Interaction [See Clinical Pharmacology (12.3) (Tables 6 and 7) for Magnitude of Interaction.] Concomitant Drug Class:
Drug Name Effect on concentration of INCIVEK or Concomitant Drug Clinical Comment
The direction of the arrow (↑ = increase, ↓ = decrease, ↔ = no change) indicates the direction of the change in PK.
*
These interactions have been studied. See Clinical Pharmacology (12.3), Tables 6 and 7.
ANTIARRHYTHMICS
lidocaine (systemic), amiodarone, bepridil, flecainide, propafenone, quinidine ↑ antiarrhythmics
Co-administration with telaprevir has the potential to produce serious and/or life-threatening adverse events and has not been studied. Caution is warranted and clinical monitoring is recommended when co-administered with telaprevir.
digoxin* ↑ digoxin Concentrations of digoxin were increased when co-administered with telaprevir. The lowest dose of digoxin should be initially prescribed. The serum digoxin concentrations should be monitored and used for titration of digoxin dose to obtain the desired clinical effect.
ANTIBACTERIALS
clarithromycin
erythromycin
telithromycin ↑ telaprevir
↑ antibacterials Concentrations of both telaprevir and the antibacterial may be increased during co-administration. Caution is warranted and clinical monitoring is recommended when co-administered with telaprevir. QT interval prolongation and Torsade de Pointes have been reported with clarithromycin and erythromycin. QT interval prolongation has been reported with telithromycin.
ANTICOAGULANT
warfarin ↑ or ↓ warfarin Concentrations of warfarin may be altered when co-administered with telaprevir. The international normalized ratio (INR) should be monitored when warfarin is co-administered with telaprevir.
ANTICONVULSANTS
carbamazepine
phenobarbital
phenytoin ↓ telaprevir
↑ carbamazepine
↑ or ↓ phenytoin
↑ or ↓ phenobarbital
Concentrations of the anticonvulsant may be altered and concentrations of telaprevir may be decreased. Caution should be used when prescribing carbamazepine, phenobarbital, and phenytoin.
Telaprevir may be less effective in patients taking these agents concomitantly.
Clinical or laboratory monitoring of carbamazepine, phenobarbital, and phenytoin concentrations and dose titration are recommended to achieve the desired clinical response.
ANTIDEPRESSANTS
escitalopram* ↔ telaprevir
↓ escitalopram Concentrations of escitalopram were decreased when co-administered with telaprevir. Selective serotonin reuptake inhibitors such as escitalopram have a wide therapeutic index, but doses may need to be adjusted when combined with telaprevir.
desipramine
trazodone ↑ desipramine
↑ trazodone Concomitant use of trazodone or desipramine and telaprevir may increase plasma concentrations of trazodone or desipramine which may lead to adverse events such as nausea, dizziness, hypotension and syncope. If trazodone or desipramine is used with telaprevir, the combination should be used with caution and a lower dose of trazodone or desipramine should be considered.
ANTIFUNGALS
ketoconazole*
itraconazole
posaconazole
voriconazole ↑ ketoconazole
↑ telaprevir
↑ itraconazole
↑ posaconazole
↑ or ↓ voriconazole Ketocon |
