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Identification
NameTelaprevir
Accession NumberDB05521
TypeSmall Molecule
GroupsApproved
Description

Telaprevir (VX-950) is a highly selective and potent inhibitor of the HCV NS3-4A serine protease. It is a member of a class of antiviral drugs known as protease inhibitors and is the first hepatitis C drug that has demonstrated activity in patients who have failed prior therapy. On April 28, 2011, the FDA Antiviral Drugs Advisory Committee voted 18-0 to recommend approval telaprevir for people with genotype 1 chronic hepatitis C and was approved in the U.S. in May, 2011.

Structure
Thumb
Synonyms
(1S,3AR,6as)-(2S)-2-cyclohexyl-N-(pyrazinylcarbonyl)glycyl-3-methyl-L-valyl-N-((1S)-1-((cyclopropylamino)oxoacetyl)butyl)octahydrocyclopenta(c)pyrrole-1-carboxamide
Incivek
MP-424
VX 950
VX-950
External Identifiers
  • AIDS-213006
  • AIDS213006
  • LY-570310
  • VRT111950
  • VX-950
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Incivektablet375 mgoralVertex Pharmaceuticals (Canada) Incorporated2011-10-032015-04-21Canada
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International BrandsNot Available
Brand mixturesNot Available
SaltsNot Available
Categories
UNII655M5O3W0U
CAS number402957-28-2
WeightAverage: 679.8493
Monoisotopic: 679.405732463
Chemical FormulaC36H53N7O6
InChI KeyInChIKey=BBAWEDCPNXPBQM-GDEBMMAJSA-N
InChI
InChI=1S/C36H53N7O6/c1-5-10-25(29(44)34(48)39-23-15-16-23)40-33(47)28-24-14-9-13-22(24)20-43(28)35(49)30(36(2,3)4)42-32(46)27(21-11-7-6-8-12-21)41-31(45)26-19-37-17-18-38-26/h17-19,21-25,27-28,30H,5-16,20H2,1-4H3,(H,39,48)(H,40,47)(H,41,45)(H,42,46)/t22-,24-,25-,27-,28-,30+/m0/s1
IUPAC Name
(3S)-3-{[(1S,3aR,6aS)-2-[(2S)-2-[(2S)-2-cyclohexyl-2-(pyrazin-2-ylformamido)acetamido]-3,3-dimethylbutanoyl]-octahydrocyclopenta[c]pyrrol-1-yl]formamido}-N-cyclopropyl-2-oxohexanamide
SMILES
[H][C@@]12CCC[C@]1([H])[[email protected]](N(C2)C(=O)[C@@H](NC(=O)[C@@H](NC(=O)C1=NC=CN=C1)C1CCCCC1)C(C)(C)C)C(=O)N[C@@H](CCC)C(=O)C(=O)NC1CC1
Taxonomy
DescriptionThis compound belongs to the class of organic compounds known as hybrid peptides. These are compounds containing at least two different types of amino acids (alpha, beta, gamma, delta) linked to each other through a peptide bond.
KingdomOrganic compounds
Super ClassOrganic acids and derivatives
ClassCarboxylic acids and derivatives
Sub ClassAmino acids, peptides, and analogues
Direct ParentHybrid peptides
Alternative Parents
Substituents
  • Hybrid peptide
  • N-acyl-alpha amino acid or derivatives
  • Alpha-amino acid amide
  • N-substituted-alpha-amino acid
  • Pyrazinecarboxamide
  • Pyrazine carboxylic acid or derivatives
  • Pyrrolidine-2-carboxamide
  • Pyrrolidine carboxylic acid or derivatives
  • N-acylpyrrolidine
  • Fatty acyl
  • Pyrazine
  • N-acyl-amine
  • Fatty amide
  • Heteroaromatic compound
  • Tertiary carboxylic acid amide
  • Pyrrolidine
  • Cyclic alcohol
  • Alpha-aminoketone
  • Tertiary amine
  • Secondary carboxylic acid amide
  • Ketone
  • Carboxamide group
  • Azacycle
  • Organoheterocyclic compound
  • Carboxylic acid amide
  • Hydrocarbon derivative
  • Organooxygen compound
  • Organonitrogen compound
  • Carbonyl group
  • Amine
  • Aromatic heteropolycyclic compound
Molecular FrameworkAromatic heteropolycyclic compounds
External Descriptors
Pharmacology
IndicationTreating chronic hepatitis C virus (genotype 1) infection in patients with compensated liver (due to liver diseases like cirrhosis) that are treatment naive or have failed therapy with interferons (either null or partial responders and treatment relapsers).
PharmacodynamicsTelaprevir is a direct-acting antiviral agent (DAA) against the hepatitis C virus. In a biochemical assay, telaprevir inhibited the proteolytic activity of the recombinant HCV NS3 protease domain with an IC50 value of 10 nM.
Mechanism of actionTelaprevir is an inhibitor of the HCV NS3/4A serine protease, necessary for the proteolytic cleavage of the HCV encoded polyprotein into mature forms of the NS4A, NS4B, NS5A and NS5B proteins and essential for viral replication. It belongs to the chemical class of alpha-ketoamids and binds to NS3/4A in a covalent but reversible manner.
Related Articles
AbsorptionTelaprevir is orally available, most likely absorbed in the small intestine, with no evidence for absorption in the colon. Maximum plasma concentrations after a single dose of telaprevir are generally achieved after 4 to 5 hours. In vitro studies performed with human Caco-2 cells indicated that telaprevir is a substrate of P-glycoprotein (P-gp). Exposure to telaprevir is higher during co-administration of peginterferon alfa and ribavirin than after administration of telaprevir alone. Dissolution of telaprevir is not dependent by pH.
Volume of distribution

