How does this medication work? What will it do for me?

Boceprevir is an antiviral agent. Specifically, it belongs to the class of medications known as protease inhibitors. Protease is an enzyme that is needed by viruses for reproduction. Boceprevir blocks the action of protease, slowing the growth of the virus.

This medication is used in combination with peginterferon alfa and ribavirin to treat chronic (long-term) hepatitis C for people who have not been treated before, who have been treated with interferons and have not responded well, and in patients with stable liver disease.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

January 10, 2017

Victrelis is no longer being manufactured for sale in Canada. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

The usual adult dose of boceprevir is 800 mg (four 200 mg capsules) taken 3 times a day (every 7 to 9 hours) with food such as a light meal or snack.

It is important that the dose is not reduced, as this may cause the treatment to fail. Boceprevir must be taken in combination with peginterferon alfa and ribavirin. This helps reduce the risk of the hepatitis C virus becoming resistant to the medication. Boceprevir will only be started once 4 weeks of peginterferon alfa and ribavirin have been completed. The total duration of your treatment will depend on how your virus responds to the treatment.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, and it is more than 2 hours before the next dose is due, take it as soon as possible with food, and continue with your regular schedule. If it is less than 2 hours before the next dose is due, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication in the refrigerator between 2°C and 8°C in the original container. It may be used until the expiration date if it has been refrigerated. Boceprevir may be stored in the original container at room temperature (15°C to 30°C) for up to 3 months. Keep out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to boceprevir or any ingredients of the medication
  • are taking any of the following medications:
    • alfuzosin
    • amiodarone
    • carbamazepine
    • cisapride
    • drospirenone
    • ergot derivatives (e.g., dihydroergotamine, ergotamine)
    • flecainide
    • phenobarbital
    • phenytoin
    • pimozide
    • propafenone
    • quinidine
    • rifampin
    • sildenafil
    • "statin" cholesterol-lowering medications (e.g., atorvastatin, lovastatin, simvastatin)
    • St. John's wort
    • triazolam
    • vardenafil
  • have liver disease caused by the body's immune system
  • have worsening liver failure
  • you or your partner are pregnant or are planning to become pregnant during or up to  6 months after treatment ends

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal pain
  • change in taste sensation
  • diarrhea
  • difficulty sleeping
  • dry skin
  • fatigue
  • headache
  • mouth ulcers or sores
  • muscle or joint pain
  • nausea
  • vomiting
  • weight loss

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • blurred vision
  • dizziness
  • fainting
  • signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
  • signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, cough, headache, stiff neck, weight loss, or listlessness)
  • unusual bruising or bleeding (e.g., blood in the urine, bleeding gums, bloody nose, cuts that take a long time to stop bleeding)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • signs of a serious allergic reaction (shortness of breath, hives, swelling of the mouth, tongue, or throat)
  • signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Anemia: Boceprevir may cause low levels of red blood cells, a condition called anemia. If you experience symptoms of anemia, such as dizziness, shortness of breath, feeling unusually tired, or pale skin, contact your doctor as soon as possible.

Your doctor will do blood tests regularly to monitor the number of specific types of blood cells, including red blood cells, in your blood.

Birth control: Treatment that includes boceprevir can cause severe birth defects to an unborn child. Both partners should use a reliable form of birth control while taking this medication and for 6 months afterwards (the time it takes for ribavirin to be cleared from the body). For women, your doctor will not give you boceprevir until you have had a negative pregnancy test. Your doctor should have you continue to do monthly pregnancy tests to ensure that you do not become pregnant while using this medication.

Methods of birth control that use hormones, such as a birth control pill, patch, or injection, may not be fully reliable as boceprevir interacts with many medications and may change the way that your body uses the hormones. At least 2 forms of non-hormonal birth control (condom, diaphragm) must be used while you are taking this medication.

Drowsiness/reduced alertness: Boceprevir may cause dizziness, fatigue, or blurred vision. Do not drive, operate machinery, or perform other hazardous tasks until you have determined how this medication affects you.

Infection: Boceprevir appears to reduce the number of cells that fight infection in the body (white blood cells). If possible, avoid contact with people with contagious infections. Tell your doctor immediately if you notice signs of an infection, such as fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness. Your doctor will do blood tests regularly to monitor the number of specific types of blood cells in your blood.

