The latest research & treatment news about Hepatitis C infection, diagnosis, symptoms and treatment.

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
Neuroleptic Pimozide (Orap®)
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
ANTIARRHYTHMICS
lidocaine (systemic), amiodarone (Cordarone®, Exterone®, Pacerone®), bepridil (Vascor®), flecainide (Tambocor®), propafenone (Rhythmol®, Rhythmol SR®), quinidine Increases antiarrhythmics
digoxin (Lanoxin®) Increases digoxin
ANTIBACTERIALS
clarithromycin (Biaxin®, Biaxin XL®, Prevpac®),erythromycin, telithromycin Increases telaprevir
Increases antibacterials
ANTICOAGULANT
warfarin (Coumarin®) Increases or decreases warfarin
ANTICONVULSANTS
carbamazepine, phenobarbital, phenytoin Decreases telaprevir
Increases carbamazepine
Increases or decreases phenytoin
Increases or decreases phenobarbital
ANTIDEPRESSANTS
escitalopram No change in telaprevir
Decreases escitalopram
trazadone (Desyrel®), desipramine (Norpramin®) Increases trazadone
Increases desipramine
ANTIFUNGALS
ketoconazole (Nizoral®),
itraconazole (Sporanox®), posaconazole (Noxafil®),
voriconazole (Vfend®)
Increases telaprevir
Increases ketoconazole
Increases itraconazole
Increases posaconazole
Increases or decreases voriconazole
ANTI GOUT
colchicines (Colcrys®, Probenecid and Colchicine, COL-Probenecide) Increases colchicine
ANTIMYCOBACTERIAL
Rifabutin (Mycobutin®) Decreases telaprevir
Increases rifabutin
BENZODIAZEPINES
alprazolam Increases alprazolam
parenterally administered midazolam Increases midazolam
zolpidem (non-benzodiazepine sedative) Decreases zolpidem
CALCIUM CHANNEL BLOCKERS
amlodipine Increases amlodipine
diltiazem, felodipine (Plendil®),
nifedipine (Procardia®, Adala CC®, Procardia XL®, Afeditab CR®), nicardipine (Cardene SR ®, Cardene®), nisoldipine, verapamil
Increases calcium channel blockers
CORTICOSTEROIDS
Systemic: prednisone, methylprednisolone, Increases prednisone
Increases methylprednisolone
Systemic: dexamethasone Decreases telaprevir
Inhaled/Nasal:
Budesonide (Pulmicort®, Pulmicort Flexihaler®, Rhinocort®, Pulmicort Respules®, Symbicort®), fluticasone (Veramyst®, Flovent HFA®, Flovent Diskus®, Advair HFA®, Advair Diskus®)
Increases budesonide
Increases fluticasone
ENDOTHELIN RECEPTOR ANTAGONIST
bosentan (Tracleer®) Increases bosentan
HIV-ANTIVIRAL AGENTS: HIV-PROTEASE INHIBITORS (PIs)
atazanavir/ritonavir Increases telaprevir
Decreases atazanavir
darunavir/ritonavir Decreases telaprevir
fosamprenavir/ritonavir Decreases telaprevir
Decreases fosamprenavir
lopinavir/ritonavir Decreases telaprevir
No change to lopinavir
HIV-ANTIVIRAL AGENTS: REVERSE TRANSCRIPTASE INHIBITORS
efavirenz (Sustiva®, Atripla®) Decreases telaprevir
Decreases efavirenz
tenofovir disoproxil fumarate No change to telaprevir
Increases tenofovir
HORMONAL CONTRACEPTIVES
ethinyl estradiol
norethindrone
Decreases ethinyl estradiol
No change norethindrone
IMMUNOSUPRESSANTS
Cyclosporine (Gengraf®, Neoral®, Sandimmune®), sirolimus (Rapamune®), tacrolimus (Prograf®) Increases cyclosporine
Increases sirolimus
Increases tacrolimus
INHALED BETA AGONIST
salmeterol (Advair HFA®, Advair Diskus®, Serevent®) Increases salmeterol
NARCOTIC ANALGESIC
methadone (Dolophine®), Decreases R-methadone
PDE5 INHIBITORS
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.