Boceprevir and Versed

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using midazolam together with boceprevir is not recommended. Combining these medications may significantly increase the blood levels and effects of midazolam, which can lead to increased or prolonged drowsiness and breathing difficulties. Death may occur as a result of excessive midazolam levels. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

CONTRAINDICATED: Coadministration with the hepatitis C virus (HCV) NS3/4A protease inhibitors, boceprevir and telaprevir, may significantly increase the plasma concentrations and pharmacologic effects of orally administered midazolam and triazolam. The mechanism involves inhibition of intestinal and hepatic CYP450 3A4, the isoenzyme primarily responsible for the metabolic clearance of these benzodiazepines. When a single 4 mg oral dose of midazolam was given in combination with boceprevir (800 mg three times daily for 6 days), midazolam peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 2.8- and 5.3-fold, respectively. Likewise, in 21 study subjects, administration of a single 2 mg oral dose of midazolam during treatment with telaprevir (750 mg every 8 hours for 11 days) increased the midazolam Cmax and AUC by an average of 2.9- and 9.0-fold, respectively, compared to administration alone. When a single 0.5 mg intravenous dose of midazolam was given during treatment with telaprevir in 22 study subjects, midazolam Cmax was not significantly altered, but AUC increased by an average of 3.4-fold. No data are available for triazolam; however, a similar interaction is expected.

MANAGEMENT: Given the potential for prolonged and/or increased sedation and respiratory depression associated with excessive benzodiazepine blood levels, concomitant use of oral midazolam or triazolam with HCV NS3/4A protease inhibitors is considered contraindicated. Caution and close clinical monitoring are recommended when administering parenteral midazolam in combination with these protease inhibitors. Appropriate medical management should be readily available in case of respiratory depression and/or prolonged sedation. Dosage adjustment for midazolam may be appropriate, especially if more than a single dose of midazolam is administered.

Boceprevir

Generic Name: boceprevir

Brand name: Victrelis

Synonyms: Boceprevir (Oral)

What is Boceprevir?

Versed

Generic Name: midazolam

Brand name: Versed, Nayzilam

Synonyms: n.a.

What is Versed?