Telzir (fosamprenavir)

How can this medicine affect other medicines?

You should tell your doctor or pharmacist what medicines you are using, particularly those listed below, before you start treatment with this medicine. This includes those bought without a prescription and herbal medicines. Likewise, check with your doctor or pharmacist before starting any new medicines while you are taking this medicine, so they can check that the combination is safe.

As Telzir is used in combination with ritonavir, your doctor or pharmacist will also check whether any of your medicines interact with ritonavir .

Telzir should not be taken in combination with any other medicines that contain amprenavir, eg Agenerase.

Telzir must not be taken with any of the following medicines because it may increase their blood levels and lead to a risk of serious or life threatening side effects:

- amiodarone
- astemizole
- cilostazol
- cisapride
- dihydroergotamine
- ergotamine
- flecainide
- midazolam taken by mouth
- pimozide
- propafenone
- quinidine
- terfenadine.

Telzir must not be taken with any of the following medicines because they may reduce the blood level of amprenavir, thus making it less effective against HIV:

- rifampicin
- the herbal remedy St John's wort (Hypericum perforatum).

Nevirapine may reduce the blood level of amprenavir. Dosage adjustments may be made by your doctor if nevirapine is added to your anti-HIV treatment.

Amprenavir may increase the blood level of rifabutin. If you need treatment with rifabutin a lower than normal dose may be prescribed.

Amprenavir with ritonavir may also increase the blood levels of the following medicines, and you may need increased monitoring by your doctor if you are taking any of these with Telzir:

- alprazolam
- ciclosporin
- cimetidine
- clarithromycin
- clozapine
- dapsone
- diazepam
- erythromycin
- flurazepam
- halofantrine (not recommended for people taking Telzir)
- itraconazole (high doses of more than 200mg per day are not recommended in combination with Telzir)
- ketoconazole (high doses of more than 200mg per day are not recommended in combination withTelzir)
- lidocaine by injection (not recommended for people taking Telzir)
- loratadine
- midazolam given by injection
- sildenafil (not recommended for people taking Telzir)
- sirolimus
- tacrolimus
- tadalafil (not recommended for people taking Telzir)
- the calcium channel blockers diltiazem, nicardipine, nifedipine or nimodipine
- tricyclic antidepressants
- vardenafil (not recommended for people taking Telzir)
- warfarin (your blood clotting time, INR, should be monitored more frequently if you are taking warfarin with Telzir).

Amprenavir may also increase the blood level of cholesterol-lowering medicines known as statins. Simvastatin and lovastatin are not recommended for use in combination with Telzir, as the increased blood levels may lead to side effects on the muscles. If cholesterol-lowering treatment is needed, fluvastatin or pravastatin are recommended.

Amprenavir and ritonavir may increase the blood level of the corticosteroids fluticasone or budesonide taken by inhaler or nasal spray. This could increase the risk of systemic side effects of these steroids, such as Cushing's syndrome, or decreased production of natural steroids by the adrenal glands. For this reason, the use of these corticosteroids in combination with amprenavir and ritonavir is not recommended, unless the benefits are thought to outweigh the potential risks.

Amprenavir may reduce the effect of hormonal contraceptives and for this reason a barrier method of contraception, such as condoms, should be used to prevent pregnancy, as well as to prevent transmission of the HIV virus.

Amprenavir may reduce the blood level of opiate derivatives such as methadone.

The antiepileptics phenobarbitone, phenytoin or carbamazepine may affect the blood level of amprenavir, while amprenavir may affect their blood levels. These antiepileptic medicines should be used with caution in combination with Telzir.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain fosamprenavir. Agenerase contains amprenavir.

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