Apparent volume of distribution (Vd/F) = 252 L. This large volume of distribution suggests extensive penetration into tissues.

Protein binding59% to 76% and binds to alpha 1-acid glycoprotein and albumin in a concentration dependent manner.
Metabolism

Telaprevir is extensively metabolized in the liver, involving hydrolysis, oxidation, and reduction. Multiple metabolites were detected in feces, plasma, and urine. After repeated-oral administration, the R-diastereomer of telaprevir (30-fold less active), pyrazinoic acid, and a metabolite that underwent reduction at the α-ketoamide bond of telaprevir (not active) were found to be the predominant metabolites of telaprevir. In vitro studies using recombinant human cytochrome P450 (CYP) isoforms indicated that CYP3A4 was the major CYP isoform responsible for telaprevir metabolism. However, non-CYP mediated metabolism likely plays a role after multiple dosing of telaprevir.

SubstrateEnzymesProduct
Telaprevir
Not Available
Pyrazinoic acidDetails
Route of eliminationFollowing administration of a single oral dose of 750 mg 14C-telaprevir in healthy subjects, 90% of total radioactivity was recovered in feces, urine and expired air within 96 hours post-dose. The median recovery of the administered radioactive dose was approximately 82% in the feces, 9% in exhaled air and 1% in urine. The contribution of unchanged 14C-telaprevir and the R-diastereomer of telaprevir towards total radioactivity recovered in feces was 31.9% and 18.8%, respectively.
Half lifeThe mean elimination half-life after single-dose oral administration of telaprevir 750 mg typically ranged from about 4.0 to 4.7 hours. At steady state, the effective half-life is about 9 to 11 hours.
Clearance

After oral administration, the apparent total clearance (Cl/F) was estimated to be 32.4 L/h with an inter-individual variability of 27.2%.

ToxicityThe highest documented dose administered is 1875 mg every 8 hours for 4 days in healthy subjects with telaprevir alone. In that study, the following common adverse events were reported more frequently with the 1875 mg q8h regimen compared to the 750 mg q8h regimen: nausea, headache, diarrhea, decreased appetite, dysgeusia, and vomiting. The two most common adverse events that caused the discontinuation of treatment are anemia and rash.
Affected organisms
  • Hepatitis C virus, RSV and other RNA/DNA viruses
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
ADMET
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.9547
Blood Brain Barrier-0.9659
Caco-2 permeable-0.7982
P-glycoprotein substrateSubstrate0.8567
P-glycoprotein inhibitor IInhibitor0.9355
P-glycoprotein inhibitor IIInhibitor0.8879
Renal organic cation transporterNon-inhibitor0.8919
CYP450 2C9 substrateNon-substrate0.8245
CYP450 2D6 substrateNon-substrate0.6612
CYP450 3A4 substrateSubstrate0.7632
CYP450 1A2 substrateNon-inhibitor0.6961
CYP450 2C9 inhibitorInhibitor0.5969
CYP450 2D6 inhibitorNon-inhibitor0.7431
CYP450 2C19 inhibitorInhibitor0.5866
CYP450 3A4 inhibitorInhibitor0.8926
CYP450 inhibitory promiscuityHigh CYP Inhibitory Promiscuity0.8476
Ames testNon AMES toxic0.7536
CarcinogenicityNon-carcinogens0.8622
BiodegradationNot ready biodegradable0.9954
Rat acute toxicity2.6980 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9894
hERG inhibition (predictor II)Inhibitor0.6931
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397 )
Pharmacoeconomics
ManufacturersNot Available
PackagersNot Available
Dosage forms
FormRouteStrength
Tabletoral375 mg
PricesNot Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US7820671 No2005-02-252025-02-25Us
US8431615 No2008-05-302028-05-30Us
US8529882 No2001-08-312021-08-31Us
Properties
StateSolid
Experimental Properties
PropertyValueSource
water solubility0.0047 mg/mLFDA Label
Predicted Properties
PropertyValueSource
Water Solubility0.0355 mg/mLALOGPS
logP2.56ALOGPS
logP2.58ChemAxon
logS-4.3ALOGPS
pKa (Strongest Acidic)11.86ChemAxon
pKa (Strongest Basic)-0.69ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count8ChemAxon
Hydrogen Donor Count4ChemAxon
Polar Surface Area179.56 Å2ChemAxon
Rotatable Bond Count14ChemAxon
Refractivity180.04 m3·mol-1ChemAxon
Polarizability74.37 Å3ChemAxon
Number of Rings5ChemAxon
Bioavailability0ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleYesChemAxon
Spectra
Mass Spec (NIST)Not Available
SpectraNot Available
References
Synthesis Reference

