Glecaprevir

Identification

Summary

Glecaprevir is a Hepatitis C NS3/4A protease inhibitor used to treat Hepatitis C.

Brand Names
Maviret, Mavyret
Generic Name
Glecaprevir
DrugBank Accession Number
DB13879
Background

Glecaprevir is a direct acting antiviral agent and Hepatitis C virus (HCV) NS3/4A protease inhibitor that targets the the viral RNA replication. In combination with Pibrentasvir, glecaprevir is a useful therapy for patients who experienced therapeutic failure from other NS3/4A protease inhibitors. It demonstrates a high genetic barrier against resistance mutations of the virus. In cell cultures, the emergence of amino acid substitutions at NS3 resistance-associated positions A156 or D/Q168 in HCV genotype 1a, 2a or 3a replicons led to reduced susceptibility to glecaprevir Label. The combinations of amino acid substitutions at NS3 position Y65H and D/Q168 also results in greater reductions in glecaprevir susceptibility, and NS3 Q80R in genotype 3a patients also leads to glecaprevir resistance Label.

Glecaprevir is available as an oral combination therapy with Pibrentasvir under the brand name Mavyret. This fixed-dose combination therapy was FDA-approved in August 2017 to treat adults with chronic hepatitis C virus (HCV) genotypes 1-6 without cirrhosis (liver disease) or with mild cirrhosis, including patients with moderate to severe kidney disease and those who are on dialysis 2. Mavyret is also indicated for HCV genotype 1-infected patients who have been previously treated with regimens either containing an NS5A inhibitor or an NS3/4A protease inhibitor, but not both 2. Hepatitis C viral infection often leads to decreased liver function and subsequent liver failure, causing a significantly negative impact on the patients' quality of life. The ultimate goal of the combination treatment is to achieve sustained virologic response (SVR) and cure the patients from the infection. In clinical trials, this combination therapy achieved SVR12 rate, or undetectable Hepatitis C for twelve or more weeks after the end of treatment, of ≥93% across genotypes 1a, 2a, 3a, 4, 5 and 6 Label.

Type
Small Molecule
Groups
Approved, Investigational
Structure
Thumb
Weight
Average: 838.87
Monoisotopic: 838.298310911
Chemical Formula
C38H46F4N6O9S
Synonyms
  • Glécaprévir
  • Glecaprevir
  • Glecaprevirum
External IDs
  • A-1282576
  • A-1282576.0
  • A-12825760
  • ABT 493
  • ABT-493

Pharmacology

Indication

Indicated for the treatment of adult patients with chronic hepatitis C virus (HCV) genotype 1, 2, 3, 4, 5 or 6 infection without cirrhosis or with compensated cirrhosis (Child-Pugh A). MAVYRET is also indicated for the treatment of adult patients with HCV genotype 1 infection, who previously have been treated with a regimen containing an HCV NS5A inhibitor or an NS3/4A protease inhibitor (PI), but not both Label.

Pharmacology
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

In a biochemical assay studying clinical isolates of HCV genotypes 1a, 1b, 2a, 2b, 3a, 4a, 5a, and 6a, glecaprevir displayed IC50 values ranging from 3.5 to 11.3 nM that resulted in inhibition of the proteolytic activity of recombinant NS3/4A enzymes. In HCV replicon assays, glecaprevir had median EC50 values of 0.08-4.6 nM against laboratory and clinical isolates from subtypes 1a, 1b, 2a, 2b, 3a, 4a, 4d, 5a, and 6a Label. In a QT study, glecaprevir is not shown to prolong the QTc interval.

