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What Is Telaprevir?

By Maggie J. Hall
Updated May 17, 2024
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Physicians prescribe the antiviral medication telaprevir in conjunction with peginterferon alfa and ribavirin for the treatment of the hepatitis C virus (HCV). The HCV drug not only increases the likelihood of disabling the virus but also may decrease the amount of time patients require treatment. The treatment regimen may cause anemia and typically produces flu-like symptoms. Telaprevir interacts with many prescribed medications.

Telaprevir is a protease inhibitor antiviral medication that interferes with the NS3/4A serine protease. This enzyme is responsible for protein maturity and protein adhesion. When these processes are inhibited, the virus cannot replicate. Genotype 1 hepatitis C virus is the most common strain of the disease and is also most resistant to treatment. Treating HCV does not completely eliminate the virus from the body. The medications, however, usually decrease the viral load to the point where the infection becomes undetectable.

Conventional therapy typically involved a combination regimen of peginterferon alfa and ribavirin taken for 24 to 48 weeks. Some patients experience difficulty adhering to the treatment as prescribed because of the length of therapy. Other patients discontinue therapy because of the side effects associated with the medications. Of the individuals adhering to the prescribed therapy, up to one half experienced a resurgence of the virus.

Adding telaprevir to the therapy regimen demonstrated evidence of decreased viral loads at anywhere from four to 12 weeks. The drastic rate and quality of improvement witnessed in patients during trial studies allowed physicians to decrease the time required for peginterferon alfa and ribavirin administration. The recommended dosage of telaprevir is 750 milligrams three times a day, up to 30 minutes after consuming food containing at least 20% fat. Optimal treatment requires patients take telaprevir for 12 weeks. Patients must continue the other prescribed medications for another 12 to 36 weeks.

Side effects of telaprevir include nausea, vomiting, and diarrhea to the extent of developing rectal irritation. Individuals may also develop anemia experienced as dizziness, shortness of breath, and fatigue followed by generalized weakness. Hematological effects also include decreased numbers of platelets and white blood cells, making patients more susceptible to infection. Patients exhibiting blisters, lesions, or rash on the skin or in the mouth should notify a physician. Individuals should also report fevers, facial swelling, and any reddening of the eyes that resembles conjunctivitis.

Prior to receiving telaprevir treatment, patients must disclose all medical conditions and current medications taken. Pregnant women cannot undergo the therapy regimen because of possible interference with normal cellular reproduction, and physicians strongly recommend that women use at least two forms of contraception during treatment. The antiviral medication also interacts with numerous medications, including anti-infectives, cholesterol lowering agents, and certain cardiac formulations.

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