Telaprevir (Oral)

Telaprevir is used as a treatment for Hepatitis C alongside two other injectable medicines. It is used as an effective method to reduce the virus within the body, eventually preventing the virus from being able to survive.

Overview

Telaprevir is a medication used in the treatment of Hepatitis C, along with injectable Peginterferon Alfa and Ribavirin, as an efficient way to reduce the amount of Hepatitis C virus in the body. However, treatment with Telaprevir may not stop or prevent the spread of hepatitis C to other people.

This medication belongs to a class of drugs under the name protease inhibitors and acts as a way to inhibit the proteolytic cleavage of the HCV encoded polyprotein, which can prevent the virus from surviving within the body.

The US brand name for this medication was Incivek. However, this brand of Telaprevir was discontinued in 2014 in favor of new direct-acting antiviral agents that were proven to be better tolerated, more effective and more convenient.

Conditions Treated

Telaprevir, in combination with injectable Peginterferon Alfa and Ribavirin, is used to treat the following conditions:

  • Hepatitis C infection

Type of Medicine

  • Protease Inhibitor
  • By Mouth Tablet

Side Effects

Alongside the effects Telaprevir is designed to produce, this medication may also cause some negative side effects. Not all, if any, of these side effects, will occur in every patient, but if they do happen it is vital the patient seeks proper medical attention as soon as possible, depending on the severity of the side effects they are experiencing.

The most severe side effects caused by treatment with Telaprevir are skin reactions, which if not treated as soon as possible can be life-threatening. If any of the side effects listed occur, the patient should request emergency medical treatment immediately to prevent further skin reactions:

  • Blisters
  • Fever
  • Itching
  • Rash
  • Red, swollen, itchy, or teary eyes
  • Sores in the mouth
  • Sores on the skin
  • Swelling of the face

In addition to any skin reactions, If any of the following side effects occur, consult with a medical professional immediately:

  • Upper right abdominal or stomach pain
  • Unusual weight gain
  • Unusual tiredness/weakness
  • Unusual bleeding or bruising
  • Troubled breathing with exertion
  • Swelling of the feet or lower legs
  • Sore throat
  • Shortness of breath
  • Painful/difficult urination
  • Nausea or vomiting
  • Lower back, side, or stomach pain
  • Light-colored stools
  • Joint pain, stiffness, or swelling
  • Joint or muscle pain
  • Itching
  • Headache
  • General tiredness and weakness
  • Fever
  • Drowsiness
  • Difficulty with breathing
  • Diarrhea
  • Dark urine
  • Cough
  • Cloudy urine
  • Chills
  • Blood in urine or stools
  • Bleeding gums
  • Black, tarry stools

During a course of treatment with Telaprevir, some side effects may be present as a result of the treatment that usually does not require medical attention when they initially occur. These side effects may reduce or even go away as the body adapts to the drug or can continue consistently during your treatment cycle.

If any of these side effects appear to increase in severity over time, continue for longer than expected or are particularly uncomfortable, inform a medical professional at your convenience.

The following side effects may occur when taking Telaprevir, but usually, do not require medical attention:

  • Bleeding with stools
  • Uncomfortable swelling around the anus

Telaprevir, as with any medication, can cause a moderate to a severe allergic reaction within the patient. The symptoms of allergic reaction can include:

  • Hives on the face and body
  • Difficulty with breathing
  • Painful swelling of the face, lips, tongue, or throat

If any of the above symptoms occur, the patient should notify a medical professional immediately so they can receive support and treatment for the allergic reaction, and to prevent any further dosages from happening that may worsen the allergic reaction and cause further harm.

If the patient is already known to be allergic to any of the components within Telaprevir, the diagnostic team and medical professional involved in the patient's treatment should be advised as soon as possible to discuss viable alternatives.

Also, as Telaprevir is used in conjunction with both Peginterferon Alfa and Ribavirin, it is crucial that the patient is aware of the side effects and potential allergens in these medications to ensure the safety of the patient and effectiveness of treatment.

Dosage

Incivek, the US brand name for Telaprevir, was available in the following dosages before discontinuation in 2014:

  • 1125 mg orally twice a day (10 to 14 hours apart) with food (not low fat)

The medication comes as a capsule to take by mouth. The standard dose for is six tablets per day, taken two times a day, every 10-14 hours. It is required that the patient eats a meal or snack that contains around 20 grams of fat 30 minutes before they take Incivek.

To be sure this medicine is helping the condition of the patient, frequent blood tests should be undertaken to track progress and observe levels of the Hepatitis C virus within the body. Treatment with Telaprevir may be discontinued based on the results of these tests.