Mechanism of action

Glecaprevir is an inhibitor of the HCV NS3/4A protease, which is a viral enzyme necessary for the proteolytic cleavage of the HCV encoded polyprotein into mature forms of the NS3, NS4A, NS4B, NS5A, and NS5B proteins Label. These multifunctional proteins, including NS3, are essential for viral replication. The N-terminal of NS3 protein confers serine protease activity, whileThe C-terminus of NS3 encodes a DExH/D-box RNA helicase which hydyolyzes NTP as an energy source to unwind double-stranded RNA in a 3′ to 5′ direction during replication of viral genomic RNA 1. NS4A is a cofactor for NS3 that directs the localization of NS3 and modulates its enzymatic activities 1. Glecaprevir disrupts the intracellular processes of the viral life cycle through inhibiting the NS3/4A protease activity of cleaving downstream junctions of HCV polypeptide and proteolytic processing of mature structural proteins 1.

TargetActionsOrganism
ANS3 protease
inhibitor
Hepatitis C Virus
Absorption

In healthy subjects, the time it takes to reach the peak plasma concentration (Tmax) is approximately 5 hours. The mean peak plasma concentration (Cmax) is 597ng/mL in non-cirrhotic HCV-infected subjects. Relative to fasting conditions, the consumption of meals increases the absorption of glecaprevir by 83-163% Label.

Volume of distribution

Not Available

Protein binding

Pibrentasvir is 97.5% bound to human plasma proteins. The Blood-to-plasma ratio is approximately 0.57 Label.

Metabolism

Glecaprevir undergoes limited secondary metabolism in vitro, predominantly by CYP3A Label.

Route of elimination

The predominant route of elimination of the drug is biliary-fecal, where 92.1% of administered drug is excreted in feces and 0.7% of the drug is excreted in the urine Label.

Half-life

The elimination half life (t1/2) is approximately 6 hours Label.

Clearance

Not Available

Adverse Effects
Medicalerrors
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Toxicity

Glecaprevir is not shown to be genotoxic according to in vitro or in vivo studies. It also shows to have no effect on mating, female or male fertility, or early embryonic development in rodent studies. Carcinogenicity studies with glecaprevir have not been conducted Label.

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 Glecaprevir.
AbemaciclibThe metabolism of Glecaprevir can be decreased when combined with Abemaciclib.
AcalabrutinibThe metabolism of Acalabrutinib can be decreased when combined with Glecaprevir.
AcenocoumarolThe metabolism of Acenocoumarol can be decreased when combined with Glecaprevir.
AcetaminophenThe metabolism of Acetaminophen can be decreased when combined with Glecaprevir.
AcetylcysteineThe excretion of Glecaprevir can be decreased when combined with Acetylcysteine.
Adenovirus type 7 vaccine liveThe therapeutic efficacy of Adenovirus type 7 vaccine live can be decreased when used in combination with Glecaprevir.
AfatinibThe serum concentration of Afatinib can be increased when it is combined with Glecaprevir.
AlbendazoleThe metabolism of Albendazole can be decreased when combined with Glecaprevir.
AlectinibThe metabolism of Glecaprevir can be decreased when combined with Alectinib.
Interactions
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Food Interactions
  • Avoid St. John's Wort. Co-administration may lead to decreased serum concentrations of glecaprevir.
  • Take with food.

Products

Products
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Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
MaviretGlecaprevir (100 mg) + Pibrentasvir (40 mg)TabletOralAbbvie2017-09-13Not applicableCanada flag
MaviretGlecaprevir (100 mg) + Pibrentasvir (40 mg)Tablet, film coatedOralAbb Vie Deutschland Gmb H Co. Kg2020-12-16Not applicableEU flag
MAVİRET 100 MG/40 MG FİLM KAPLI TABLET, 84 ADETGlecaprevir (100 mg) + Pibrentasvir (40 mg)Tablet, coatedOralABBVİE TIBBİ İLAÇLAR SAN. VE TİC. LTD. ŞTİ.2020-08-14Not applicableTurkey flag
MavyretGlecaprevir (100 mg/1) + Pibrentasvir (40 mg/1)Tablet, film coatedOralAbbVie Inc.2017-08-03Not applicableUS flag

