Doravirine Lamivudine Tenofovir disoproxil fumarate Brand Name– DELSTRIGO
What is Doravirine Lamivudine Tenofovir disoproxil fumarate
Doravirine lamivudine tenofovir disoproxil fumarate (DF) is indicated as a complete regimen for the treatment of HIV-1 infection in adults with no 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 resistance-associated substitutions to the drug components.
The drug contains 3 medications in a single tablet that is given once daily; doravirine (a nonnucleoside reverse transcriptase inhibitor [NNRTI]), lamivudine, and tenofovir DF (both nucleoside analog reverse transcriptase inhibitors [NRTIs]).
Avoid use of doravirine; lamivudine; tenofovir DF in patients receiving strong CYP3A inducers, as concurrent therapy may result in subtherapeutic concentrations of doravirine which could impair virologic response. Patients coinfected with HIV-1 and hepatitis B virus (HBV) who have discontinued treatment with lamivudine or tenofovir DF have experienced severe acute exacerbations of HBV.
Closely monitor hepatic function in coinfected patients who stop doravirine; lamivudine; tenofovir DF.
If appropriate, reinitiation of anti-hepatitis B therapy may be warranted.
Also, 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
NOTE: HIV guidelines recommend consideration be given to avoiding the use of tenofovir disoproxil fumarate-containing regimens in patients with renal disease and osteoporosis.
Side Effects
- abdominal pain
- abnormal dreams
- alopecia
- anaphylactoid reactions
- anemia
- angioedema
- asthenia
- bone fractures
- depression
- diabetes insipidus
- diarrhea
- dizziness
- dyspnea
- elevated hepatic enzymes
- Fanconi syndrome
- headache
- hepatitis B exacerbation
- hepatomegaly
- hyperbilirubinemia
- hypercholesterolemia
- hyperglycemia
- hypertriglyceridemia
- hypokalemia
- hypophosphatemia
- insomnia
- interstitial nephritis
- lactic acidosis
- lipodystrophy
- maculopapular rash
- myopathy
- nausea
- nightmares
- osteomalacia
- osteopenia
- osteoporosis
- pancreatitis
- polyuria
- proteinuria
- pruritus
- rash
- renal failure (unspecified)
- renal tubular necrosis
- rhabdomyolysis
- steatosis
- suicidal ideation
- urticaria
- weakness
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/BUN
- serum lipid profile
- serum phosphate
- serum triglycerides
- urinalysis
Contraindications
- alcoholism
- autoimmune disease
- bipolar disorder
- bone fractures
- breast-feeding
- children
- depression
- driving or operating machinery
- geriatric
- Graves’ disease
- Guillain-Barre syndrome
- hepatic disease
- hepatitis
- hepatitis B and HIV coinfection
- hepatitis B exacerbation
- hepatitis C and HIV coinfection
- hepatomegaly
- hepatotoxicity or lactic acidosis
- human immunodeficiency virus (HIV) infection resistance
- hypophosphatemia
- immune reconstitution syndrome
- infants
- mania
- neonates
- obesity
- osteomalacia
- osteopenia
- osteoporosis
- peripheral neuropathy
- pregnancy
- psychosis
- renal disease
- renal failure
- renal impairment
- substance abuse
- use with ribavirin
Interactions
- Acalabrutinib
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acyclovir
- Adefovir
- Alogliptin; Metformin
- Amikacin
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Aminoglycosides
- Aminosalicylate sodium, Aminosalicylic acid
- Amiodarone
- Amlodipine; Celecoxib
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Apalutamide
- Armodafinil
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Bacitracin
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Bepridil
- Bexarotene
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Bismuth Subsalicylate
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Boceprevir
- Bortezomib
- Bosentan
- Brigatinib
- Butabarbital
- Cabozantinib
- Canagliflozin; Metformin
- Capmatinib
- Carbamazepine
- Carboplatin
- Carvedilol
- Celecoxib
- Cenobamate
- Ceritinib
- Chloramphenicol
- Choline Salicylate; Magnesium Salicylate
- Cidofovir
- Cisplatin
- Clarithromycin
- Clobazam
- Clofarabine
- Cobicistat
- Colchicine
- Colchicine; Probenecid
- Colistimethate, Colistin, Polymyxin E
- Conivaptan
- Cyclosporine
- Dabrafenib
- Dapagliflozin; Metformin
- Darolutamide
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deferasirox
- Delavirdine
- Dexamethasone
- Dextromethorphan; Quinidine
- Dichlorphenamide
- Diclofenac
- Diclofenac; Misoprostol
- Didanosine, ddI
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Dofetilide
- Donepezil; Memantine
- Dronedarone
- Echinacea
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir alafenamide
- Emtricitabine; Tenofovir disoproxil fumarate
- Enzalutamide
- Ertugliflozin; Metformin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Eslicarbazepine
- Esomeprazole; Naproxen
- Etodolac
- Etravirine
- Famotidine; Ibuprofen
- Fenoprofen
- Flurbiprofen
- food
- Fosamprenavir
- Foscarnet
- Fosphenytoin
- Fostamatinib
- Ganciclovir
- Gentamicin
- Glipizide; Metformin
- Glyburide; Metformin
- grapefruit juice
- Hydrocodone; Ibuprofen
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Idelalisib
- Indinavir
- Indomethacin
- Interferon Alfa-2b; Ribavirin
- Interferons
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isosulfan Blue
- Istradefylline
- Itraconazole
- Ivacaftor
- Kanamycin
- Ketoconazole
- Ketoprofen
- Ketorolac
- Lansoprazole; Naproxen
- Lapatinib
- Ledipasvir; Sofosbuvir
- Lesinurad
- Lesinurad; Allopurinol
- Linagliptin; Metformin
- Lopinavir; Ritonavir
- Lorlatinib
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Magnesium Salicylate
- Meclofenamate Sodium
- Mefenamic Acid
- Mefloquine
- Meloxicam
- Memantine
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Mifepristone
- Mitotane
- Modafinil
- Nabumetone
- Nafcillin
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nefazodone
- Nelfinavir
- Neratinib
- Nevirapine
- Non-Ionic Contrast Media
- Nonsteroidal antiinflammatory drugs
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Oritavancin
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- Osimertinib
- Oxaliplatin
- Oxaprozin
- Oxcarbazepine
- Pamidronate
- Paromomycin
- Phenobarbital
- Phentermine; Topiramate
- Phenytoin
- Piroxicam
- Plazomicin
- Polymyxin B
- Polymyxins
- Posaconazole
- Primidone
- Probenecid
- Procainamide
- Propafenone
- Quinidine
- Ranolazine
- Regorafenib
- Ribavirin
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Rifaximin
- Ritonavir
- Rofecoxib
- Rolapitant
- Salicylates
- Salsalate
- Sapropterin
- Saquinavir
- Secobarbital
- Simeprevir
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sorafenib
- Sorbitol
- St. John’s Wort, Hypericum perforatum
- Streptomycin
- Sulindac
- Tacrolimus
- Tafamidis
- Tazemetostat
- Tedizolid
- Telaprevir
- Telithromycin
- Telotristat Ethyl
- Temsirolimus
- Testosterone
- Tezacaftor; Ivacaftor
- Ticagrelor
- Tipranavir
- Tobramycin
- Tolmetin
- Tolvaptan
- Topiramate
- Trandolapril; Verapamil
- Trospium
- Tucatinib
- Valacyclovir
- Valdecoxib
- Valganciclovir
- Vancomycin
- Vemurafenib
- Verapamil
- Voriconazole
- Zoledronic Acid
- Zonisamide
