Incivek™ (telaprevir) and Hepatitis C
When is Incivek™ contraindicated?
The same contraindications that pertain to peginterferon alfa and ribavirin also apply to Incivek™ combination treatment. The combination treatment is contraindicated in the following:
- Pregnant women and men whose female partner is pregnant due to the risks for birth defects and fetal death associated with ribavirin.
- Coadministration with drugs that are highly dependent on CYP3a for clearance, and for which elevated plasma concentrations are associated with serious and/or life-threatening events. It is also contraindicated with drugs that strongly induce CYP3a and thus may lead to lower exposure and loss of efficacy of Incivek™. The following drugs are contraindicated:
|Drug Class||Specific Drugs Within Class Contraindicated with Victrelis™|
|Alpha 1-Adrenoreceptor antagonist||Alfuzosin (Uroxatral®)|
|Antimycobacterial||Rifampin (Rifadin®, Rifamate®, Rifater®, Rimactane®)|
|Ergot Derivatives||Dihydroergotamine (D.H.E. 45®, Migranal®)
Ergonovine and methylergonovine (Ergotrate®, Methergine®)
Ergotamine (Cafergot®, Migergot®, Ergomar®, Ergostat®, Medihaler Ergotamine®, Wigraine®, Wigrettes®)
|GI Motility Agent||Cisapride (Propulsid®)|
|Herbal Products||St. John’s Wort (hypericum perforatum) or products containing St. John’s Wort|
|HMG-CoA Reductase Inhibitors||Lovastatin (Advicor®, Altoprev®, Mevacor®) Simvastatin (Simcor®, Vytorin®, Zocor®)|
|PDE5 enzyme Inhibitor||Soldenafil (REVATIO®) or tadalafil (ADCIRCA®)
when used for the treatment of pulmonary arterial hypertension or lung problems
|Sedative/Hypnotics||Triazolam (Halcion®) or midazolam (Versed®) when taken by mouth|
- Other potentially significant drug interactions include:
|Drug Class: Drug Name||Effect on Concentration of Boceprevir or Drug|
|lidocaine (systemic), amiodarone (Cordarone®, Exterone®, Pacerone®), bepridil (Vascor®), flecainide (Tambocor®), propafenone (Rhythmol®, Rhythmol SR®), quinidine||Increases antiarrhythmics|
|digoxin (Lanoxin®)||Increases digoxin|
|clarithromycin (Biaxin®, Biaxin XL®, Prevpac®),erythromycin, telithromycin||Increases telaprevir
|warfarin (Coumarin®)||Increases or decreases warfarin|
|carbamazepine, phenobarbital, phenytoin||Decreases telaprevir
Increases or decreases phenytoin
Increases or decreases phenobarbital
|escitalopram||No change in telaprevir
|trazadone (Desyrel®), desipramine (Norpramin®)||Increases trazadone
itraconazole (Sporanox®), posaconazole (Noxafil®),
Increases or decreases voriconazole
|colchicines (Colcrys®, Probenecid and Colchicine, COL-Probenecide)||Increases colchicine|
|Rifabutin (Mycobutin®)||Decreases telaprevir
|parenterally administered midazolam||Increases midazolam|
|zolpidem (non-benzodiazepine sedative)||Decreases zolpidem|
|CALCIUM CHANNEL BLOCKERS|
|diltiazem, felodipine (Plendil®),
nifedipine (Procardia®, Adala CC®, Procardia XL®, Afeditab CR®), nicardipine (Cardene SR ®, Cardene®), nisoldipine, verapamil
|Increases calcium channel blockers|
|Systemic: prednisone, methylprednisolone,||Increases prednisone
|Systemic: dexamethasone||Decreases telaprevir|
Budesonide (Pulmicort®, Pulmicort Flexihaler®, Rhinocort®, Pulmicort Respules®, Symbicort®), fluticasone (Veramyst®, Flovent HFA®, Flovent Diskus®, Advair HFA®, Advair Diskus®)
|ENDOTHELIN RECEPTOR ANTAGONIST|
|bosentan (Tracleer®)||Increases bosentan|
|HIV-ANTIVIRAL AGENTS: HIV-PROTEASE INHIBITORS (PIs)|
No change to lopinavir
|HIV-ANTIVIRAL AGENTS: REVERSE TRANSCRIPTASE INHIBITORS|
|efavirenz (Sustiva®, Atripla®)||Decreases telaprevir
|tenofovir disoproxil fumarate||No change to telaprevir
|Decreases ethinyl estradiol
No change norethindrone
|Cyclosporine (Gengraf®, Neoral®, Sandimmune®), sirolimus (Rapamune®), tacrolimus (Prograf®)||Increases cyclosporine
|INHALED BETA AGONIST|
|salmeterol (Advair HFA®, Advair Diskus®, Serevent®)||Increases salmeterol|
|methadone (Dolophine®),||Decreases R-methadone|
|sildenafil, tadalafil, vardenafil (Staxyn®, Levitra®)||Increases PDE5 inhibitors|
For recommendations regarding the coadministration of these medications with Incivek™ combination therapy please visit www.pi.vrtx.com.
Last Updated: July 2014
Vertex Pharmaceuticals "Highlights of Prescribing Information - Incivek™" http://pi.vrtx.com/files/uspi_telaprevir.pdf. Retrieved May 23, 2011.
Vertex Pharmaceuticals "Medication Guide - Incivek™" http://pi.vrtx.com/files/usmedguide_telaprevir.pdf. Retrieved May 23, 2011.
Vertex Pharmaceuticals "For Patients - Helping People Get Incivek™ (telaprevir) tablets" http://www.vrtx.com/patients.html. Retrieved May 23, 2011.
- What is Incivek™ (telaprevir)?
- What is the dosage for Incivek™ (telaprevir)?
- Does the dosage and administration of Incivek™ (telaprevir) differ for various people?
- When is Incivek™ contraindicated?
- What types of adverse reactions were reported when taking Incivek™?
- Are there any other warnings one should know regarding Incivek™ combination therapy?
- At what point would one know the Incivek™ combination therapy is not working?
- Can those co-infected with HIV and Hepatitis C begin Incivek™ combination therapy?
- When can I get a prescription for Incivek™ (telaprevir)?
- How can I get assistance paying for Incivek™ (telaprevir)? Is Incivek™ covered by insurance?