Categories

ATC Codes
J05AP57 — Glecaprevir and pibrentasvir
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as cyclic peptides. These are compounds containing a cyclic moiety bearing a peptide backbone.
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Carboxylic acids and derivatives
Sub Class
Amino acids, peptides, and analogues
Direct Parent
Cyclic peptides
Alternative Parents
Macrolactams / N-acyl-alpha amino acids and derivatives / Alpha amino acid amides / Quinoxalines / Pyrrolidinecarboxamides / Alkyl aryl ethers / Pyrazines / Benzenoids / Cyclopropanecarboxylic acids and derivatives / Tertiary carboxylic acid amides
show 16 more
Substituents
Alkyl aryl ether / Alkyl fluoride / Alkyl halide / Alpha-amino acid amide / Alpha-amino acid or derivatives / Aminosulfonyl compound / Aromatic heteropolycyclic compound / Azacycle / Benzenoid / Carbamic acid ester
show 33 more
Molecular Framework
Aromatic heteropolycyclic compounds
External Descriptors
Not Available
Affected organisms
  • Hepatitis C Virus

Chemical Identifiers

UNII
K6BUU8J72P
CAS number
1365970-03-1
InChI Key
MLSQGNCUYAMAHD-ITNVBOSISA-N
InChI
InChI=1S/C38H46F4N6O9S/c1-35(2,3)28-32(50)48-19-20(17-24(48)30(49)46-37(18-21(37)29(39)40)33(51)47-58(53,54)36(4)14-15-36)56-31-27(43-22-9-5-6-10-23(22)44-31)38(41,42)13-8-16-55-25-11-7-12-26(25)57-34(52)45-28/h5-6,8-10,13,20-21,24-26,28-29H,7,11-12,14-19H2,1-4H3,(H,45,52)(H,46,49)(H,47,51)/b13-8+/t20-,21+,24+,25-,26-,28-,37-/m1/s1
IUPAC Name
(1R,14E,18R,22R,26S,29S)-26-tert-butyl-N-[(1R,2R)-2-(difluoromethyl)-1-{[(1-methylcyclopropyl)sulfonyl]carbamoyl}cyclopropyl]-13,13-difluoro-24,27-dioxo-2,17,23-trioxa-4,11,25,28-tetraazapentacyclo[26.2.1.0^{3,12}.0^{5,10}.0^{18,22}]hentriaconta-3,5(10),6,8,11,14-hexaene-29-carboxamide
SMILES
[H][C@@]12CN(C(=O)[C@@]([H])(NC(=O)O[C@]3([H])CCC[C@@]3([H])OC\C=C\C(F)(F)C3=NC4=C(C=CC=C4)N=C3O1)C(C)(C)C)[C@@]([H])(C2)C(=O)N[C@@]1(C[C@H]1C(F)F)C(=O)NS(=O)(=O)C1(C)CC1

