylphenyl)-5-{4-[(2S)-1-[(2S)-2-[(methoxycarbonyl)amino]-3-methylbutanoyl]pyrrolidine-2-amido]phenyl}pyrrolidin-2-yl]phenyl}carbamoyl)pyrrolidin-1-yl]-3-methyl-1-oxobutan-2-yl]carbamate
SMILES
COC(=O)N[[email protected]@H](C(C)C)C(=O)N1CCC[[email protected]]1C(=O)NC1=CC=C(C=C1)[[email protected]@H]1CC[[email protected]](N1C1=CC=C(C=C1)C(C)(C)C)C1=CC=C(NC(=O)[[email protected]@H]2CCCN2C(=O)[[email protected]@H](NC(=O)OC)C(C)C)C=C1

References

General References
  1. Shen J, Serby M, Surber B, Lee AJ, Ma J, Badri P, Menon R, Kavetskaia O, de Morais SM, Sydor J, Fischer V: Metabolism and Disposition of Pan-Genotypic Inhibitor of Hepatitis C Virus NS5A Ombitasvir in Humans. Drug Metab Dispos. 2016 Aug;44(8):1148-57. doi: 10.1124/dmd.115.067496. Epub 2016 May 13. [PubMed:27179128]
  2. DeGoey DA, Randolph JT, Liu D, Pratt J, Hutchins C, Donner P, Krueger AC, Matulenko M, Patel S, Motter CE, Nelson L, Keddy R, Tufano M, Caspi DD, Krishnan P, Mistry N, Koev G, Reisch TJ, Mondal R, Pilot-Matias T, Gao Y, Beno DW, Maring CJ, Molla A, Dumas E, Campbell A, Williams L, Collins C, Wagner R, Kati WM: Discovery of ABT-267, a pan-genotypic inhibitor of HCV NS5A. J Med Chem. 2014 Mar 13;57(5):2047-57. doi: 10.1021/jm401398x. Epub 2014 Jan 15. [PubMed:24400777]
  3. Keating GM: Ombitasvir/Paritaprevir/Ritonavir: A Review in Chronic HCV Genotype 4 Infection. Drugs. 2016 Aug;76(12):1203-11. doi: 10.1007/s40265-016-0612-1. [PubMed:27401997]
  4. Macdonald A, Harris M: Hepatitis C virus NS5A: tales of a promiscuous protein. J Gen Virol. 2004 Sep;85(Pt 9):2485-502. [PubMed:15302943]
  5. Bagaglio S, Uberti-Foppa C, Morsica G: Resistance Mechanisms in Hepatitis C Virus: implications for Direct-Acting Antiviral Use. Drugs. 2017 May 12. doi: 10.1007/s40265-017-0753-x. [PubMed:28497432]
  6. Myers RP, Shah H, Burak KW, Cooper C, Feld JJ: An update on the management of chronic hepatitis C: 2015 Consensus guidelines from the Canadian Association for the Study of the Liver. Can J Gastroenterol Hepatol. 2015 Jan-Feb;29(1):19-34. Epub 2015 Jan 13. [PubMed:25585348]
  7. Dusheiko G: Side effects of alpha interferon in chronic hepatitis C. Hepatology. 1997 Sep;26(3 Suppl 1):112S-121S. [PubMed:9305675]
  8. American Association for the Study of Liver Diseases; Infectious Diseases Society of America. HCV guidance. http://hcvguidelines.org. Accessed June 12, 2017. [Link]
  9. Dailymed: Technivie [Link]
KEGG Drug
D10745
PubChem Compound
54767916
PubChem Substance
310265188
ChemSpider
31136214
RxNav
1597371
ChEBI
85183
ChEMBL
CHEMBL3127326
ZINC
ZINC000150601177
PharmGKB
PA166163409
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Ombitasvir
FDA label
Download (540 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4Active Not RecruitingTreatmentChronic Hepatitis C Virus (HCV) Infection1
4Active Not RecruitingTreatmentChronic Hepatitis C Virus (HCV) Infection / Chronic Kidney Disease (CKD)1
4Active Not RecruitingTreatmentHepatitis C Virus (HCV) Infection1
4CompletedPreventionHepatitis C Viral Infection1
4CompletedTreatmentChronic Hepatitis C Virus (HCV) Infection1
4CompletedTreatmentEnd Stage Renal Disease (ESRD) / HCV Coinfection1
4CompletedTreatmentHCV Coinfection1
4CompletedTreatmentHepatitis Viruses1
4Unknown StatusTreatmentAntiviral Drug Adverse Reaction1
4Unknown StatusTreatmentChronic Hepatitis C Virus (HCV) Infection2

