HIV medications: Difference between revisions

From IDWiki
(→)
m (→: changed table formatting)
Line 38: Line 38:


{| class="wikitable sortable"
{| class="wikitable sortable"
! Medication
! Medication !! Abbr !! Class
! AKA
! Class
! Notes
! Notes
|-
|-
| [[lamivudine]]
| [[lamivudine]] || 3TC || NRTI
| 3TC
| NRTI
|
|
|-
|-
| [[emtricitabine]]
| [[emtricitabine]] || FTC || NRTI
| FTC
| NRTI
|
|
|-
|-
| [[tenofovir disoproxol fumarate]]
| [[tenofovir disoproxol fumarate]] || TDF || NRTI
| TDF
| NRTI
|
|
|-
|-
| [[tenofovir alafenamide]]
| [[tenofovir alafenamide]] || TAF || NRTI
| TAF
| NRTI
| Fewer renal and bone effects.
| Fewer renal and bone effects.
|-
|-
| [[zidovudine]]
| [[zidovudine]] || AZT || NRTI
| AZT
| NRTI
|
|
|-
|-
| [[abacavir]]
| [[abacavir]] || ABC || NRTI
| ABC
| NRTI
| Need to check HLA-B*5701 before starting therapy.
| Need to check HLA-B*5701 before starting therapy.
|-
|-
| [[efavirenz]]
| [[efavirenz]] || EFZ || NNRTI
| EFZ
| NNRTI
|
|
|-
|-
| [[rilpivirine]]
| [[rilpivirine]] || RPV || NNRTI
| RPV
| NNRTI
| Take with meal, not with PPI.
| Take with meal, not with PPI.
|-
|-
| [[doravirine]]
| [[doravirine]] || DOR || NNRTI
| DOR
| NNRTI
|
|
|-
|-
| [[lopinavir/ritonavir]]
| [[lopinavir/ritonavir]] || LPV/r || PI
| LPV/r
| PI
| GI side effects.
| GI side effects.
|-
|-
| [[darunivir]]
| [[darunivir]] || DRV || PI
| DRV
| PI
|
|
|-
|-
| [[dolutegravir]]
| [[dolutegravir]] || DTG || INSTI
| DTG
| INSTI
| Increases metformin levels. Avoid in pregnancy.
| Increases metformin levels. Avoid in pregnancy.
|-
|-
| [[elvitegravir/cobicistat]]
| [[elvitegravir/cobicistat]] || EVG/c || INSTI
| EVG/c
| INSTI
| Requires booster that has drug interaction.
| Requires booster that has drug interaction.
|-
|-
| [[raltegravir]]
| [[raltegravir]] || RAL || INSTI
| RAL
| INSTI
| First INSTI. BID dosing. Only INSTI that can be used in pregnancy.
| First INSTI. BID dosing. Only INSTI that can be used in pregnancy.
|-
|-
| [[bictegravir]]
| [[bictegravir]] || BIC || INSTI
| BIC
| INSTI
|
|
|-
|-
| [[cabotegravir]]
| [[cabotegravir]] || CAB || INSTI
| CAB
| INSTI
| Long-acting injectable available.
| Long-acting injectable available.
|-
|-
| [[ibalizumab]]
| [[ibalizumab]] || ||
|
|
| CD4-receptor antibody.
| CD4-receptor antibody.
|}
|}

Revision as of 00:23, 13 February 2020

Classes

Class Examples Description
Nucleoside reverse-transcriptase inhibitor (NRTI) tenofovir, emtricitabine, abacavir Nucleoside/nucleotide analogues that get incorporated into viral DNA by reverse transcriptase, causing missense or non-sense mutations. The backbone of HIV treatments, with a high barrier to resistance.
Non-NRTI efavirenz Actively inhibit reverse transcriptase at its active site. Resistance develops with a single point mutation.
Protease inhibitor (PI) dirunavir Inhibits protease, which is required for processing proteins in the creation of the virion. Causes a metabolic syndrome.
Integrase strand transfer inhibitor (INSTI) raltegravir, dolutegravir, bictegravir Extremely potent with few side effects. Take separate from PPIs etc.
Fusion inhibitor
CCR5 inhibitor
CD4-mAb ibalizumab Blocks entry of HIV into CD4 cells.

Specific Medications

Medication Abbr Class Notes
lamivudine 3TC NRTI
emtricitabine FTC NRTI
tenofovir disoproxol fumarate TDF NRTI
tenofovir alafenamide TAF NRTI Fewer renal and bone effects.
zidovudine AZT NRTI
abacavir ABC NRTI Need to check HLA-B*5701 before starting therapy.
efavirenz EFZ NNRTI
rilpivirine RPV NNRTI Take with meal, not with PPI.
doravirine DOR NNRTI
lopinavir/ritonavir LPV/r PI GI side effects.
darunivir DRV PI
dolutegravir DTG INSTI Increases metformin levels. Avoid in pregnancy.
elvitegravir/cobicistat EVG/c INSTI Requires booster that has drug interaction.
raltegravir RAL INSTI First INSTI. BID dosing. Only INSTI that can be used in pregnancy.
bictegravir BIC INSTI
cabotegravir CAB INSTI Long-acting injectable available.
ibalizumab CD4-receptor antibody.

Single-Tablet Regimens

Brand name NRTIs Non-NRTI First-line? Notes
Atripla tenofovir disoproxil fumarate / emtricitabine efavirenz (NNRTI) No Older regimen. Neuropsychiatric symptoms, possibly including suicide.
Biktarvy tenofovir alafenamide / emtricitabine bictegravir (INI) Yes
Complera tenofovir disoproxil fumarate / emtricitabine rilpivirine (NNRTI) No Avoid with viral loads (>100,000) or low CD4 (<200). Pill must be taken with food (>400kcal) and without PPIs.
Delstrigo tenofovir disoproxil fumarate / lamivudine doravirine (NNRTI) No
Dovato emtricitabine dolutegravir (INI) Yes Two-medication regimen
Genvoya tenofovir alafenamide / emtricitabine elvitegravir/cobicistat (INI) See Stribild, above.
Odefsey tenofovir alafenamide / emtricitabine rilpivirine (NNRTI) No
Stribild tenofovir disoproxil fumarate / emtricitabine elvitegravir/cobicistat (INI) No Includes a P450 inhibitor to boost elvitegravir levels, with resultant drug-drug interactions. Avoid if CrCl <70.
Symfi tenofovir disoproxil fumarate / emtricitabine efavirenz (NNRTI) No
Symtuza tenofovir alafenamide / emtricitabine darunavir/cobicistat (PI) No
Triumeq abacavir / lamivudine dolutegravir (INI) Yes Highest barrier to resistance. Need to test for HLA-B5701 allele before starting. Avoid in hepatitis B coinfection.

Considerations

  • Hepatitis B: Avoid Triumeq; use TDF/FTC-based regimen instead
  • CKD: Avoid Stribild in CrCl <70

Further Reading

Retrieved from "https://idwiki.org/index.php?title=HIV_medications&oldid=3582"
Powered by MediaWiki
Powered by Semantic MediaWiki