Znabet A, Polak MM, Janssen E, de Kanter FJ, Turner NJ, Orru RV, Ruijter E. A highly efficient synthesis of telaprevir by strategic use of biocatalysis and multicomponent reactions. Chem Commun (Camb). 2010 Nov 14;46(42):7918-20. Epub 2010 Sep 20.

General References
  1. Kim JJ, Culley CM, Mohammad RA: Telaprevir: an oral protease inhibitor for hepatitis C virus infection. Am J Health Syst Pharm. 2012 Jan 1;69(1):19-33. doi: 10.2146/ajhp110123. [PubMed:22180548 ]
  2. Liu-Young G, Kozal MJ: Hepatitis C protease and polymerase inhibitors in development. AIDS Patient Care STDS. 2008 Jun;22(6):449-57. doi: 10.1089/apc.2007.0199. [PubMed:18479202 ]
  3. Forestier N, Zeuzem S: Telaprevir for the treatment of hepatitis C. Expert Opin Pharmacother. 2012 Mar;13(4):593-606. doi: 10.1517/14656566.2012.660524. Epub 2012 Feb 15. [PubMed:22332992 ]
  4. Garg V, Kauffman RS, Beaumont M, van Heeswijk RP: Telaprevir: pharmacokinetics and drug interactions. Antivir Ther. 2012;17(7):1211-21. doi: 10.3851/IMP2356. Epub 2012 Sep 7. [PubMed:22954756 ]
External Links
ATC CodesJ05AE11
AHFS Codes
  • 8:18.40
PDB EntriesNot Available
FDA labelDownload (508 KB)
MSDSDownload (88.2 KB)
Interactions
Drug Interactions
Drug
Ado-trastuzumab emtansineThe serum concentration of the active metabolites of ado-trastuzumab emtansine can be increased when ado-trastuzumab emtansine is used in combination with Telaprevir.
AfatinibThe serum concentration of Afatinib can be increased when it is combined with Telaprevir.
AlfuzosinThe serum concentration of Alfuzosin can be increased when it is combined with Telaprevir.
AlmotriptanThe serum concentration of Almotriptan can be increased when it is combined with Telaprevir.
AlosetronThe serum concentration of Alosetron can be increased when it is combined with Telaprevir.
AlprazolamThe serum concentration of Alprazolam can be increased when it is combined with Telaprevir.
AmiodaroneThe risk or severity of adverse effects can be increased when Telaprevir is combined with Amiodarone.
ApixabanThe serum concentration of Apixaban can be increased when it is combined with Telaprevir.
AripiprazoleThe serum concentration of Aripiprazole can be increased when it is combined with Telaprevir.
AstemizoleThe serum concentration of Astemizole can be increased when it is combined with Telaprevir.
AtazanavirThe serum concentration of Telaprevir can be decreased when it is combined with Atazanavir.
AtorvastatinThe serum concentration of Atorvastatin can be increased when it is combined with Telaprevir.
AvanafilThe serum concentration of Avanafil can be increased when it is combined with Telaprevir.
AxitinibThe serum concentration of Axitinib can be increased when it is combined with Telaprevir.
BarnidipineThe serum concentration of Barnidipine can be increased when it is combined with Telaprevir.
BedaquilineThe serum concentration of Bedaquiline can be increased when it is combined with Telaprevir.
BepridilThe risk or severity of adverse effects can be increased when Telaprevir is combined with Bepridil.
BetamethasoneThe serum concentration of Telaprevir can be decreased when it is combined with Betamethasone.
BexaroteneThe serum concentration of Telaprevir can be decreased when it is combined with Bexarotene.
BortezomibThe serum concentration of Bortezomib can be increased when it is combined with Telaprevir.
BosentanThe serum concentration of Telaprevir can be decreased when it is combined with Bosentan.
BosutinibThe serum concentration of Bosutinib can be increased when it is combined with Telaprevir.
Brentuximab vedotinThe serum concentration of Brentuximab vedotin can be increased when it is combined with Telaprevir.
BrexpiprazoleThe serum concentration of Brexpiprazole can be increased when it is combined with Telaprevir.
BrinzolamideThe serum concentration of Brinzolamide can be increased when it is combined with Telaprevir.
BudesonideThe serum concentration of Budesonide can be increased when it is combined with Telaprevir.
CabazitaxelThe serum concentration of Cabazitaxel can be increased when it is combined with Telaprevir.
CabozantinibThe serum concentration of Cabozantinib can be increased when it is combined with Telaprevir.
CarbamazepineThe serum concentration of Carbamazepine can be increased when it is combined with Telaprevir.
CeritinibThe serum concentration of Ceritinib can be increased when it is combined with Telaprevir.
ChlorotrianiseneThe serum concentration of Chlorotrianisene can be decreased when it is combined with Telaprevir.
CilostazolThe serum concentration of Cilostazol can be increased when it is combined with Telaprevir.
CisaprideThe serum concentration of Cisapride can be increased when it is combined with Telaprevir.
ClarithromycinThe serum concentration of Telaprevir can be increased when it is combined with Clarithromycin.
CobicistatThe serum concentration of Telaprevir can be increased when it is combined with Cobicistat.
ColchicineThe serum concentration of Colchicine can be increased when it is combined with Telaprevir.