References

General References
  1. Salam KA, Akimitsu N: Hepatitis C virus NS3 inhibitors: current and future perspectives. Biomed Res Int. 2013;2013:467869. doi: 10.1155/2013/467869. Epub 2013 Oct 27. [Article]
  2. FDA Press Announcements: FDA approves Mavyret for Hepatitis C [Link]
KEGG Drug
D10814
PubChem Compound
66828839
PubChem Substance
347829330
ChemSpider
35013015
RxNav
1940635
ChEMBL
CHEMBL3545363
ZINC
ZINC000164528615
PDBe Ligand
O31
Wikipedia
Glecaprevir
PDB Entries
6p6l / 6p6m / 6p6o / 6p6r / 6p6s / 6p6t / 6p6v / 6p6z / 6vdl / 6vdm
FDA label
Download (925 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4Active Not RecruitingPreventionChronic Hepatitis C Virus (HCV) Infection / End Stage Renal Disease (ESRD)1
4Active Not RecruitingPreventionChronic Renal Failure (CRF) / Hepatitis C Viral Infection1
4Active Not RecruitingTreatmentChronic Hepatitis C Virus (HCV) Infection / Chronic Kidney Disease (CKD)1
4CompletedTreatmentEnd Stage Renal Disease (ESRD) / Hepatitis C Viral Infection1
4Enrolling by InvitationPreventionHepatitis C Viral Infection / Respiratory Failure1
4Enrolling by InvitationTreatmentEnd Stage Renal Disease (ESRD) / Hepatitis C Viral Infection1
4RecruitingBasic ScienceCardiovascular Disease (CVD) / Hepatitis C Viral Infection / Human Immunodeficiency Virus (HIV) Infections1
4RecruitingTreatmentChronic Kidney Disease (CKD) / Hepatitis C Viral Infection / Kidney Failure1
4RecruitingTreatmentHeart Transplant Infection / Hepatitis C Viral Infection / Kidney Transplant; Complications1
4RecruitingTreatmentHepatitis C Viral Infection1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
TabletOral
Tablet, coatedOral
Tablet, film coatedOral
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US9586978No2017-03-072030-06-10US flag
US8648037No2014-02-112032-01-19US flag
US9321807No2016-04-262035-06-05US flag
US8937150No2015-01-202032-05-18US flag
US10039754No2018-08-072030-06-10US flag
US10028937No2018-07-242030-06-10US flag
US10286029No2019-05-142034-03-14US flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
water solubility<0.1 to 0.3 mg/mLFDA Label
Predicted Properties
PropertyValueSource
Water Solubility0.0463 mg/mLALOGPS
logP4.26ALOGPS
logP3.95ChemAxon
logS-4.3ALOGPS
pKa (Strongest Acidic)3.74ChemAxon
pKa (Strongest Basic)-1.2ChemAxon
Physiological Charge-1ChemAxon
Hydrogen Acceptor Count10ChemAxon
Hydrogen Donor Count3ChemAxon
Polar Surface Area195.22 Å2ChemAxon
Rotatable Bond Count6ChemAxon
Refractivity194.55 m3·mol-1ChemAxon
Polarizability78.89 Å3ChemAxon
Number of Rings7ChemAxon
Bioavailability1ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleYesChemAxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available

Targets

Drugtargets
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Kind
Protein
Organism
Hepatitis C Virus
Pharmacological action
Yes
Actions
Inhibitor
General Function
Serine-type peptidase activity
Specific Function
Not Available
Gene Name
Not Available
Uniprot ID
Q91RS4
Uniprot Name
NS3 protease
Molecular Weight
19113.77 Da

Enzymes

Kind
Protein group
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
General Function
Vitamin d3 25-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 performs a variety of oxidation react...

Components:
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Steroid binding
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
UGT1A1
Uniprot ID
P22309
Uniprot Name
UDP-glucuronosyltransferase 1-1
Molecular Weight
59590.91 Da
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Vitamin d3 25-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 performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Glecaprevir FDA label [Link]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
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
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
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
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates the Na(+)-independent uptake of organic anions such as pravastatin, taurocholate, methotrexate, dehydroepiandrosterone sulfate, 17-beta-glucuronosyl estradiol, estrone sulfate, prostagland...
Gene Name
SLCO1B1
Uniprot ID
Q9Y6L6
Uniprot Name
Solute carrier organic anion transporter family member 1B1
Molecular Weight
76447.99 Da
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
General Function
Sodium-independent organic anion transmembrane transporter activity
Specific Function
Mediates the Na(+)-independent uptake of organic anions such as 17-beta-glucuronosyl estradiol, taurocholate, triiodothyronine (T3), leukotriene C4, dehydroepiandrosterone sulfate (DHEAS), methotre...
Gene Name
SLCO1B3
Uniprot ID
Q9NPD5
Uniprot Name
Solute carrier organic anion transporter family member 1B3
Molecular Weight
77402.175 Da

Drug created on August 31, 2017 15:33 / Updated on February 21, 2021 18:54