Priapism induced by boceprevir-CYP3A4 inhibition and α-adrenergic blockade: case report

Clin Infect Dis. 2014 Jan;58(1):e35-8. doi: 10.1093/cid/cit673. Epub 2013 Oct 2.

Abstract

A 44-year-old white man presented to the emergency department with a 3-day history of priapism requiring a surgically performed distal penile shunt. A drug-drug interaction is the suspected cause whereby CYP3A4 inhibition by boceprevir led to increased exposures of doxazosin, tamsulosin, and/or quetiapine, resulting in additional α-adrenergic blockade.

Keywords: boceprevir; drug interaction; priapism; quetiapine; α-adrenergic.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic alpha-Antagonists / administration & dosage
  • Adrenergic alpha-Antagonists / adverse effects*
  • Adult
  • Cytochrome P-450 CYP3A
  • Cytochrome P-450 CYP3A Inhibitors*
  • Drug Interactions*
  • Humans
  • Male
  • Priapism / diagnosis*
  • Priapism / etiology*
  • Priapism / surgery
  • Proline / administration & dosage
  • Proline / adverse effects
  • Proline / analogs & derivatives*
  • Receptors, Adrenergic, alpha / drug effects*

Substances

  • Adrenergic alpha-Antagonists
  • Cytochrome P-450 CYP3A Inhibitors
  • Receptors, Adrenergic, alpha
  • N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide
  • Proline
  • Cytochrome P-450 CYP3A
  • CYP3A4 protein, human