Victrelis Boceprevir Contraindications | Hepatitis Central

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Victrelis Boceprevir Contraindications

 

Victrelis™ (boceprevir) and Hepatitis C


When is Victrelis™ contraindicated?

The same contraindications that pertain to peginterferon and ribavirin also apply to the Victrelis™ combination treatment. This 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 CYP3a4/5 for clearance, and for which elevated plasma concentrations are associated with serious and/or life-threatening events including:
Drug Class Specific Drugs Within Class Contraindicated with Victrelis™
Alpha 1-Adrenoreceptor antagonist Alfuzosin (Uroxatral®)
Anticonvulsants Carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®, Tegretol XR ®, Teril®)
Phenobarbital
Phenytoin (Dilantin®)
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®)
Oral Contraceptives Drosperinone (including Yaz®, Yasmin®, Zarah®, Ocella®, Gianvi®, Beyaz®, Safyral®)
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: amiodarone (Cordarone®, Exterone®, Pacerone®),
bepridil (Vascor®), flecainide (Tambocor®), propafenone (Rhythmol®, Rhythmol SR®),
quinidine
digoxin (Lanoxin®)
Increases antiarrhythmics
Increases digoxin
Anticoagulant: warfarin (Coumarin®) Increases or decreases warfarin
Antidepressants: trazadone (Desyrel®), desipramine (Norpramin®) Increases trazadone
Increases desipramine
Antifungals: ketoconazole (Nizoral®),
Itraconazole (Sporanox®), posaconazole (Noxafil®),
Voriconazole (Vfend®)
Increases boceprevir
Increases itraconazole
Increases ketoconazole
Increases posaconazole
Increases voriconazole
Anti-gout: colchicines (Colcrys®, Probenecid and Colchicine, COL-Probenecide) Increases colchicine
Anti-infective: clarithromycin (Biaxin®, Biaxin XL®, Prevpac®) Increases clarithromycin
Antimycobacterial:
Rifabutin (Mycobutin®)
Decreases boceprevir
Increases rifabutin
Calcium Channel Blockers,
dihydropyridine:
felodipine (Plendil®),
nifedipine (Procardia®, Adala CC®, Procardia XL®, Afeditab CR®), nicardipine (Cardene SR ®, Cardene®)
Increases dihydropyridine
calcium channel
blockers
Corticosteroid, systemic:
Dexamethasone
Decreases boceprevir
Corticosteroid, inhaled:
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 Non-Nucleoside Reverse Transcriptase Inhibitors: efavirenz (Sustiva®, Atripla®) Decreases boceprevir
HIV Protease Inhibitors: ritonavir (Norvir®, Kaletra®) Decreases boceprevir
Increases or decreases HIV protease inhibitors
HMG-CoA Reductase Inhibitors:
Atorvastatin (Lipitor®)
Increases atorvastatin
Immunosuppressants:
Cyclosporine (Gengraf®, Neoral®, Sandimmune®), sirolimus (Rapamune®), tacrolimus (Prograf®)
Increases immunosuppressants
Inhaled beta-agonist: salmeterol (Advair HFA®, Advair Diskus®, Serevent®) Increases salmeterol
Narcotic Analgesic/Opioid
Dependence:
methadone (Dolophine®),
Buprenorphine (Butrans®, Buprenex®, Suboxone®, Subutex®)
Increases or decreases methadone
Increases or decreases buprenorphine
Oral hormonal contraceptives:
drospirenone/ethinyl estradiol
Increases drospirenone
Decreases ethinyl estradiol
PDE5 inhibitors: sildenafil,
tadalafil, vardenafil (Staxyn®, Levitra®)
Increases sildenafil
Increases tadalafil
Increases vardenafil
Sedative/hypnotics: alprazolam (Xanax®);
IV midazolam
Increases midazolam
Increases alprazolam

For recommendations regarding the coadministration of these medications with Victrelis™ combination therapy please visit www.Merck.com.