Infection with HIV or hepatitis B: The safety and effectiveness of using boceprevir have not been established for people who also have hepatitis B or HIV.

Organ transplantation: The safety and effectiveness of boceprevir treatment have not been established for patients with liver or other organ transplants. Boceprevir may interact with medications used to prevent rejection of the transplanted organ. If you have had an organ transplant, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: Boceprevir has not been studied for use by pregnant women and it must be taken with peginterferon alfa and ribavirin. Ribavirin has been shown to cause serious problems in the developing fetus. As a result, boceprevir (plus peginterferon alfa-2b and ribavirin) should not be used by pregnant women or by men whose partners are pregnant. Both partners should use a reliable form of birth control while taking this medication and for 6 months afterwards. Tell your doctor immediately if you become pregnant while using this medication.

Breast-feeding: It is not known if boceprevir passes into breast milk. Because side effects of this medication could be harmful to the baby, women should not breast-feed while using this medication.

Children and adolescents: The safety and effectiveness of using this medication have not been established for children and adolescents under 18 years of age.

What other drugs could interact with this medication?

There may be an interaction between boceprevir and any of the following:

  • alfuzosin
  • almotriptan
  • amiodarone
  • apixaban
  • aprepitant
  • aripiprazole
  • axitinib
  • "azole" antifungals (e.g., ketoconazole, itraconazole, voriconazole)
  • benzodiazepines (e.g., alprazolam, diazepam, midazolam, triazolam)
  • bosentan
  • bosutinib
  • brinzolamide
  • bromocriptine
  • buprenorphine
  • buspirone
  • busulfan
  • calcitriol
  • calcium channel blockers (e.g., amlodipine, nifedipine, verapamil, nicardipine)
  • carbamazepine
  • chlordiazepoxide
  • chloroquine
  • chlorpheniramine
  • cisapride
  • colchicine
  • conivaptan
  • crizotinib
  • cyclosporine
  • cyproterone
  • dapsone
  • dabrafenib
  • dasatinib
  • deferasirox
  • desipramine
  • digoxin
  • dipyridamole
  • domperidone
  • doxazosin
  • doxorubicin
  • dronedarone
  • drospirenone
  • dutasteride
  • efavirenz
  • enzalutamide
  • eplerenone
  • ergot derivatives (e.g., dihydroergotamine, ergotamine)
  • etoposide
  • everolimus
  • fentanyl
  • fesoterodine
  • flecainide
  • fosphenytoin
  • haloperidol
  • HIV protease inhibitors (e.g., azatanavir, lopinavir, ritonavir)
  • ifosfamide
  • imatinib
  • immunosuppressants (e.g., cyclosporine, sirolimus, tacrolimus)
  • irinotecan
  • isosorbide
  • lapatinib
  • lidocaine
  • lomitapide
  • lurasidone
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • maraviroc
  • mefloquine
  • methadone
  • mirtazapine
  • modafinil
  • nicardipine
  • nilotinib
  • oral contraceptives
  • oral corticosteroids (e.g., budesonide, dexamethasone, methylprednisolone)
  • oxcarbazepine
  • oxycodone
  • paclitaxel
  • phenobarbital
  • phenytoin
  • pimozide
  • propafenone
  • quetiapine
  • quinidine
  • quinine
  • quinolone antibiotics (e.g., ciprofloxacin, moxifloxacin)
  • rifabutin
  • rifampin
  • rifapentine
  • rivaroxaban
  • ruxolitinib
  • salmeterol
  • saxagliptin
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, escitalopram, sertraline)
  • sildenafil
  • silodosin
  • "statin" cholesterol-lowering medications (e.g., atorvastatin, lovastatin, simvastatin)
  • St. John's wort
  • tadalafil
  • tamoxifen
  • tamsulosin
  • telaprevir
  • theophylline
  • ticagrelor
  • tocilizumab
  • tolterodine
  • tolvaptan
  • tramadol
  • trazodone
  • ulipristal
  • vardenafil
  • venlafaxine
  • vinblastine
  • vincristine
  • warfarin
  • zolpidem
  • zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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