title: [Drug-drug interaction with telaprevir or boceprevir in liver transplant patients: about four cases].
abstract: Boceprevir and telaprevir are both direct-acting antivirals indicated, as part of combination therapy for the management of chronic hepatitis C virus (HCV) genotype 1 infection. Transplanted patients treated with anticalcineurines (tacrolimus and cyclosporine) are confronted with major risks of interactions. Indeed, these antiviral are strong inhibitors of the enzyme cytochrome 3A4/A5, responsible for the metabolisme of ciclosprine and tacrolimus. The literature gives evidence of the dangerousness of this drug-drug interaction. We report four clinical cases illustrating the dosage adaptations at liver transplant patients and treated by telaprevir or boceprevir. To protect the immunosuppressive efficiency, a multidisciplinary care and narrow monitoring of the interaction between immunosuppressing agents and protease inhibitors were necessary.
authors.affiliation: Département de pharmacie, Centre hospitalier universitaire de Grenoble, La Tronche, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Delaborde
authors.affiliation: Centre régional de pharmacovigilance, Centre hospitalier universitaire de Grenoble, La Tronche, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Logerot
authors.affiliation: Laboratoire de pharmacologie-toxicologie, Centre hospitalier universitaire de Grenoble, La Tronche France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Fonrose
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000008:administration & dosage* / Q000009:adverse effects*; D011392:Proline / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D009842:Oligopeptides; C486464:telaprevir; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline