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波普瑞韦胶囊Victrelis(boceprevir)

2011-06-27 23:47:46  作者:新特药房  来源:中国新特药网天津分站  浏览次数:552  文字大小:【】【】【
简介:制造商: 默克制药公司 药理分类: 丙型肝炎病毒蛋白酶抑制剂NS3/4A 活性成分(S): Boceprevir 200毫克;上限。 指示(S): 慢性丙型肝炎基因1型感染,与聚乙二醇干扰素α和利巴韦林(PR)的成人患者代 ...

制造商:
默克制药公司

药理分类:
丙型肝炎病毒蛋白酶抑制剂NS3/4A

活性成分(S):
Boceprevir 200毫克;上限。

指示(S):
慢性丙型肝炎基因1型感染,与聚乙二醇干扰素α和利巴韦林(PR)的成人患者代偿性肝病,包括肝硬化,谁是以前未经处理或谁没有以前的干扰素和利巴韦林治疗相结合。不作为单一疗法使用。

药理:
Boceprevir抑制由可逆结合到活动网站上这种酶,在丙型肝炎病毒感染的宿主细胞,从而抑制病毒复制的丙型肝炎病毒(HCV)非结构蛋白3丝氨酸蛋白酶。

临床试验:
在安慰剂对照研究,以增加boceprevir公关显着提高的持续病毒学应答率相比,公关孤单。与基线肝硬化科,持续病毒学反应是在那些谁被赋予了44周(后铅与公关治疗)boceprevir + PR高于给定的反应引导治疗的基础上在治疗结果8到24周。

在另一项研究中,患者谁失败,以前的治疗公关,以公关加入boceprevir显着提高的持续病毒学应答率相比,公关孤单。与那些在基线肝硬化,持续病毒学应答是与boceprevir + PR治疗44周(后铅治疗与PR)的患者相比,谁更高收到的响应引导治疗。

法律分类:
接收

成人:
≥18yrs:取食物。 800毫克,每日三次。 4周后开始用聚乙二醇干扰素和利巴韦林治疗。如果没有肝硬化:继续为8周时表示,12日,24日和HCV - RNA水平(见文献)的治疗。肝硬化:继续为44周。不要减少剂量。如果停止HCV - RNA水平表明徒劳(见文献)。

儿童:
<18yrs:不推荐。

禁忌(S):
伴随有力的CYP3A4 / 5诱导剂(如卡马西平,苯巴比妥,苯妥英钠,利福平,圣约翰草)或狭窄的治疗指数CYP3A4 / 5底物(如,阿夫唑嗪,西沙必利,麦角衍生物,洛伐他汀,辛伐他汀,drosperinone,匹莫齐特,西地那非或他达拉非的PAH,三唑仑,咪达唑仑口服)。怀孕的妇女和男子的伙伴怀孕(注:利巴韦林是Cat.X)。回顾聚乙二醇干扰素和利巴韦林的禁忌。

警告/注意事项:
女患者和合作伙伴必须有( - )治疗前妊娠试验,使用适当,有效的避孕措施,并进行每月的怀孕测试。监控CBC W.差,HCV - RNA。合作与乙肝病毒或艾滋病毒感染。失代偿性肝硬化。器官移植受者。妊娠(Cat.B)。哺乳母亲:不推荐。

交互(S):
见文献。伴随利福布丁,沙美特罗,肾或肝功能不全伴秋水仙碱依非韦伦:不推荐。 Potentiates CYP3A4 / 5底物(如胺碘酮,苄普地尔,普罗帕酮,奎尼丁,氟卡尼,曲唑酮,地昔帕明,唑类抗真菌药,克拉霉素)。拮抗炔雌醇。通过强有力的拮抗CYP3A4 / 5抑制剂。监测华法林,地高辛,二氢吡啶类钙通道阻滞剂,波生坦,蛋白酶抑制剂,免疫抑制剂,阿片类药物。同时服用酮康唑,伊曲康唑:最大200mg/day。同时服用阿托伐他汀:最大20mg/day。秋水仙碱,PDE5的对外债务(例如,西地那非,他达拉非,伐地那非),阿普唑仑,咪达唑仑IV抑制剂:减少剂量和监控。皮质类固醇:避免,如果需要监控。

不良反应(S):
疲劳,恶心,头痛,味觉障碍,越来越严重贫血,中性粒细胞减少。


如何提供:
瓶(12帽/瓶)-28


最后更新:
2011年6月21日

【原产地英文商品名】VICTRELIS 200mg/cap 12caps/bottle 28bottles/box
【原产地英文药品名】BOCEPREVIR
【中文参考商品译名】VICTRELIS 200毫克/胶囊 12胶囊/瓶 28瓶/盒
【中文参考药品译名】BOCEPREVIR
【生产厂家中文参考译名】先灵
【生产厂家英文名】SCHERING

VICTRELIS

Manufacturer:

Merck & Co., Inc.

