Spotlight Series on Hepatitis C

Victrelis "Not Recommended" With Some HIV Meds

May/June 2012

The new hepatitis C drug Victrelis (boceprevir) is "not recommended" to be taken with some HIV medications, according to a "Dear Doctor" letter issued in February by Merck & Co. Merck reported drug interaction data showing that Victrelis and some HIV medications reduce each other's effectiveness when taken together. As a result, the company does not recommend that Victrelis be taken with any Norvir-boosted HIV protease inhibitor (Aptivus, Crixivan, Invirase, Kaletra, Lexiva, Prezista, or Reyataz).

The Food and Drug Administration (FDA) reported that patients already taking Victrelis along with a boosted HIV protease inhibitor should not stop any of their medications, but consult with their doctor. The FDA also suggested that providers closely monitor these patients for their antiviral response to both treatments.

Along with Victrelis, Incivek (telaprevir), the other new hepatitis C protease inhibitor medication that was FDA approved in May of last year, also interacts with some HIV medications. Of the HIV protease inhibitors, it can only be taken with boosted Reyataz. It can also be taken with Sustiva and Isentress, with an increased dose of Incivek if taken with Sustiva. But the company behind Incivek, Vertex Pharmaceuticals (with development originally by Tibotec Pharmaceuticals), made these interactions known at the time of FDA approval.

In his outstanding blog HIV and ID Observations, Dr. Paul Sax wrote, "For now, the bottom line is that there really is no optimal HCV protease inhibitor for HIV/HCV co-infected patients, especially for those on a boosted PI. And why careful assessment of those with HIV/HCV is critical [since] many patients are stable enough to wait for the next wave of HCV drugs."

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