--- title: "Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Effects on other drugs" description: "Formulary evidence on Hibsago (bepirovirsen, GSK3228836) in Chronic hepatitis B virus infection in adults without cirrhosis: Effects on other drugs. Topics: Effect on nucleos(t)ide analogue exposure and on enzymes and transporters: prescribing information, Entecavir and tenofovir exposure during bepirovirsen coadministration: B-Clear, No effect of bepirovirsen on entecavir or tenofovir pharmacokinetics, In vitro inhibition and induction of enzymes and transporters, and 4 further topics. 8 evidence topics quoted from 2 sources." canonical: "https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/product-information-and-disease-description/effects-on-other-drugs" published: "2026-10-21T22:39:04-04:00" modified: "2026-10-22T19:07:03-04:00" --- # Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Effects on other drugs ## 2.1.2.9.2 Effects of Bepirovirsen on Other Drugs ### Effect on nucleos(t)ide analogue exposure and on enzymes and transporters: prescribing information > “In addition, HIBSAGO did not impact NrtI exposure.” > “Based on in vitro study results, HIBSAGO is not a substrate, inducer or inhibitor of major cytochrome P450 (CYP) enzymes, or drug transporters; therefore, clinically relevant pharmacokinetic interactions are not expected.” Source: [Hibsago prescribing information (2026)](https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Hibsago/pdf/HIBSAGO-PI-MG-IFU.PDF) ### Entecavir and tenofovir exposure during bepirovirsen coadministration: B-Clear | Nucleos(t)ide analogue and data source | AUC0-24 (ng•h/mL) | Cmax (ng/mL) | Ctau (ng/mL) | | --- | --- | --- | --- | | Entecavir 0.5 mg once daily with bepirovirsen, B-Clear, mean ± SD | “24.4 ± 6.8” | “6.5 ± 2.3” | “0.5 ± 0.1” | | Tenofovir disoproxil fumarate 245 or 300 mg once daily with bepirovirsen, B-Clear, mean ± SD | “2754 ± 661” | “319 ± 95.9” | “57.0 ± 17.1” | | Tenofovir disoproxil fumarate 300 mg single dose, published, mean ± SD | “2290 ± 690” | “300 ± 90.0” | Not reported | | Tenofovir alafenamide 25 mg once daily with bepirovirsen, B-Clear, mean ± SD | “308 ± 105” | “19.4 ± 5.9” | “10.3 ± 3.5” | | Tenofovir alafenamide 25 mg once daily, product label, mean (CV %) | “400 (35.2)” | “30.0 (24.6)” | “10.0 (39.6)” | Source: [Han et al. (2025)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11975176/) ### No effect of bepirovirsen on entecavir or tenofovir pharmacokinetics > “The analysis included 186 ETV plasma concentrations from 16 participants treated with bepirovirsen and ETV, 70 TFV plasma concentrations from 6 participants treated with bepirovirsen and TDF, and 70 TFV plasma concentrations from 5 participants treated with bepirovirsen and TAF. As summarized in Table 3, mean ETV and TFV Cmax and AUC values from participants in the B‐Clear study who received coadministration of bepirovirsen and NA (ETV, TDF, or TAF) were consistent with published data without coadministered bepirovirsen.” > “Thus, the analyses reported here showed no potential for DDI between bepirovirsen and ETV or TFV, substantiated by both in vitro assessments and clinical evaluation. Based on the totality of data, bepirovirsen Phase 3 studies were permitted by health authorities to proceed without conducting dedicated DDI studies.” Source: [Han et al. (2025)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11975176/) ### In vitro inhibition and induction of enzymes and transporters > “Bepirovirsen was not a clinically relevant reversible or time‐dependent inhibitor of CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, or CYP3A4/5 or a reversible inhibitor of UGT enzymes.” > “Bepirovirsen was an inducer of CYP3A4 in vitro in 1 of 3 cryopreserved human hepatocyte donors only, with unbound concentration causing half‐maximal induction effect and maximum induction effect values of 13.6 µM and 2.28‐fold, respectively (Table 1). The results of the basic static modeling indicate that bepirovirsen is not considered to be a CYP3A4 inducer of clinical DDI concern.” > “Bepirovirsen inhibited the MRP2 transporter in vitro with an IC50,u of 8.49 µM. Results of the basic static model predicted that bepirovirsen is not a clinically relevant inhibitor of MRP2.” > “The maximum unbound plasma concentration (Cmax), following the therapeutic subcutaneous dose of 300 mg, administered weekly for 24 weeks, was 57 nM.” Source: [Han et al. (2025)](https://pmc.ncbi.nlm.nih.gov/articles/PMC11975176/) ### Anticoagulants, antiplatelets, and drugs that decrease platelet count > “Monitor patients for signs of bleeding and thrombocytopenia if HIBSAGO is taken concomitantly with anticoagulants, antiplatelets, or drugs that decrease platelet count [see Warnings and Precautions (5.2), Adverse Reactions (6.1)].” Source: [Hibsago prescribing information (2026)](https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Hibsago/pdf/HIBSAGO-PI-MG-IFU.PDF) ### Drugs that impair renal function > “Monitor patients for signs of worsening renal function during concomitant administration of HIBSAGO with drugs that may impair renal function. Refer to individual drug information before prescribing [see Warnings and Precautions (5.3), Adverse Reactions (6.1)].” Source: [Hibsago prescribing information (2026)](https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Hibsago/pdf/HIBSAGO-PI-MG-IFU.PDF) ### Peginterferon alfa-2a > “Concomitant administration of HIBSAGO and peginterferon alfa-2a is not recommended due to the potential for an exacerbated risk of increased ALT, decreased platelet count, and immune-mediated effects.” Source: [Hibsago prescribing information (2026)](https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Hibsago/pdf/HIBSAGO-PI-MG-IFU.PDF) ### Drug-disease interaction: hepatitis D virus coinfection and ALT increases > “HIBSAGO is not recommended in patients with HDV coinfection due to the potential for an exacerbated risk of clinically significant ALT increases.” Source: [Hibsago prescribing information (2026)](https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Hibsago/pdf/HIBSAGO-PI-MG-IFU.PDF) ## Related pages - [Hibsago (bepirovirsen): Chronic hepatitis B virus infection in adults without cirrhosis](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Terms and abbreviations](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/terms-and-abbreviations) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/terms-and-abbreviations.md) - [Hibsago (bepirovirsen): Chronic hepatitis B virus infection in adults without cirrhosis](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/executive-summary) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/executive-summary.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Product information and disease description](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/product-information-and-disease-description) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/product-information-and-disease-description.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Clinical evidence](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/clinical-evidence) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/clinical-evidence.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: Economic information and modeling report](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/economics) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/economics.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: References](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/references) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/references.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: new drug review](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/monograph/review) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/monograph/review.md) - [Hibsago (bepirovirsen) in Chronic hepatitis B virus infection in adults without cirrhosis: cost-effectiveness analyses and utility weights](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/cost-effectiveness-analyses) · [Markdown](https://www.evicenter.com/drugs/hibsago--chronic-hepatitis-b-virus-infection-in-adults-without-cirrhosis/cost-effectiveness-analyses.md)