Telaprevir should always be taken with food. Examples of snacks that contain about 20 grams of fat include three tablespoons of peanut butter, a bagel and cream cheese, 2 ounces of potato chips, 2 ounces of American or cheddar cheese, a half-cup of nuts or trail mix, or 1 cup of ice cream.

It is essential to drink plenty of liquids while you are taking this medicine, as well as not eating a low-fat diet that may prevent this medication from performing adequately.

Taking Telaprevir precisely as directed is key to effective treatment. More or less of this drug should not be taken, and patients should stick strictly to the amount prescribed by your doctor. Even if the patient is feeling better, they should not discontinue their treatment without direction from a relevant medical professional.

It is essential to take a missed dose as soon as you remember it. However, if it more than 6 hours past your treatment time, skip the missed dose and continue your regular medication schedule. Do not take a larger or double dose to make up for a missed one as this can result in further issues including potential overdose.

If you're unsure if you've taken your medication for that day, do not take the second dose just in case. If you've experienced any of the following symptoms and believe you have taken more Telaprevir than prescribed, then you may have taken an overdose and should request emergency medical help immediately:

  • Blurred vision
  • Diarrhea
  • Dizziness or light-headedness that occurs when getting up from a lying or sitting position suddenly
  • Indigestion
  • Pain or weakness in the hands or feet
  • Passing of gas
  • Stomach fullness or discomfort
  • Sweating
  • Trembling

Interaction

Many drugs can interact with other medicines within the human body, both those currently being taken and those taken recently, which can lead to changing effects of medication and even additional side effects that can cause the drug to become less effective or even actively cause negative effects to the patient.

Patients and physicians should keep an up-to-date list of all medications and diagnostic drugs currently in use to prevent issues with adverse drug interaction. This allows the doctor to build an entirely realized picture of the patient's medical history and any current or past reactions to drugs that may influence the medical professional's decision to prescribe Telaprevir as a viable medication.

It's critical that the patient's doctor is aware of every drug within their system, from long-term medication to over the counter drugs, and makes sure their doctor knows their current and recent medication usage. This ensures that treatment is more effective and is less likely to cause issues to the patient.

The following medications can cause a severe interaction when taken with Telaprevir, and is is recommended for the patient to contact their healthcare professional urgently if already taking one of these medications:

  • Alfuzosin
  • Ziprasidone
  • Venetoclax
  • Triazolam
  • Tolvaptan
  • Thioridazine
  • Terfenadine
  • Tadalafil
  • St John's Wort
  • Sparfloxacin
  • Simvastatin
  • Sildenafil
  • Saquinavir
  • Romidepsin
  • Riociguat
  • Rifampin
  • Primidone
  • Pimozide
  • Phenytoin
  • Phenobarbital
  • Pazopanib
  • Nimodipine
  • Nelfinavir
  • Naloxegol
  • Midazolam
  • Methylergonovine
  • Mesoridazine
  • Maraviroc
  • Lurasidone
  • Lovastatin
  • Lomitapide
  • Ketoconazole
  • Ivabradine
  • Isavuconazonium Sulfate
  • Fosphenytoin
  • Fluconazole
  • Flibanserin
  • Ergotamine
  • Ergonovine
  • Eplerenone
  • Eletriptan
  • Dronedarone
  • Doxorubicin Hydrochloride Liposome
  • Doxorubicin
  • Dihydroergotamine
  • Conivaptan
  • Colchicine
  • Cisapride
  • Carbamazepine
  • Bepridil
  • Amisulpride
  • Amifampridine

The following medications can cause a moderate interaction when taken with Triamterene, and it is recommended for the patient to contact their healthcare professional if already taking one of these medications or if both medications are taken together unintentionally:

