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ANTIFUNGALS |
ketoconazole*
itraconazole
posaconazole
voriconazole |
↑ ketoconazole
↑ telaprevir
↑ itraconazole
↑ posaconazole
↑ or ↓ voriconazole |
Ketoconazole increases the plasma concentrations of telaprevir. Concomitant systemic use of itraconazole or posaconazole with telaprevir may increase plasma concentration of telaprevir.
Plasma concentrations of itraconazole, ketoconazole, or posaconazole may be increased in the presence of telaprevir. When co-administration is required, high doses of itraconazole or ketoconazole (greater than 200 mg/day) are not recommended. |
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Caution is warranted and clinical monitoring is recommended for itraconazole, posaconazole and voriconazole. |
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QT interval prolongation and Torsade de Pointes have been reported with voriconazole and posaconazole. QT interval prolongation has been reported with ketoconazole.
Due to multiple enzymes involved with voriconazole metabolism, it is difficult to predict the interaction with telaprevir. Voriconazole should not be administered to patients receiving telaprevir unless an assessment of the benefit/risk ratio justifies its use. |
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ANTI GOUT |
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colchicine |
↑ colchicine |
Patients with renal or hepatic impairment should not be given colchicine with telaprevir, due to the risk of colchicine toxicity. A reduction in colchicine dosage or an interruption of colchicine treatment is recommended in patients with normal renal or hepatic function.
Treatment of gout flares: co-administration of colchicine in patients on telaprevir:
0.6 mg (1 tablet) for 1 dose, followed by 0.3 mg (half tablet) 1 hour later. Not to be repeated before 3 days.
If used for prophylaxis of gout flares: co-administration of colchicine in patients on telaprevir:
If the original regimen was 0.6 mg twice a day, the regimen should be adjusted to 0.3 mg once a day.
If the original regimen was 0.6 mg once a day, the regimen should be adjusted to 0.3 mg once every other day.
Treatment of familial Mediterranean fever (FMF): co-administration of colchicine in patients on telaprevir:
Maximum daily dose of 0.6 mg (may be given as 0.3 mg twice a day). |
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ANTIMYCOBACTERIAL |
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rifabutin |
↓ telaprevir
↑ rifabutin |
Concentrations of telaprevir may be decreased, while rifabutin concentrations may be increased during co-administration. Telaprevir may be less effective due to decreased concentrations. The concomitant use of rifabutin and telaprevir is not recommended. |
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BENZODIAZEPINES |
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alprazolam* |
↑ alprazolam |
Concomitant use of alprazolam and telaprevir increases exposure to alprazolam. Clinical monitoring is warranted. |
parenterally administered midazolam*
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↑ midazolam |
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