Pharmacological Class:

HCV NS3/4A protease inhibitor

Active Ingredient(s):

Boceprevir 200mg; caps.

Indication(s):

Chronic hepatitis C genotype 1 infection, in combination with peginterferon alfa and ribavirin (PR) in adult patients with compensated liver disease, including cirrhosis, who are previously untreated or who have failed previous interferon and ribavirin therapy. Not for use as monotherapy.

Pharmacology:

Boceprevir inhibits the hepatitis C virus (HCV) non-structural protein 3 serine protease by reversibly binding to an active site on this enzyme, thereby inhibiting viral replication in HCV-infected host cells.

Clinical Trials:

In a placebo-controlled study, adding boceprevir to PR significantly increased the sustained virologic response rates compared to PR alone. In subjects with cirrhosis at baseline, the sustained virologic response was higher in those who were given boceprevir + PR for 44 weeks (after lead-in therapy with PR) compared to those given response-guided therapy based on results at treatment weeks 8 through 24.

In another study, in patients who failed previous therapy with PR, adding boceprevir to PR significantly increased the sustained virologic response rates compared to PR alone. In those with cirrhosis at baseline, sustained virologic response was higher in patients treated with boceprevir + PR for 44 weeks (after lead-in therapy with PR) compared to those who received response-guided therapy.

Legal Classification:

Rx

Adults:

≥18yrs: Take with food. 800mg three times daily. Start after 4 weeks therapy with peginterferon and ribavirin. Without cirrhosis: continue treatment as indicated by HCV-RNA levels at weeks 8, 12, and 24 (see literature). With cirrhosis: continue for 44 weeks. Do not reduce dose. Discontinue if HCV-RNA levels indicate futility (see literature).

Children:

<18yrs: not recommended.

Contraindication(s):

Concomitant potent CYP3A4/5 inducers (eg, carbamazepine, phenobarbital, phenytoin, rifampin, St. John’s Wort) or narrow therapeutic index CYP3A4/5 substrates (eg, alfuzosin, cisapride, ergot derivatives, lovastatin, simvastatin, drosperinone, pimozide, sildenafil or tadalafil for PAH, triazolam, oral midazolam). Pregnant women and men whose partners are pregnant (note: ribavirin is Cat.X). Review peginterferon and ribavirin contraindications.

Warnings/Precautions:

Female patients and partners must have (–) pregnancy test before therapy, use appropriate effective contraception, and undergo monthly pregnancy test. Monitor CBC w. differential, HCV-RNA. Co-infection with HBV or HIV. Decompensated cirrhosis. Organ transplant recipients. Pregnancy (Cat.B). Nursing mothers: not recommended.

Interaction(s):

See literature. Concomitant rifabutin, salmeterol, efavirenz, concomitant colchicine in renal or hepatic impairment: not recommended. Potentiates CYP3A4/5 substrates (eg, amiodarone, bepridil, propafenone, quinidine, flecainide, trazodone, desipramine, azole antifungals, clarithromycin). Antagonizes ethinyl estradiol. Antagonized by potent CYP3A4/5 inhibitors. Monitor warfarin, digoxin, dihydropyridine calcium channel blockers, bosentan, protease inhibitors, immunosuppressants, opioids. Concomitant ketoconazole, itraconazole: max 200mg/day. Concomitant atorvastatin: max 20mg/day. Colchicine, PDE5 inhibitors for ED (eg, sildenafil, tadalafil, vardenafil), alprazolam, IV midazolam: reduce doses and monitor. Corticosteroids: avoid, monitor if needed.

Adverse Reaction(s):

Fatigue, nausea, headache, dysgeusia, worsening anemia, neutropenia.

How Supplied:

Bottles (12 caps/bottle)—28

Last Updated:

6/21/2011

责任编辑:admin


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