Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with the hepatitis C virus (HCV) NS3/4A protease inhibitors, boceprevir and telaprevir, may decrease the plasma concentrations and efficacy of estrogens used for hormonal replacement therapy. The mechanism involves induction of CYP450 3A4, the isoenzyme primarily responsible for the metabolic clearance of sex hormones. When an oral contraceptive containing drospirenone-ethinyl estradiol (3 mg-0.02 mg daily for 14 days) was given in combination with boceprevir (800 mg three times daily for 7 days), ethinyl estradiol systemic exposure (AUC) decreased by approximately 25%, with no change in the peak plasma concentration (Cmax). In a study of 24 subjects who were administered an oral contraceptive containing ethinyl estradiol-norethindrone (0.035 mg-0.5 mg daily) concomitantly with telaprevir (750 mg every 8 hours) for 21 days, the Cmax and AUC of ethinyl estradiol decreased by 26% and 28%, respectively. In addition, there was a 33% reduction in the trough plasma concentration (Cmin) of ethinyl estradiol.

MANAGEMENT: Dosage adjustments as well as increased clinical and laboratory monitoring for estrogen deficiency should be considered whenever boceprevir or telaprevir is used concomitantly with estrogens used for hormonal replacement therapy.

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; or half cup of trail mix. Talk to your healthcare provider if you have additional questions about how to take telaprevir.

Information for this minor interaction is available on the professional version.