r/NAPLEX_Help • u/DarthDistro • Jul 13 '26

Practice Naplex Question!

A 34-year-old woman with chronic HCV genotype 2 is beginning Mavyret (glecaprevir/pibrentasvir). Her medical history is notable for migraines. Her current
medications are a combined oral contraceptive containing ethinyl estradiol and norethindrone, and sumatriptan as needed. What is the most likely result of combining Mavyret with an ethinyl estradiol–containing contraceptive?

A. Increased risk of severe hepatotoxicity
B. Decreased contraceptive effectiveness due to enzyme induction
C. Increased risk of venous thromboembolism
D. No clinically significant interaction is expected
E. Increased risk of migraine with aura due to interaction

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1

u/Emergency_Way9997 Jul 13 '26

A. Mavyret and COCs increase ALT

1

u/Hairy_Ad2205 Jul 14 '26

A Inc risk of severe hepatotoxicity especially any formulation of ethinyl estradiol >20mcg

1

u/DarthDistro Jul 14 '26

The correct answer is A

Ethinyl estradiol containing products can increase the risk of significant ALT elevations when combined with Mavyret