ConivaptanThe serum concentration of Conivaptan can be increased when it is combined with Telaprevir.
CorticotropinThe serum concentration of Telaprevir can be decreased when it is combined with Corticotropin.
Cortisone acetateThe serum concentration of Telaprevir can be decreased when it is combined with Cortisone acetate.
CrizotinibThe serum concentration of Crizotinib can be increased when it is combined with Telaprevir.
CyclosporineThe serum concentration of Cyclosporine can be increased when it is combined with Telaprevir.
Dabigatran etexilateThe serum concentration of the active metabolites of Dabigatran etexilate can be increased when Dabigatran etexilate is used in combination with Telaprevir.
DabrafenibThe serum concentration of Telaprevir can be decreased when it is combined with Dabrafenib.
DaclatasvirThe serum concentration of Daclatasvir can be increased when it is combined with Telaprevir.
DapoxetineThe serum concentration of Dapoxetine can be increased when it is combined with Telaprevir.
DarunavirThe serum concentration of Telaprevir can be decreased when it is combined with Darunavir.
DasatinibThe serum concentration of Dasatinib can be increased when it is combined with Telaprevir.
DeferasiroxThe serum concentration of Telaprevir can be decreased when it is combined with Deferasirox.
DexamethasoneThe serum concentration of Telaprevir can be decreased when it is combined with Dexamethasone.
DienogestThe serum concentration of Dienogest can be decreased when it is combined with Telaprevir.
DigoxinThe serum concentration of Digoxin can be increased when it is combined with Telaprevir.
DihydroergotamineThe serum concentration of Dihydroergotamine can be increased when it is combined with Telaprevir.
DofetilideThe serum concentration of Dofetilide can be increased when it is combined with Telaprevir.
DomperidoneThe serum concentration of Domperidone can be increased when it is combined with Telaprevir.
DoxorubicinThe serum concentration of Doxorubicin can be increased when it is combined with Telaprevir.
DronabinolThe serum concentration of Dronabinol can be increased when it is combined with Telaprevir.
DronedaroneThe serum concentration of Dronedarone can be increased when it is combined with Telaprevir.
DutasterideThe serum concentration of Dutasteride can be increased when it is combined with Telaprevir.
EdoxabanThe serum concentration of Edoxaban can be increased when it is combined with Telaprevir.
EfavirenzThe serum concentration of Telaprevir can be decreased when it is combined with Efavirenz.
EletriptanThe serum concentration of Eletriptan can be increased when it is combined with Telaprevir.
EliglustatThe serum concentration of Eliglustat can be increased when it is combined with Telaprevir.
EnzalutamideThe serum concentration of Telaprevir can be decreased when it is combined with Enzalutamide.
EplerenoneThe serum concentration of Eplerenone can be increased when it is combined with Telaprevir.
Ergoloid mesylateThe serum concentration of Ergoloid mesylate can be increased when it is combined with Telaprevir.
ErgonovineThe serum concentration of Ergonovine can be increased when it is combined with Telaprevir.
ErgotamineThe serum concentration of Ergotamine can be increased when it is combined with Telaprevir.
ErlotinibThe serum concentration of Erlotinib can be increased when it is combined with Telaprevir.
ErythromycinThe serum concentration of Erythromycin can be increased when it is combined with Telaprevir.
EscitalopramThe serum concentration of Escitalopram can be decreased when it is combined with Telaprevir.
EstazolamThe serum concentration of Estazolam can be increased when it is combined with Telaprevir.
EtizolamThe serum concentration of Etizolam can be increased when it is combined with Telaprevir.
EtonogestrelThe serum concentration of Etonogestrel can be decreased when it is combined with Telaprevir.
EtravirineThe serum concentration of Telaprevir can be decreased when it is combined with Etravirine.
EverolimusThe serum concentration of Everolimus can be increased when it is combined with Telaprevir.
FentanylThe serum concentration of Fentanyl can be increased when it is combined with Telaprevir.
FesoterodineThe serum concentration of the active metabolites of Fesoterodine can be increased when Fesoterodine is used in combination with Telaprevir.
FlecainideThe risk or severity of adverse effects can be increased when Telaprevir is combined with Flecainide.
FlibanserinThe serum concentration of Flibanserin can be increased when it is combined with Telaprevir.
FluconazoleThe metabolism of Telaprevir can be decreased when combined with Fluconazole.
FludrocortisoneThe serum concentration of Telaprevir can be decreased when it is combined with Fludrocortisone.
FlunisolideThe serum concentration of Flunisolide can be increased when it is combined with Telaprevir.
Fluticasone furoateThe serum concentration of Fluticasone furoate can be increased when it is combined with Telaprevir.
