boceprevir

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.

Victrelis

GENERIC AVAILABLE: No

Yes

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.

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.

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 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.