Doravirine Brand Name– PIFELTRO
What is Doravirine
Doravirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) indicated for use in combination with other antiretroviral medications.
The drug is approved to treat HIV-1 infection in adult patients with no prior antiretroviral treatment history or as replacement therapy in patients who are virologically suppressed (i.e., HIV-1 RNA less than 50 copies/mL) on a stable antiretroviral regimen, have no history of treatment failure, and have no known doravirine resistance-associated substitutions.
Avoid use of doravirine in patients receiving strong CYP3A inducers, as concurrent therapy may result in an impaired virologic response.
Monitor drug recipients for neuropsychiatric adverse events, especially during the first 4 weeks of treatment
Indications
- human immunodeficiency virus (HIV)
- human immunodeficiency virus (HIV) infection
Side Effects
- abdominal pain
- abnormal dreams
- asthenia
- depression
- diarrhea
- dizziness
- elevated hepatic enzymes
- fatigue
- headache
- hyperbilirubinemia
- hypercholesterolemia
- hypertriglyceridemia
- insomnia
- maculopapular rash
- malaise
- nausea
- nightmares
- rash
- suicidal ideation
Monitoring Parameters
- blood glucose
- CBC with differential
- CD4+ T cell count
- hepatitis B serology
- LFTs
- plasma hepatitis C RNA
- plasma HIV RNA
- pregnancy testing
- serum bilirubin (total and direct)
- serum cholesterol
- serum creatinine
- serum lipid profile
- urinalysis
Contraindications
- alcoholism
- autoimmune disease
- bipolar disorder
- breast-feeding
- children
- depression
- driving or operating machinery
- geriatric
- Graves’ disease
- Guillain-Barre syndrome
- hepatic disease
- hepatitis B and HIV coinfection
- hepatitis C and HIV coinfection
- human immunodeficiency virus (HIV) infection resistance
- immune reconstitution syndrome
- infants
- mania
- neonates
- pregnancy
- psychosis
- substance abuse
Interactions
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Apalutamide
- Armodafinil
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bexarotene
- Bosentan
- Butabarbital
- Carbamazepine
- Cenobamate
- Ceritinib
- Chloramphenicol
- Clarithromycin
- Clobazam
- Cobicistat
- Conivaptan
- Dabrafenib
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deferasirox
- Delavirdine
- Dexamethasone
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Enzalutamide
- Eslicarbazepine
- Etravirine
- Fosamprenavir
- Fosphenytoin
- grapefruit juice
- Idelalisib
- Indinavir
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ketoconazole
- Lesinurad
- Lesinurad; Allopurinol
- Lopinavir; Ritonavir
- Lorlatinib
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Mifepristone
- Mitotane
- Modafinil
- Nafcillin
- Nefazodone
- Nelfinavir
- Nevirapine
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oritavancin
- Oxcarbazepine
- Phenobarbital
- Phentermine; Topiramate
- Phenytoin
- Posaconazole
- Primidone
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Rifaximin
- Ritonavir
- Saquinavir
- Secobarbital
- St. John’s Wort, Hypericum perforatum
- Tazemetostat
- Telithromycin
- Telotristat Ethyl
- Tipranavir
- Topiramate
- Tucatinib
- Voriconazole