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Kit; tabletOral
TabletOral
Tablet, film coatedOral12.5 MG
Tablet, coatedOral12.5 mg
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US6703403Yes2004-03-092016-12-26US flag
US6037157Yes2000-03-142016-12-26US flag
US7364752Yes2008-04-292021-05-10US flag
US7148359Yes2006-12-122020-01-19US flag
US8268349Yes2012-09-182025-02-25US flag
US8399015Yes2013-03-192025-02-25US flag
US9139536No2015-09-222028-11-09US flag
US8685984No2014-04-012032-09-04US flag
US8466159No2013-06-182032-09-04US flag
US8642538No2014-02-042029-09-10US flag
US8501238No2013-08-062028-09-17US flag
US8680106No2014-03-252032-09-04US flag
US8492386No2013-07-232032-09-04US flag
US8188104No2012-05-292029-05-17US flag
US9006387No2015-04-142030-06-10US flag
US9044480No2015-06-022031-04-10US flag
US8686026No2014-04-012031-06-09US flag
US8420596Yes2013-04-162031-10-10US flag
US8691938No2014-04-082032-04-13US flag
US9629841No2017-04-252033-10-18US flag
US9333204No2016-05-102035-01-02US flag
US9744170No2017-08-292035-01-02US flag
US10105365No2018-10-232035-01-02US flag
US10201584No2019-02-122032-05-17US flag
US10201542No2019-02-122033-10-18US flag
US10201541No2019-02-122032-05-17US flag
Additional Data Available
  • Filed On
    Filed On

    The date on which a patent was filed with the relevant government.

    Learn more

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility0.00193 mg/mLALOGPS
logP5.72ALOGPS
logP7.49ChemAxon
logS-5.7ALOGPS
pKa (Strongest Acidic)12.77ChemAxon
pKa (Strongest Basic)2.16ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count7ChemAxon
Hydrogen Donor Count4ChemAxon
Polar Surface Area178.72 Å2ChemAxon
Rotatable Bond Count16ChemAxon
Refractivity250.79 m3·mol-1ChemAxon
Polarizability99.1 Å3ChemAxon
Number of Rings6ChemAxon
Bioavailability0ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Targets

Kind
Protein
Organism
Hepatitis C Virus
Pharmacological action
Yes
Actions
Inhibitor
General Function
Zinc ion binding
Specific Function
Not Available
Gene Name
NS5A
Uniprot ID
Q5L478
Uniprot Name
Nonstructural protein 5A
Molecular Weight
48598.34 Da
References
  1. DeGoey DA, Randolph JT, Liu D, Pratt J, Hutchins C, Donner P, Krueger AC, Matulenko M, Patel S, Motter CE, Nelson L, Keddy R, Tufano M, Caspi DD, Krishnan P, Mistry N, Koev G, Reisch TJ, Mondal R, Pilot-Matias T, Gao Y, Beno DW, Maring CJ, Molla A, Dumas E, Campbell A, Williams L, Collins C, Wagner R, Kati WM: Discovery of ABT-267, a pan-genotypic inhibitor of HCV NS5A. J Med Chem. 2014 Mar 13;57(5):2047-57. doi: 10.1021/jm401398x. Epub 2014 Jan 15. [PubMed:24400777]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP2C8
Uniprot ID
P10632
Uniprot Name
Cytochrome P450 2C8
Molecular Weight
55824.275 Da
References
  1. Shen J, Serby M, Surber B, Lee AJ, Ma J, Badri P, Menon R, Kavetskaia O, de Morais SM, Sydor J, Fischer V: Metabolism and Disposition of Pan-Genotypic Inhibitor of Hepatitis C Virus NS5A Ombitasvir in Humans. Drug Metab Dispos. 2016 Aug;44(8):1148-57. doi: 10.1124/dmd.115.067496. Epub 2016 May 13. [PubMed:27179128]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Xenobiotic-transporting atpase activity
Specific Function
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name
ABCB1
Uniprot ID
P08183
Uniprot Name
Multidrug resistance protein 1
Molecular Weight
141477.255 Da
References
  1. Keating GM: Ombitasvir/Paritaprevir/Ritonavir: A Review in Chronic HCV Genotype 4 Infection. Drugs. 2016 Aug;76(12):1203-11. doi: 10.1007/s40265-016-0612-1. [PubMed:27401997]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Protein homodimerization activity
Specific Function
UDPGT is of major importance in the conjugation and subsequent elimination of potentially toxic xenobiotics and endogenous compounds. This isoform glucuronidates bilirubin IX-alpha to form both the...
Gene Name
UGT1A4
Uniprot ID
P22310
Uniprot Name
UDP-glucuronosyltransferase 1-4
Molecular Weight
60024.535 Da
References
  1. Keating GM: Ombitasvir/Paritaprevir/Ritonavir: A Review in Chronic HCV Genotype 4 Infection. Drugs. 2016 Aug;76(12):1203-11. doi: 10.1007/s40265-016-0612-1. [PubMed:27401997]
Kind
Protein
Organism
Humans
Pharmacological action
No
Actions
Substrate
General Function
Xenobiotic-transporting atpase activity
Specific Function
High-capacity urate exporter functioning in both renal and extrarenal urate excretion. Plays a role in porphyrin homeostasis as it is able to mediates the export of protoporhyrin IX (PPIX) both fro...
Gene Name
ABCG2
Uniprot ID
Q9UNQ0
Uniprot Name
ATP-binding cassette sub-family G member 2
Molecular Weight
72313.47 Da

Drug created on October 30, 2015 09:54 / Updated on June 12, 2020 11:42

Logo pink
Are you a
new drug developer?
Contact us to learn more about our customized products and solutions.
Logo pink
Stay in the know!
As part of our commitment to providing the most up-to-date drug information, we will be releasing #DrugBankUpdates with our newly added curated drug pages.
#DrugBankUpdates