  • Ado-Trastuzumab Emtansine
  • Zuclopenthixol
  • Zolpidem
  • Voriconazole
  • Vorapaxar
  • Vinflunine
  • Vincristine Sulfate Liposome
  • Vincristine
  • Vilazodone
  • Vilanterol
  • Vemurafenib
  • Vardenafil
  • Vandetanib
  • Triptorelin
  • Trabectedin
  • Topotecan
  • Tipranavir
  • Telithromycin
  • Tamsulosin
  • Tacrolimus
  • Suvorexant
  • Sulpiride
  • Sotalol
  • Sonidegib
  • Sirolimus
  • Simeprevir
  • Sevoflurane
  • Salmeterol
  • Ruxolitinib
  • Rivaroxaban
  • Rifabutin
  • Retapamulin
  • Regorafenib
  • Reboxetine
  • Quinidine
  • Quetiapine
  • Propafenone
  • Prednisone
  • Posaconazole
  • Ponatinib
  • Pixantrone
  • Pitolisant
  • Piperaquine
  • Pimavanserin
  • Pasireotide
  • Panobinostat
  • Palbociclib
  • Oxycodone
  • Orlistat
  • Olaparib
  • Nilotinib
  • Nifedipine
  • Nevirapine
  • Nafarelin
  • Moxifloxacin
  • Morphine Sulfate Liposome
  • Morphine
  • Mifepristone
  • Metronidazole
  • Methylprednisolone
  • Manidipine
  • Macitentan
  • Lumefantrine
  • Lopinavir
  • Lidocaine
  • Levomilnacipran
  • Levofloxacin
  • Leuprolide
  • Ivacaftor
  • Irinotecan Liposome
  • Irinotecan
  • Ifosfamide
  • Idelalisib
  • Ibrutinib
  • Hydroxyzine
  • Hydroxychloroquine
  • Hydrocodone
  • Histrelin
  • Goserelin
  • Gonadorelin
  • Fosaprepitant
  • Fosamprenavir
  • Fluticasone
  • Flecainide
  • Fentanyl
  • Everolimus
  • Eszopiclone
  • Escitalopram
  • Erythromycin
  • Erlotinib
  • Enzalutamide
  • Donepezil
  • Domperidone
  • Digoxin
  • Dexamethasone
  • Deslorelin
  • Delamanid
  • Degarelix
  • Darunavir
  • Daclatasvir
  • Dabrafenib
  • Dabigatran Etexilate
  • Cyclosporine
  • Cyclophosphamide
  • Cobimetinib
  • Clozapine
  • Clarithromycin
  • Cilostazol
  • Ceritinib
  • Cariprazine
  • Calcifediol
  • Cabozantinib
  • Cabazitaxel
  • Buserelin
  • Budesonide
  • Bromocriptine
  • Brexpiprazole
  • Bosutinib
  • Bedaquiline
  • Axitinib
  • Avanafil
  • Atorvastatin
  • Artemether
  • Arsenic Trioxide
  • Aripiprazole
  • Aprepitant
  • Apixaban
  • Anagrelide
  • Amprenavir
  • Amlodipine
  • Amiodarone
  • Alfentanil
  • Afatinib

Using this medication with any of the following drugs may carry an increased risk of certain side effects, but using both drugs together may be the best treatment for you. If both medications are prescribed together, your doctor may change the dose or how often you use one or both of the medicines to achieve the best results:

  • Norgestrel
  • Norgestimate
  • Norethindrone
  • Norelgestromin
  • Methadone
  • Mestranol
  • Medroxyprogesterone Acetate
  • Levonorgestrel
  • Etonogestrel
  • Ethynodiol Diacetate
  • Ethinyl Estradiol
  • Estradiol Valerate
  • Estradiol Cypionate
  • Efavirenz
  • Drospirenone
  • Dienogest
  • Desogestrel
  • Atazanavir
  • Alprazolam

Certain drugs should generally not be used at or around the time of eating food, both in general or specific food types, as interactions may occur. Using alcohol or tobacco with certain medications may also cause interactions to occur.

The main interaction with Telaprevir is food itself - as food significantly increases the absorption of this medication. It is advised that 30 minutes before you take each dose of Telaprevir, you should eat a meal or snack containing approximately 20 grams of fat. Taking this medication on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication.

Other pre-existing medical conditions may also impact the use of this medicine, or cause alternative side effects. Ensure a medical professional is informed if you have any other medical conditions or problems, as this medication can make these illnesses recurrent or worse:

  • Anemia
  • Gout
  • Hepatitis b (HBV)
  • Human immunodeficiency virus (HIV)
  • Liver disease other than hepatitis c
  • Organ transplant
  • Problems with your immune system

Warnings

Telaprevir's pregnancy category (FDA) is X. Though this medication by itself is not harmful to an unborn baby, it is given together with Ribavirin and Peginterferon Alfa. Ribavirin is known to potentially cause birth defects or other harm, including death, in an unborn baby, which makes this course of treatment not suitable for patients currently pregnant or looking to get pregnant. If female patients undergoing this course of treatment may need to prove that they are not pregnant using a negative pregnancy test prior to using these medications to ensure safety, as well as every month during treatment.

Should the patient suspect they are pregnant, or become pregnant, during a course of treatment, it is essential to contact a medical professional immediately to discuss the next step of the process.

