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Protease Inhibitors (PIs) for Hepatitis C

Examples

Generic NameBrand Name
boceprevir Victrelis
telaprevir Incivek

These medicines are usually used along with peginterferon and ribavirin to treat hepatitis C.

How It Works

Protease inhibitors (PIs) are antiretroviral medicines. They prevent the hepatitis C virus from multiplying.

Why It Is Used

Combination antiviral therapy with boceprevir or telaprevir is used to treat people who have ongoing (chronic) hepatitis C infection.

How Well It Works

Adding boceprevir to peginterferon and ribavirin treatment of people who have hepatitis C (genotype 1 only) worked significantly better than using peginterferon and ribavirin alone.1, 2

Adding telaprevir to peginterferon and ribavirin significantly improved hepatitis C treatment in people who have genotype 1.3, 4

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.

Common side effects of this medicine include:

  • Fatigue.
  • Rash or itching.
  • Nausea and diarrhea.
  • Headache.
  • Low red blood cell count (anemia).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

People with normal or slightly elevated liver enzyme levels but whose liver biopsy shows little or no liver damage may choose not to have antiviral treatment. Instead, a doctor can monitor the condition with periodic liver function tests and a liver biopsy every 3 to 5 years.

Even if the initial treatment does not eliminate the virus, your doctor may advise you to continue antiviral treatment, because it may reduce liver inflammation. For some people with significant liver damage, antiviral therapy may slow the progression of liver damage or make liver cancer less likely.5, 6 If you already have cirrhosis, some studies show that antiviral therapy can help you live longer.7

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Pregnancy advice for women and men

If you need to take this medicine, talk to your doctor about how you can prevent pregnancy.

For women: Do not use this medicine if you are pregnant or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

  1. Poordad F, et al. (2011). Boceprevir for untreated chronic HCV genotype 1 infection. New England Journal of Medicine, 364(13): 1195–1206.
  2. Bacon BR, et al. (2011). Boceprevir for previously treated chronic HCV genotype 1 infection. New England Journal of Medicine, 364(13): 1207–1217.
  3. McHutchison JG, et al. (2009). Telaprevir with peginterferon and ribavirin for chronic HCV genotype 1 infection. New England Journal of Medicine, 360(18): 1827–1838.
  4. McHutchison JG, et al. (2009). Telaprevir and peginterferon with or without ribavirin for chronic HCV infection. New England Journal of Medicine, 360(18): 1839–1850.
  5. Singal AK, et al. (2010). Antiviral therapy reduces risk of hepatocellular carcinoma in patients with hepatitis C virus-related cirrhosis, Clinical Gastroenterology and Hepatology, 8(2): 192–199.
  6. Morgan RL, et al. (2013). Eradication of hepatitis C Virus infection and the development of hepatocellular carcinoma: A meta-analysis of observational studies. Annals of Internal Medicine, 158(5, Part 1): 329–337.
  7. Dienstag JL (2010). Chronic viral hepatitis. In GL Mandell et al., eds., Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed., vol. 1, pp. 1593–1670. Philadelphia: Churchill Livingstone Elsevier.

Credits

By Healthwise Staff
E. Gregory Thompson, MD - Internal Medicine
W. Thomas London, MD - Hepatology
Last Revised June 27, 2013

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