Fluticasone PropionateThe serum concentration of Fluticasone Propionate can be increased when it is combined with Telaprevir.
FluvastatinThe serum concentration of Fluvastatin can be increased when it is combined with Telaprevir.
FosamprenavirThe serum concentration of Telaprevir can be decreased when it is combined with Fosamprenavir.
FosphenytoinThe serum concentration of Fosphenytoin can be increased when it is combined with Telaprevir.
Fusidic AcidThe serum concentration of Telaprevir can be increased when it is combined with Fusidic Acid.
GuanfacineThe serum concentration of Guanfacine can be increased when it is combined with Telaprevir.
HalofantrineThe serum concentration of Halofantrine can be increased when it is combined with Telaprevir.
HydrocodoneThe serum concentration of Hydrocodone can be increased when it is combined with Telaprevir.
HydrocortisoneThe serum concentration of Telaprevir can be decreased when it is combined with Hydrocortisone.
IbrutinibThe serum concentration of Ibrutinib can be increased when it is combined with Telaprevir.
IdelalisibThe serum concentration of Telaprevir can be increased when it is combined with Idelalisib.
IfosfamideThe serum concentration of the active metabolites of Ifosfamide can be reduced when Ifosfamide is used in combination with Telaprevir resulting in a loss in efficacy.
IloperidoneThe serum concentration of the active metabolites of Iloperidone can be increased when Iloperidone is used in combination with Telaprevir.
ImatinibThe serum concentration of Imatinib can be increased when it is combined with Telaprevir.
ImidafenacinThe serum concentration of Imidafenacin can be increased when it is combined with Telaprevir.
IrinotecanThe serum concentration of the active metabolites of Irinotecan can be increased when Irinotecan is used in combination with Telaprevir.
IsavuconazoniumThe serum concentration of the active metabolites of Isavuconazonium can be increased when Isavuconazonium is used in combination with Telaprevir.
ItraconazoleThe serum concentration of Itraconazole can be increased when it is combined with Telaprevir.
IvabradineThe serum concentration of Ivabradine can be increased when it is combined with Telaprevir.
IvacaftorThe serum concentration of Ivacaftor can be increased when it is combined with Telaprevir.
IxabepiloneThe serum concentration of Ixabepilone can be increased when it is combined with Telaprevir.
KetoconazoleThe serum concentration of Telaprevir can be increased when it is combined with Ketoconazole.
LacosamideThe serum concentration of Lacosamide can be increased when it is combined with Telaprevir.
LapatinibThe serum concentration of Lapatinib can be increased when it is combined with Telaprevir.
LedipasvirThe serum concentration of Ledipasvir can be increased when it is combined with Telaprevir.
LercanidipineThe serum concentration of Lercanidipine can be increased when it is combined with Telaprevir.
LevobupivacaineThe serum concentration of Levobupivacaine can be increased when it is combined with Telaprevir.
LevomilnacipranThe serum concentration of Levomilnacipran can be increased when it is combined with Telaprevir.
LevonorgestrelThe serum concentration of Levonorgestrel can be decreased when it is combined with Telaprevir.
LidocaineThe risk or severity of adverse effects can be increased when Telaprevir is combined with Lidocaine.
LomitapideThe serum concentration of Lomitapide can be increased when it is combined with Telaprevir.
LopinavirThe serum concentration of Telaprevir can be decreased when it is combined with Lopinavir.
LovastatinThe serum concentration of Lovastatin can be increased when it is combined with Telaprevir.
LuliconazoleThe serum concentration of Telaprevir can be increased when it is combined with Luliconazole.
LumefantrineThe serum concentration of Lumefantrine can be increased when it is combined with Telaprevir.
LurasidoneThe serum concentration of Lurasidone can be increased when it is combined with Telaprevir.
MacitentanThe serum concentration of MACITENTAN can be increased when it is combined with Telaprevir.
MaravirocThe serum concentration of Maraviroc can be increased when it is combined with Telaprevir.
Medroxyprogesterone AcetateThe serum concentration of Medroxyprogesterone Acetate can be decreased when it is combined with Telaprevir.
MethadoneThe serum concentration of Methadone can be decreased when it is combined with Telaprevir.
MethylergometrineThe serum concentration of Methylergometrine can be increased when it is combined with Telaprevir.
MethylprednisoloneThe serum concentration of Telaprevir can be decreased when it is combined with Methylprednisolone.
MidazolamThe serum concentration of Midazolam can be increased when it is combined with Telaprevir.
MifepristoneThe serum concentration of Mifepristone can be increased when it is combined with Telaprevir.
MitotaneThe serum concentration of Telaprevir can be decreased when it is combined with Mitotane.
NaloxegolThe serum concentration of Naloxegol can be increased when it is combined with Telaprevir.