In order the prevent pregnancy during treatment with Telaprevir, Peginterferon Alfa, and Ribavirin, it is recommended that the following precautions are taken:

  • A least two non-hormonal types of birth control should be used while either person is using Incivek with ribavirin and peginterferon alfa. 2 methods of birth control should be used for at least six months post treatment.
  • For female patients, it is not advised to use Telaprevir with Ribavirin and Peginterferon Alfa if you are pregnant.
  • For male patients, it is not advised to use Telaprevir with Ribavirin and Peginterferon Alfa if your partner is likely to be pregnant. The fetus could also be harmed or have complication if a man fathers the child while he is taking this medication.

Hormonal contraception (birth control pills, implants, injections and skin patches) might not be effective enough for the prevention of pregnancy during treatment. The patient should consult with their doctor about non-hormone methods of birth control (such as an IUD, condom, diaphragm with spermicide, etc.) in order to efficiently prevent pregnancy while taking Telaprevir, Ribavirin and Peginterferon Alfa.

It is unknown whether Telaprevir passes on through breast milk or if it could be of harm to a nursing baby. It is not recommended to breastfeed a baby while taking this medicine.

If the patient is suffering from ongoing vomiting or diarrhea either due to illness or other means, or if you are sweating more than usual, it is easy to become dehydrated when taking Telaprevir. It is recommended that the patient tries to maintain a high level of hydration, and if this is not viable, they should contact a medical professional as soon as possible.

If the patient is expected to undergo any form of surgery, including dental surgery, during the period they are taking Telaprevir, the doctor or dentist performing this operation should be made aware that the patient is currently taking the medication to prevent issues or complications related.

It is important to note that this medication does not prevent the spread of Hepatitis C from one person to another. It is advised that the patient should not share razors/toothbrushes, or have unprotected sex. Sharing needles from drugs or medicine is never safe, and is never recommended or advised.

Storage

Telaprevir should be stored medicine in the container it came in, tightly closed, and out of reach of children. This medication should be kept away from excess heat and moisture (such as bathrooms and kitchens).

Telaprevir is always placed by pharmacies in a tight, light-resistant container. This medication should be stored at a temperature of 25°C (77°F); though temperatures between 15° - 30°C (59° - 86°F) are within the acceptable range for correct storing of this medication without causing any adverse effects.

Unneeded or extra medications should be disposed of correctly to ensure that pets, children, and other people cannot consume them accidentally, as this may cause harm. However, you should not flush this or any other drugs down the toilet. Rather, the best way to dispose of your medication is through a medication take-back program. Talk to a pharmacist or a local garbage/recycling department to learn more about take-back programs in the local community.

All medication, including Telaprevir, should always be stored out of sight and reach of children, pets and any other vulnerable parties as a best practice. Many containers, especially those where medication has been removed from usual storage, are not developed to be child-resistant - such as daily pill minders. To protect young children from poisoning or other medication-related illness, always ensure safety caps are locked and immediately store the medication in a secure place after use.

Summary

Telaprevir is a medication used for the effective treatment of Hepatitis C, an is administered alongside with injectable Peginterferon Alfa and Ribavirin, as a way to reduce the amount of Hepatitis C virus in the body.

This medication belongs to a class of drugs under the name protease inhibitors and acts as a way to inhibit the proteolytic cleavage of the HCV encoded polyprotein, which can prevent the virus from surviving within the body.

During treatment, the patient will still be able to spread Hepatitis C to other individuals, and as such certain precautions such as safe sex, not using the same razor and toothbrush should be adhered to as per the recommendation of your doctor. This medication works over time to lower the amount of virus in the body.

This medication requires food with high-fat content to be efficiently absorbed into the body, and as such is not suitable for those whose pre-existing medical conditions need a low-fat diet. It is also very easy to become dehydrated when undergoing this treatment, and therefore keeping a proper hydration level is highly recommended.

Also, Telaprevir in combination with Peginterferon Alfa and Ribavirin is not recommended as a medication to use during pregnancy, as Ribavirin is known to cause both congenital disabilities and other pregnancy issues that may render the pregnancy unviable. Due to this, it is recommended that multiple forms of non-hormonal birth control are used during the time the patient is undergoing treatment, whether they are male or female.

The US brand name for this medication was Incivek. However, this brand of Telaprevir was discontinued in 2014 in favor of new direct-acting antiviral agents that were proven to be better tolerated, more effective and more convenient.

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Last Reviewed:
December 24, 2017
Last Updated:
April 05, 2018
Content Source: