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Drug Interactions between bosentan and telaprevir

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

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Interactions between your drugs

Moderate

bosentan telaprevir

Applies to: bosentan and telaprevir

MONITOR: Coadministration of bosentan with boceprevir or telaprevir is expected to increase the plasma concentrations of bosentan and decrease the plasma concentrations of the hepatitis C virus (HCV) NS3/4A protease inhibitor. The proposed mechanism involves inhibition of bosentan metabolism via CYP450 3A4 and, conversely, induction of boceprevir and telaprevir metabolism via the same isoenzyme. The interaction has not been specifically studied with either boceprevir or telaprevir, but has been reported with HIV protease inhibitors.

MANAGEMENT: Caution is recommended if bosentan is used in combination with boceprevir or telaprevir. The possibility of prolonged and/or increased pharmacologic effects of bosentan, including serious adverse effects such as hepatotoxicity, should also be considered. Patients should be advised to notify their physician if they experience signs and symptoms of hepatotoxicity such as fever, rash, anorexia, nausea, vomiting, fatigue, right upper quadrant pain, dark urine, and jaundice. Close clinical monitoring of the virologic response to the HCV NS3/4A protease inhibitor is also appropriate.

References (3)
  1. (2001) "Product Information. Tracleer (bosentan)." Actelion Pharmaceuticals US Inc
  2. (2011) "Product Information. Victrelis (boceprevir)." Schering-Plough Corporation
  3. (2011) "Product Information. Incivek (telaprevir)." Vertex Pharmaceuticals

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

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.

See also

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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.

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