Home Drug Guide Telaprevir

Drug Guide

Generic Name

Telaprevir

Brand Names Incivek

Classification

Therapeutic: Antiviral Agent

Pharmacological: HCV NS3/4A Protease Inhibitor

FDA Approved Indications

  • Treatment of chronic hepatitis C virus (HCV) genotype 1 infection in combination with pegylated interferon and ribavirin

Mechanism of Action

Telaprevir inhibits the HCV NS3/4A protease, an enzyme essential for viral replication, thereby preventing the virus from processing its polyprotein and forming mature viral proteins.

Dosage and Administration

Adult: 750 mg every 8 hours with food for 12 weeks in combination therapy.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dose adjustment; use with caution as per general guidelines.

Renal Impairment: No dosage adjustment needed for mild to moderate impairment; limited data for severe impairment.

Hepatic Impairment: Use with caution; no specific dosing recommendations.

Pharmacokinetics

Absorption: Well absorbed; food increases absorption.

Distribution: Wide distribution including plasma.

Metabolism: Primarily metabolized by CYP3A4 and CYP1A2 enzymes.

Excretion: Primarily feces; minimal urinary excretion.

Half Life: 4-5 hours.

Contraindications

  • Hypersensitivity to telaprevir or any component.
  • Use with drugs highly dependent on CYP3A4 for metabolism and with a narrow therapeutic window.

Precautions

  • Use with caution in patients with severe hepatic impairment.
  • Monitor for rash, anemia, and gastrointestinal side effects.
  • Potential for drug interactions; review all concomitant medications.

Adverse Reactions - Common

  • Rash (Common)
  • Anemia (Common)
  • Discontinuation due to adverse events (Less common)

Adverse Reactions - Serious

  • Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis) (Rare)
  • Hepatotoxicity (Rare, but serious)
  • Anemia leading to atrial fibrillation, heart failure (Rare)

Drug-Drug Interactions

  • Strong CYP3A4 inhibitors and inducers (e.g., ketoconazole, rifampin).
  • Protease inhibitors and drugs metabolized by CYP3A4.
  • HMG-CoA reductase inhibitors (statins).

Drug-Food Interactions

  • None specifically noted.

Drug-Herb Interactions

  • St. John’s Wort.

Nursing Implications

Assessment: Monitor liver function tests, hemoglobin levels, and signs of rash.

Diagnoses:

  • Risk for infection due to immunosuppression.
  • Risk for rash and skin integrity issues.

Implementation: Administer with food. Educate patient regarding adherence and monitoring for adverse effects.

Evaluation: Continual assessment of viral load, hepatic function, and side effects.

Patient/Family Teaching

  • Take medication exactly as prescribed with food.
  • Report signs of rash, jaundice, severe fatigue, or anemia.
  • Avoid organ transplant rejection drugs without consulting a healthcare provider.

Special Considerations

Black Box Warnings:

  • Serious skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis.
  • Hepatotoxicity.

Genetic Factors: None specified.

Lab Test Interference: May cause falsely elevated cholesterol levels.

Overdose Management

Signs/Symptoms: N/A due to limited overdose data.

Treatment: Supportive care; eliminate drug exposure; no specific antidote.

Storage and Handling

Storage: Store at 20-25°C (68-77°F), protected from light.

Stability: Stable under recommended 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.