Can you take Invirase with Telaprevir?
No drug interactions found, but 15 warnings to review for the following 2 drugs:
- Invirase (saquinavir)
- telaprevir
Drug interactions
There were no interactions found between Invirase and telaprevir. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Therapeutic duplication warnings
Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition.
It can be intentional, when combining drugs with similar actions adds demonstrated therapeutic benefit — or unintentional, such as when a patient sees multiple prescribers or fills prescriptions at more than one pharmacy, which can lead to adverse effects.
Duplication:
Protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'protease inhibitors' category:
- Invirase (saquinavir)
- telaprevir
Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
saquinavir Food/Lifestyle
Applies to: Invirase (saquinavir)
Food can enhance the levels of saquinavir in your body. Saquinavir should be taken with meals or within 2 hours after eating. This will make it easier for your body to absorb the medication.
Grapefruit can raise the levels of saquinavir in your body.
Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
Moderate:
telaprevir Food/Lifestyle
Applies to: telaprevir
Food significantly increases the absorption of telaprevir.
Within 30 minutes before you take each dose of telaprevir, you should eat a meal or snack containing approximately 20 grams of fat.
Taking it on an empty stomach may lead to inadequate blood levels and reduced effectiveness of the medication.
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
- half cup of trail mix
Talk to your healthcare provider if you have additional questions about how to take telaprevir.
Disease interactions
12 potential interactions Applies to: 12 conditions, including High Cholesterol, Heart Failure, Arrhythmia, Hypokalemia, and Diabetes Mellitus.
Abnormal Glucose Tolerance
Moderate:
Invirase
The saquinavir in Invirase has a moderate potential interaction with Abnormal Glucose Tolerance.
New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.
Alcoholism
Moderate:
Invirase
The saquinavir in Invirase has a moderate potential interaction with Alcoholism.
Saquinavir is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from saquinavir due to decreased drug clearance, so therapy should be administered cautiously in these patients. Additionally, there have been reports of worsening liver disease in patients with underlying hepatitis B or C, cirrhosis, chronic alcoholism, and other liver abnormalities. Close monitoring is recommended. The use of saquinavir when administered with ritonavir is contraindicated in patients with severe hepatic impairment.
Arrhythmia
Major:
Invirase
The saquinavir in Invirase has a major potential interaction with Arrhythmia.
QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.
Cardiomyopathy
Major:
Invirase
The saquinavir in Invirase has a major potential interaction with Cardiomyopathy.
QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.
Coagulation Defects and Disorders
Moderate:
Invirase
The saquinavir in Invirase has a moderate potential interaction with Coagulation Defects and Disorders.
There have been reports of increased bleeding, including spontaneous skin hematomas and hemarthrosis, in patients with hemophilia type A and B treated with protease inhibitors; however, a causal relationship has not been established. In some patients, additional factor VIII was given. In more than half of the reported cases, protease inhibitor therapy was continued or reintroduced. Patients with hemophilia or other coagulation defects should be monitored closely for bleeding during protease inhibitor therapy.
Diabetes Mellitus
Moderate:
Invirase
The saquinavir in Invirase has a moderate potential interaction with Diabetes Mellitus.
New onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors. Some patients required either initiation or dosage adjustments of insulin or oral hypoglycemic agents for treatment of these events. In some cases, hyperglycemia persisted despite discontinuation of protease inhibitor therapy. A causal relationship has not been established between protease inhibitor therapy and these events. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during protease inhibitor therapy.
Heart Failure
Major:
Invirase
The saquinavir in Invirase has a major potential interaction with Heart Failure.
QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.
High Cholesterol
Moderate:
Invirase
The saquinavir in Invirase has a moderate potential interaction with High Cholesterol.
Treatment with ritonavir alone or in combination with other protease inhibitors (e.g., lopinavir, saquinavir, tipranavir, fosamprenavir) has resulted in substantial increases in the concentration of total cholesterol and triglycerides. These effects have also been reported with other protease inhibitors but may be the most dramatic with ritonavir. The clinical significance of these elevations is unclear. Marked elevation in triglyceride levels is a risk factor for development of pancreatitis. Triglyceride and cholesterol testing is recommended before starting ritonavir (with or without other protease inhibitors) and periodically during therapy. Lipid disorders should be managed as clinically appropriate.
Hypokalemia
Major:
Invirase
The saquinavir in Invirase has a major potential interaction with Hypokalemia.
QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.
Liver Disease
Moderate:
Invirase
The saquinavir in Invirase has a moderate potential interaction with Liver Disease.
Saquinavir is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from saquinavir due to decreased drug clearance, so therapy should be administered cautiously in these patients. Additionally, there have been reports of worsening liver disease in patients with underlying hepatitis B or C, cirrhosis, chronic alcoholism, and other liver abnormalities. Close monitoring is recommended. The use of saquinavir when administered with ritonavir is contraindicated in patients with severe hepatic impairment.
Magnesium Imbalance
Major:
Invirase
The saquinavir in Invirase has a major potential interaction with Magnesium Imbalance.
QT and PR interval dose-dependent prolongation and torsades de pointes have been reported with the use of saquinavir (saquinavir should always be used in combination with ritonavir). Saquinavir should not be used in patients with congenital long QT syndrome, patients with refractory hypokalemia or hypomagnesemia, or in combination with other drugs that can both prolong the QT interval and increase the plasma concentration of saquinavir. Saquinavir is also contraindicated in patients with a complete atrioventricular (AV) block without an implanted pacemaker or patients at risk of a complete AV block.
Caution and close EKG and electrolyte monitoring is recommended if therapy is initiated in patients with congestive heart failure, bradyarrhythmias, structural heart disease, cardiomyopathies, ischemic heart disease, hepatic impairment, and electrolyte abnormalities.
Renal Dysfunction
Moderate:
Invirase
The saquinavir in Invirase has a moderate potential interaction with Renal Dysfunction.
The principal route of excretion for saquinavir is by hepatic metabolism, therefore no initial dose adjustment is necessary in patients with renal impairment. However, saquinavir has not been studied in patients with severe renal impairment and end-stage renal disease, and caution should be exercised when prescribing this drug to these patients.
More resources
Invirase
A total of 767 drugs are known to interact with Invirase.
- Invirase is in the drug class protease inhibitors.
- Invirase is used to treat the following conditions:
telaprevir
A total of 509 drugs are known to interact with telaprevir.
- Telaprevir is in the drug class protease inhibitors.
- Telaprevir is used to treat Hepatitis C.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.