NelfinavirThe metabolism of Telaprevir can be decreased when combined with Nelfinavir.
NetupitantThe serum concentration of Telaprevir can be increased when it is combined with Netupitant.
NilotinibThe serum concentration of Nilotinib can be increased when it is combined with Telaprevir.
NimodipineThe serum concentration of Nimodipine can be increased when it is combined with Telaprevir.
NintedanibThe serum concentration of Nintedanib can be increased when it is combined with Telaprevir.
NisoldipineThe serum concentration of Nisoldipine can be increased when it is combined with Telaprevir.
NorethisteroneThe serum concentration of Norethindrone can be decreased when it is combined with Telaprevir.
OlaparibThe serum concentration of Olaparib can be increased when it is combined with Telaprevir.
OspemifeneThe serum concentration of Ospemifene can be increased when it is combined with Telaprevir.
OxybutyninThe serum concentration of Oxybutynin can be increased when it is combined with Telaprevir.
OxycodoneThe risk or severity of adverse effects can be increased when Telaprevir is combined with Oxycodone.
PalbociclibThe serum concentration of Palbociclib can be increased when it is combined with Telaprevir.
PanobinostatThe serum concentration of Panobinostat can be increased when it is combined with Telaprevir.
ParecoxibThe serum concentration of Parecoxib can be increased when it is combined with Telaprevir.
ParicalcitolThe serum concentration of Paricalcitol can be increased when it is combined with Telaprevir.
PazopanibThe serum concentration of Pazopanib can be increased when it is combined with Telaprevir.
PhenobarbitalThe serum concentration of Telaprevir can be decreased when it is combined with Phenobarbital.
PhenytoinThe serum concentration of Phenytoin can be increased when it is combined with Telaprevir.
PimecrolimusThe metabolism of Pimecrolimus can be decreased when combined with Telaprevir.
PimozideThe serum concentration of Pimozide can be increased when it is combined with Telaprevir.
PitavastatinThe serum concentration of Pitavastatin can be increased when it is combined with Telaprevir.
PonatinibThe serum concentration of Ponatinib can be increased when it is combined with Telaprevir.
PosaconazoleThe serum concentration of Posaconazole can be increased when it is combined with Telaprevir.
PranlukastThe serum concentration of Pranlukast can be increased when it is combined with Telaprevir.
PrasugrelThe serum concentration of the active metabolites of Prasugrel can be reduced when Prasugrel is used in combination with Telaprevir resulting in a loss in efficacy.
PravastatinThe serum concentration of Pravastatin can be increased when it is combined with Telaprevir.
PrednisoloneThe serum concentration of Telaprevir can be decreased when it is combined with Prednisolone.
PrednisoneThe serum concentration of Telaprevir can be decreased when it is combined with Prednisone.
PrimidoneThe serum concentration of Telaprevir can be decreased when it is combined with Primidone.
PropafenoneThe risk or severity of adverse effects can be increased when Telaprevir is combined with Propafenone.
PrucaloprideThe serum concentration of Prucalopride can be increased when it is combined with Telaprevir.
QuetiapineThe serum concentration of Quetiapine can be increased when it is combined with Telaprevir.
QuinidineThe risk or severity of adverse effects can be increased when Telaprevir is combined with Quinidine.
RamelteonThe serum concentration of Ramelteon can be increased when it is combined with Telaprevir.
RanolazineThe serum concentration of Ranolazine can be increased when it is combined with Telaprevir.
RegorafenibThe serum concentration of Regorafenib can be increased when it is combined with Telaprevir.
RepaglinideThe serum concentration of Repaglinide can be increased when it is combined with Telaprevir.
Repository corticotropinThe serum concentration of Telaprevir can be decreased when it is combined with Repository corticotropin.
RetapamulinThe serum concentration of Retapamulin can be increased when it is combined with Telaprevir.
RifabutinThe serum concentration of Telaprevir can be decreased when it is combined with Rifabutin.
RifampicinThe serum concentration of Telaprevir can be decreased when it is combined with Rifampicin.
RifapentineThe serum concentration of Telaprevir can be decreased when it is combined with Rifapentine.
RifaximinThe serum concentration of Rifaximin can be increased when it is combined with Telaprevir.
RilpivirineThe serum concentration of Rilpivirine can be increased when it is combined with Telaprevir.
RitonavirThe serum concentration of Telaprevir can be decreased when it is combined with Ritonavir.
RivaroxabanThe serum concentration of Rivaroxaban can be increased when it is combined with Telaprevir.
RomidepsinThe serum concentration of Romidepsin can be increased when it is combined with Telaprevir.
RosuvastatinThe serum concentration of Rosuvastatin can be increased when it is combined with Telaprevir.
