Home Drug Guide Boceprevir

Drug Guide

Generic Name

Boceprevir

Brand Names Victrelis

Classification

Therapeutic: Antiviral agent for hepatitis C virus (HCV) infection

Pharmacological: HCV NS3/4A protease inhibitor

FDA Approved Indications

  • Treatment of chronic hepatitis C genotype 1 infection in combination with peginterferon and ribavirin

Mechanism of Action

Boceprevir inhibits the HCV NS3/4A protease, an enzyme crucial for viral replication, thereby reducing viral load.

Dosage and Administration

Adult: 200 mg three times daily in combination with peginterferon alfa and ribavirin for up to 48 weeks.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustments recommended, consider hepatic function.

Renal Impairment: No specific dose adjustment recommended, use with caution.

Hepatic Impairment: Use with caution; avoid in decompensated liver disease.

Pharmacokinetics

Absorption: Well absorbed with food.

Distribution: Bound approximately 75% to plasma proteins.

Metabolism: Primarily via hepatic CYP3A4 enzyme.

Excretion: Metabolites eliminated in feces and urine.

Half Life: 3-4 hours.

Contraindications

  • Hypersensitivity to boceprevir or any component of the formulation.
  • Use with drugs highly dependent on CYP3A4 for clearance and with narrow therapeutic index.

Precautions

  • Use in patients with hepatic impairment, especially decompensated cirrhosis.
  • Monitor hematologic status due to potential anemia and neutropenia.

Adverse Reactions - Common

  • Anemia (Very common)
  • Neutropenia (Common)
  • Fatigue (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Sudden vision loss (rare) (Serious)
  • Allergic reactions including rash, itching, swelling (Rare)
  • Elevations in liver enzymes (Common)

Drug-Drug Interactions

  • Component of multi-drug regimens metabolized by CYP3A4, e.g., certain statins, antiarrhythmics.
  • Use caution with drugs that are CYP3A4 substrates, inhibitors, or inducers.

Drug-Food Interactions

  • No specific interactions reported.

Drug-Herb Interactions

  • Potential interactions with herbal products affecting CYP3A4, such as St. John's Wort.

Nursing Implications

Assessment: Baseline hepatic function and hemoglobin levels.

Diagnoses:

  • Risk for bleeding (due to anemia), Risk for infection (neutropenia).

Implementation: Monitor CBC, liver enzymes, and HCV RNA levels regularly. Ensure adherence to dosing schedule.

Evaluation: Assess viral load response and monitor for adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report signs of anemia, rash, or allergic reactions immediately.
  • Avoid alcohol and hepatotoxic drugs.
  • Attend all follow-up and lab appointments.

Special Considerations

Black Box Warnings:

  • Potential to cause hepatitis exacerbation upon discontinuation.
  • Use with caution in patients with hepatic decompensation.

Genetic Factors: Not specifically indicated.

Lab Test Interference: May affect liver function tests.

Overdose Management

Signs/Symptoms: N/A specific symptoms; may include severity of adverse effects.

Treatment: Supportive care; no specific antidote.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.