Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Telaprevir
Drug ID BADD_D02142
Description Telaprevir is a direct acting antiviral medication used as part of combination therapy to treat chronic Hepatitis C, an infectious liver disease caused by infection with Hepatitis C Virus (HCV). HCV is a single-stranded RNA virus that is categorized into nine distinct genotypes, with genotype 1 being the most common in the United States, and affecting 72% of all chronic HCV patients [L852]. Treatment options for chronic Hepatitis C have advanced significantly since 2011, with the development of Direct Acting Antivirals (DAAs) such as Telaprevir. Telaprevir is an inhibitor of NS3/4A, a serine protease enzyme, encoded by HCV genotype 1 [FDA Label]. These enzymes are essential for viral replication and serve to cleave the virally encoded polyprotein into mature proteins like NS4A, NS4B, NS5A and NS5B. The barrier for develoment of resistance to NS3/4A inhibitors is lower than that of NS5B inhibitors, another class of DAAs [A19593]. Subtitutions at amino acid positions 155, 156, or 168 are known to confer resistance. The substitutions of the enzyme's catalytic triad consisting of H58, D82, and S139 are also likely to alter the affinity of the drug for NS3/4A or the activity of the enzyme itself. Despite this disadvantage Telaprevir is still effective against HCV when paired with [DB00811], [DB00008], and [DB00022]. Telaprevir, [DB00811], [DB00008], and [DB00022] were used with the intent to cure, or achieve a sustained virologic response (SVR), after 12 weeks of daily administration of the combination therapy followed by 12 or 36 weeks of therapy with [DB00811], [DB00008], and [DB00022]. SVR and eradication of HCV infection is associated with significant long-term health benefits including reduced liver-related damage, improved quality of life, reduced incidence of Hepatocellular Carcinoma, and reduced all-cause mortality [A19626]. Telaprevir was available as a fixed dose product (tradename Incivek) used for the treatment of chronic Hepatitis C. Approved in May 2011 by the FDA, Incivek was indicated for the treatment of HCV genotype 1 in combination with [DB00811], [DB00008], and [DB00022] [FDA Label]. Incivek has since been withdrawn from the market.
Indications and Usage Telaprevir, when used in combination with [DB00811], [DB00008], and [DB00022] is indicated for use in the treatment of chronic HCV genotype 1 infection in adults [FDA Label].
Marketing Status Discontinued
ATC Code J05AP02
DrugBank ID DB05521
KEGG ID D09012
MeSH ID C486464
PubChem ID 3010818
TTD Drug ID D0X9CH
NDC Product Code 66039-899; 50370-0034
Synonyms telaprevir | incivek | VX 950 | VX950 cpd | VX-950
Chemical Information
Molecular Formula C36H53N7O6
CAS Registry Number 402957-28-2
SMILES CCCC(C(=O)C(=O)NC1CC1)NC(=O)C2C3CCCC3CN2C(=O)C(C(C)(C)C)NC(=O)C(C4CCCCC4)NC(=O)C 5=NC=CN=C5
Chemical Structure
ADR Related Proteins Induced by Drug
ADR Term Protein Name UniProt AC TTD Target ID PMID
Not AvailableNot AvailableNot AvailableNot AvailableNot Available
ADRs Induced by Drug
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Nausea07.01.07.001--
Nervous system disorder17.02.10.001--Not Available
Oedema peripheral14.05.06.011; 08.01.07.007; 02.05.04.007--
Oral candidiasis11.03.03.004; 07.05.07.001--Not Available
Platelet count decreased13.01.04.001--
Pregnancy18.08.02.004--Not Available
Proctalgia07.03.02.001--
Proctitis07.08.04.001--
Pruritus23.03.12.001--
Pruritus genital23.03.12.008; 21.10.01.002--Not Available
Rash23.03.13.001--Not Available
Rectal haemorrhage07.12.03.001; 24.07.02.018--
Retinal disorder06.08.03.005--Not Available
Shock24.06.02.002--Not Available
Skin disorder23.03.03.007--Not Available
Stevens-Johnson syndrome23.03.01.007; 12.03.01.014; 11.07.01.005; 10.01.03.020--
Swelling face23.04.01.018; 10.01.05.018--Not Available
Syncope24.06.02.012; 17.02.04.008; 02.01.02.008--
Thrombocytopenia01.08.01.002--Not Available
Toxic epidermal necrolysis23.03.01.008; 12.03.01.015; 11.07.01.006; 10.01.01.006--
Urate nephropathy20.05.03.014; 14.09.01.008--Not Available
Urethral disorder20.07.01.002--Not Available
Urinary tract disorder20.08.01.001--Not Available
Urticaria23.04.02.001; 10.01.06.001--
Vomiting07.01.07.003--
White blood cell count decreased13.01.06.012--
Lymphatic disorder01.09.01.003--Not Available
Epidermal necrosis23.03.03.035--Not Available
Infestation23.09.05.001; 11.09.01.001--Not Available
Malnutrition14.03.02.004--Not Available
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