RuxolitinibThe serum concentration of Ruxolitinib can be increased when it is combined with Telaprevir.
SalmeterolThe serum concentration of Salmeterol can be increased when it is combined with Telaprevir.
SaquinavirThe serum concentration of Telaprevir can be increased when it is combined with Saquinavir.
SaxagliptinThe serum concentration of Saxagliptin can be increased when it is combined with Telaprevir.
SildenafilThe serum concentration of Sildenafil can be increased when it is combined with Telaprevir.
SilodosinThe serum concentration of Silodosin can be increased when it is combined with Telaprevir.
SiltuximabThe serum concentration of Telaprevir can be decreased when it is combined with Siltuximab.
SimeprevirThe serum concentration of Simeprevir can be increased when it is combined with Telaprevir.
SimvastatinThe serum concentration of Simvastatin can be increased when it is combined with Telaprevir.
SirolimusThe serum concentration of Sirolimus can be increased when it is combined with Telaprevir.
SonidegibThe serum concentration of Sonidegib can be increased when it is combined with Telaprevir.
SorafenibThe serum concentration of Sorafenib can be increased when it is combined with Telaprevir.
St. John's WortThe serum concentration of Telaprevir can be decreased when it is combined with St. John's Wort.
StiripentolThe serum concentration of Telaprevir can be increased when it is combined with Stiripentol.
SuvorexantThe serum concentration of Suvorexant can be increased when it is combined with Telaprevir.
TacrolimusThe serum concentration of Tacrolimus can be increased when it is combined with Telaprevir.
TadalafilThe serum concentration of Tadalafil can be increased when it is combined with Telaprevir.
TamsulosinThe serum concentration of Tamsulosin can be increased when it is combined with Telaprevir.
TasimelteonThe serum concentration of Tasimelteon can be increased when it is combined with Telaprevir.
TelithromycinThe serum concentration of Telaprevir can be increased when it is combined with Telithromycin.
TenofovirThe serum concentration of Tenofovir can be increased when it is combined with Telaprevir.
TerfenadineThe serum concentration of Terfenadine can be increased when it is combined with Telaprevir.
TicagrelorThe serum concentration of the active metabolites of Ticagrelor can be reduced when Ticagrelor is used in combination with Telaprevir resulting in a loss in efficacy.
TipranavirThe serum concentration of Telaprevir can be decreased when it is combined with Tipranavir.
TocilizumabThe serum concentration of Telaprevir can be decreased when it is combined with Tocilizumab.
TofacitinibThe serum concentration of Tofacitinib can be increased when it is combined with Telaprevir.
TolterodineThe serum concentration of Tolterodine can be increased when it is combined with Telaprevir.
TolvaptanThe serum concentration of Tolvaptan can be increased when it is combined with Telaprevir.
TopotecanThe serum concentration of Topotecan can be increased when it is combined with Telaprevir.
ToremifeneThe risk or severity of adverse effects can be increased when Telaprevir is combined with Toremifene.
TrabectedinThe serum concentration of Trabectedin can be increased when it is combined with Telaprevir.
TramadolThe serum concentration of Tramadol can be increased when it is combined with Telaprevir.
TrazodoneThe serum concentration of Trazodone can be increased when it is combined with Telaprevir.
TriamcinoloneThe serum concentration of Telaprevir can be decreased when it is combined with Triamcinolone.
TriazolamThe serum concentration of Triazolam can be increased when it is combined with Telaprevir.
UlipristalThe serum concentration of Ulipristal can be increased when it is combined with Telaprevir.
VardenafilThe serum concentration of Vardenafil can be increased when it is combined with Telaprevir.
VemurafenibThe serum concentration of Vemurafenib can be increased when it is combined with Telaprevir.
VerapamilThe serum concentration of Telaprevir can be increased when it is combined with Verapamil.
VilazodoneThe serum concentration of Vilazodone can be increased when it is combined with Telaprevir.
VincristineThe serum concentration of Vincristine can be increased when it is combined with Telaprevir.
VindesineThe serum concentration of Vindesine can be increased when it is combined with Telaprevir.
VorapaxarThe serum concentration of Vorapaxar can be increased when it is combined with Telaprevir.
VoriconazoleThe serum concentration of Telaprevir can be increased when it is combined with Voriconazole.
WarfarinThe serum concentration of Warfarin can be decreased when it is combined with Telaprevir.
ZolpidemThe serum concentration of Zolpidem can be decreased when it is combined with Telaprevir.
ZopicloneThe serum concentration of Zopiclone can be increased when it is combined with Telaprevir.
ZuclopenthixolThe serum concentration of Zuclopenthixol can be increased when it is combined with Telaprevir.
Food Interactions
  • St. John's wort is a CYP3A4 inducer which will decrease levels of telaprevir.

