Incivek™ (telaprevir) and Hepatitis C
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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
Does the dosage and administration of Incivek™ (telaprevir) differ for various people?
What types of adverse reactions were reported when taking Incivek™?
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.
Topics
- 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?
