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Drug Interactions between rifabutin and telaprevir

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

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Interactions between your drugs

Major

rifabutin telaprevir

Applies to: rifabutin and telaprevir

GENERALLY AVOID: Coadministration of rifabutin with boceprevir or telaprevir is expected to increase the plasma concentrations of rifabutin and its metabolite and decrease the plasma concentrations of the hepatitis C virus NS3/4A protease inhibitor. The proposed mechanism involves inhibition of rifabutin 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, resulting in increased systemic exposure (AUC) of rifabutin by 100% to 300% and that of its 25-O-desacetyl metabolite by 13- to 35-fold. Uveitis secondary to rifabutin toxicity has been reported in some cases. The effect of rifabutin on HIV protease inhibitors may vary. Rifabutin had negligible effects on some protease inhibitors but reduced the AUC of others such as indinavir, nelfinavir, and saquinavir by 30% to nearly 50%.

MANAGEMENT: Safe and effective dosages have not been established for the concomitant use of rifabutin with either boceprevir or telaprevir. Coadministration is not recommended.

References (2)
  1. (2011) "Product Information. Victrelis (boceprevir)." Schering-Plough Corporation
  2. (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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