Targets

Kind
Protein
Organism
Hepatitis C virus
Pharmacological action
yes
Actions
inhibitor
General Function:
Serine-type peptidase activity
Specific Function:
Not Available
Gene Name:
NS3/4A
Uniprot ID:
B0B3C9
Molecular Weight:
72789.28 Da
References
  1. Liu-Young G, Kozal MJ: Hepatitis C protease and polymerase inhibitors in development. AIDS Patient Care STDS. 2008 Jun;22(6):449-57. doi: 10.1089/apc.2007.0199. [PubMed:18479202 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrateinhibitor
General Function:
Vitamin d3 25-hydroxylase activity
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation reactions (e.g. caffeine 8-oxidation, omeprazole sulphoxidation, midazolam 1'-hydroxylation and midazolam 4-hydroxylation) of structurally unrelated compounds, including steroids, fatty acids, and xenobiot...
Gene Name:
CYP3A4
Uniprot ID:
P08684
Molecular Weight:
57342.67 Da
References
  1. Kim JJ, Culley CM, Mohammad RA: Telaprevir: an oral protease inhibitor for hepatitis C virus infection. Am J Health Syst Pharm. 2012 Jan 1;69(1):19-33. doi: 10.2146/ajhp110123. [PubMed:22180548 ]

Carriers

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Toxic substance binding
Specific Function:
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloidal osmotic pressure of blood. Major zinc transporter in plasma, typically binds about 80% of all plasma zinc.
Gene Name:
ALB
Uniprot ID:
P02768
Molecular Weight:
69365.94 Da
References
  1. Garg V, Kauffman RS, Beaumont M, van Heeswijk RP: Telaprevir: pharmacokinetics and drug interactions. Antivir Ther. 2012;17(7):1211-21. doi: 10.3851/IMP2356. Epub 2012 Sep 7. [PubMed:22954756 ]
Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Not Available
Specific Function:
Functions as transport protein in the blood stream. Binds various ligands in the interior of its beta-barrel domain. Also binds synthetic drugs and influences their distribution and availability in the body. Appears to function in modulating the activity of the immune system during the acute-phase reaction.
Gene Name:
ORM1
Uniprot ID:
P02763
Molecular Weight:
23511.38 Da
References
  1. Garg V, Kauffman RS, Beaumont M, van Heeswijk RP: Telaprevir: pharmacokinetics and drug interactions. Antivir Ther. 2012;17(7):1211-21. doi: 10.3851/IMP2356. Epub 2012 Sep 7. [PubMed:22954756 ]

Transporters

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
substrate
General Function:
Xenobiotic-transporting atpase activity
Specific Function:
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name:
ABCB1
Uniprot ID:
P08183
Molecular Weight:
141477.255 Da
References
  1. Kiang TK, Wilby KJ, Ensom MH: Telaprevir: clinical pharmacokinetics, pharmacodynamics, and drug-drug interactions. Clin Pharmacokinet. 2013 Jul;52(7):487-510. doi: 10.1007/s40262-013-0053-x. [PubMed:23553423 ]
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Drug created on November 18, 2007 11:25 / Updated on May 28, 2016 02:12