What is boceprevir, and how does it work (mechanism of action)?
Boceprevir is a man-made antiviral medication that
targets hepatitis C virus (HCV). Similar drugs include
simeprevir
(Olysio) and
telaprevir
(Incivek). These drugs are called direct-acting antiviral agents
because they act directly on
hepatitis C virus. They block the replication of
hepatitis C virus in human cells by binding to and inhibiting protease enzymes
that HCV use for reproducing. Inhibiting viral replication reduces HCV viral
load in the body to undetectable levels in some patients. The FDA approved
boceprevir in March 2011.
What brand names are available for boceprevir?
Victrelis
Is boceprevir available as a generic drug?
GENERIC AVAILABLE: No
Do I need a prescription for boceprevir?
Yes
What are the side effects of boceprevir?
Side effects of boceprevir include hair loss, dry skin,
diarrhea, loss of appetite, nausea, altered taste senses, sleeplessness,
irritability, fatigue, shivering, anemia, and low white blood cell count.
Boceprevir can cause serious skin reactions, including urticaria, angioedema,
Stevens Johnson syndrome (SJS), drug reaction with eosinophilia and systemic
symptoms (DRESS), and exfoliative dermatitis. Boceprevir should be discontinued
if serious skin reactions occur.
What is the dosage for boceprevir?
Which drugs or supplements interact with boceprevir?
Boceprevir should not be combined with alfuzosin
(Uroxatral), doxazosin (Cardura), sildosin (Rapaflo), tamsulosin (Flomax),
sildenafil (Viagra), and tadalafil (Cialis) because it can increase their blood
levels, leading to increased side effects from these drugs.
Boceprevir should not be combined with carbamazepine (Tegretol),
phenobarbital, phenytoin (Dilantin), rifampin, and St. John’s wort because they
can increase the breakdown of boceprevir and decrease its effectiveness.
Boceprevir should not be combined with lovastatin (Mevacor) and simvastatin
(Zocor) due to increased risk of muscle aches, including rhabdomyolysis.
Boceprevir should be combined with midazolam (Versed) and triazolam (Halcion)
because of increased risk of sedation and respiratory depression.
Boceprevir should be used with caution with HIV medications like atazanavir
(Reyataz), ritonavir, (Norvir), darunavir (Prezista), and lopinavir/ritonavir
(Kaletra) because it leads to fluctuating levels of boceprevir and the HIV
medications, leading to decreased effectiveness.
Boceprevir should be used with caution with arrhythmia medications because
the combination can increase the risk of irregular heart rate and rhythm.
Boceprevir should be used with caution with antifungal medications like
ketoconazole (Nizoral), itraconazole (Sporanox), and voriconazole (Vfend);
antibiotics like clarithromycin (Biaxin) and erythromycin (Erythrocin);
immunosuppressant medications like cyclosporine (Gengraf, Neoral, Sandimmune),
tacrolimus (Prograf), and sirolimus (Rapamune). Boceprevir can slow the
breakdown of these medications and increase their levels in the body, leading to
increased side effects and toxicity.
Boceprevir should be used with caution with warfarin (Coumadin) because it
can increase or decrease warfarin (Coumadin) breakdown, increasing or decreasing
the effect of warfarin.
Is boceprevir safe to take if I’m pregnant or breastfeeding?
Boceprevir is combined with ribavirin and peginterferon alfa which
cause fetal harm and birth defects if used in
pregnant women or in male
partners of women who are pregnant. Female patients of childbearing potential
and their male partners as well as male patients and their female partners must
use two effective
birth
control methods during treatment and for 6 months after
treatment. Female patients should have monthly
pregnancy tests during treatment
and for 6 months after stopping treatment.
It is not known whether boceprevir enters
breast milk;
therefore, it is best to be cautious before using it in nursing mothers. To
avoid any potential risk to the newborn, a decision must be made to discontinue
nursing or to discontinue the drug.
What else should I know about boceprevir?
What preparations of boceprevir are available?
Capsule, 200 mg
How should I keep boceprevir stored?
Boceprevir should be refrigerated at 2 C to 8 C (36 F 46 F) until
dispensed. Refrigerated boceprevir can remain stable until the expiration date.
Boceprevir can also be stored at room temperature up to 25 C (77 F) for 3
months. Boceprevir should be stored in tightly closed containers, avoiding
exposure to excessive heat.