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Drug Interactions between Eliquis and telaprevir

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Major

telaprevir apixaban

Applies to: telaprevir and Eliquis (apixaban)

GENERALLY AVOID: Coadministration with potent inhibitors of CYP450 3A4 that can also inhibit P-glycoprotein (P-gp) may significantly increase the plasma concentrations of apixaban, which is a substrate of both the isoenzyme and efflux transporter. The risk of bleeding associated with apixaban may be increased. When apixaban was coadministered with the dual P-gp and potent CYP450 3A4 inhibitor, ketoconazole (400 mg once daily), mean apixaban peak plasma concentration (Cmax) and systemic exposure (AUC) increased by approximately 1.6- and 2-fold, respectively. The systemic exposure may be increased even more in patients with significant renal impairment.

MANAGEMENT: The use of apixaban should either be avoided or the dosage reduced during concomitant systemic treatment with dual P-gp and potent CYP450 3A4 inhibitors. In addition, some authorities recommend avoiding concomitant use of apixaban during and for 2 weeks after treatment with itraconazole. For patients receiving apixaban 5 mg or 10 mg twice daily, the prescribing information recommends reducing the dosage by 50%. In patients already taking apixaban at a dosage of 2.5 mg twice daily (e,g., patients meeting at least 2 of the following criteria: age >=80 years; body weight <=60 kg; serum creatinine >=1.5 mg/dL), coadministration with dual P-gp and potent CYP450 3A4 inhibitors should be avoided.

References

  1. (2002) "Product Information. Sporanox (itraconazole)." Janssen Pharmaceuticals
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."
  4. (2012) "Product Information. Eliquis (apixaban)." Bristol-Myers Squibb Canada Inc
View all 4 references

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Drug and food interactions

Moderate

telaprevir food

Applies to: telaprevir

ADJUST DOSING INTERVAL: Food significantly enhances the oral bioavailability of telaprevir. When given with a meal containing 533 kcal and 21 g fat, telaprevir systemic exposure (AUC) increased by 237% compared to administration under fasting conditions. The type of meal also affects the exposure to telaprevir. Relative to fasting, telaprevir AUC increased by approximately 117% with a low-fat meal (249 kcal; 3.6 g fat) and 330% with a high-fat meal (928 kcal; 56 g fat). In Phase 3 clinical trials, telaprevir doses were administered within 30 minutes of completing a meal or snack containing approximately 20 grams of fat.

MANAGEMENT: Telaprevir should be administered with food containing approximately 20 grams of fat. Patients should be advised that the fat content of the meal or snack is critical to the absorption of telaprevir. Food taken with telaprevir should be ingested within 30 minutes prior to each dose. Examples of some foods that could be taken with telaprevir include: bagel with cream cheese; half cup of nuts; 3 tablespoons of peanut butter; 1 cup of ice cream; 2 ounces of American or cheddar cheese; 2 ounces of potato chips; or half cup of trail mix.

References

  1. (2011) "Product Information. Incivek (telaprevir)." Vertex Pharmaceuticals

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.