Boceprevir is a potent, orally administered ketoamide inhibitor that targets the active site of the hepatitis C virus (HCV) non-structural (NS) 3
protease. The addition of
boceprevir to peginterferon plus
ribavirin resulted in higher rates of sustained virologic response (SVR) than for peginterferon plus
ribavirin alone in phase III studies in both previously treated and untreated patients with HCV
infection. Because
boceprevir is metabolized by metabolic routes common to many other drugs, and is an inhibitor of
cytochrome P450 (CYP) 3A4/5, there is a high potential for
drug-drug interactions when
boceprevir is administered with other
therapies, particularly when treating patients with chronic HCV
infection who are often receiving other medications concomitantly.
Boceprevir is no longer widely used in the US or EU due to the introduction of second-generation treatments for HCV
infection. However, in many other geographic regions, first-generation
protease inhibitors such as
boceprevir continue to form an important treatment option for patients with HCV
infection. This review summarizes the interactions between
boceprevir and other therapeutic agents commonly used in this patient population, indicating dose adjustment requirements where needed. Most drug interactions do not affect
boceprevir plasma concentrations to a clinically meaningful extent, and thus efficacy is likely to be maintained when
boceprevir is coadministered with the majority of other
therapeutics. Overall, the
drug-drug interaction profile of
boceprevir suggests that this agent is suitable for use in a wide range of HCV-infected patients receiving concomitant
therapies.