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The addition of a protease inhibitor to peginterferon and ribavirin for the treatment of chronic hepatitis C virus (HCV) has significantly improved response rates compared with previous regimens. However, it has also added complexity, adverse effects, and concern about drug interactions.
The current review reports the major drug interactions of telaprevir and boceprevir and suggests approaches to managing them for special populations, including patients with HCV infection after liver transplant. For these patients, the main immunosuppressants used are calcineurin inhibitors, such as cyclosporine and tacrolimus. Pharmacokinetic analysis shows that telaprevir and boceprevir slow the clearance of both drugs. The area under the concentration-tim…