Elvitegravir Brand Name– VITEKTA
What is Elvitegravir
Elvitegravir is a HIV integrase strand transfer inhibitor (INSTI) indicated for the treatment of human immunodeficiency virus (HIV) infection in antiretroviral-experienced adults.
The drug is not approved for monotherapy and must be used in combination with ritonavir, an additional HIV protease inhibitor, and other antiretroviral drug(s).
Elvitegravir tablets are available in two strengths, with the dosage determined by which PI is used concomitantly (85 mg for use with atazanavir and lopinavir; 150 mg for use with darunavir, fosamprenavir, tipranavir).
Approval is based on the results of a 96-week clinical trial that compared regimens containing elvitegravir 85 mg or 150 mg once daily with raltegravir 400 mg twice daily in treatment-experienced, HIV-1 infected adults.
Data from this trial found the efficacy (HIV RNA < 50 copies/mL) of elvitegravir-containing regimens (52%) to be comparable to regimens containing raltegravir (53%). Elvitegravir was originally approved by the FDA in August 2012 as part of a four-drug combination tablet that also contained cobicistat, emtricitabine, and tenofovir (Stribild).
In September 2014, the individual elvitegravir component received FDA approval for use with other antiretroviral agents.
Indications
- human immunodeficiency virus (HIV)
- human immunodeficiency virus (HIV) infection
Side Effects
- abdominal pain
- breast enlargement
- Cushingoid features
- depression
- diarrhea
- dyspepsia
- elevated hepatic enzymes
- fatigue
- gynecomastia
- headache
- hematuria
- hyperamylasemia
- hyperbilirubinemia
- hypercholesterolemia
- hyperglycemia
- hypertriglyceridemia
- insomnia
- lipodystrophy
- nausea
- neutropenia
- rash
- suicidal ideation
- vomiting
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 lipid profile
- urinalysis
Contraindications
- autoimmune disease
- breast-feeding
- 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
- pregnancy
Interactions
- Acetaminophen; Diphenhydramine
- Aldesleukin, IL-2
- Aliskiren; Valsartan
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Valsartan
- Antacids
- Apalutamide
- Aprepitant, Fosaprepitant
- Armodafinil
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bexarotene
- Boceprevir
- Bosentan
- Buprenorphine
- Buprenorphine; Naloxone
- Calcium Carbonate
- Calcium Carbonate; Magnesium Hydroxide
- Calcium Carbonate; Risedronate
- Calcium Carbonate; Simethicone
- Carbamazepine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Celecoxib
- Cenobamate
- Chloramphenicol
- Cimetidine
- Clobazam
- Cocaine
- Dabrafenib
- Danazol
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dexamethasone
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Diclofenac
- Diclofenac; Misoprostol
- Didanosine, ddI
- Dienogest; Estradiol valerate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Dronabinol
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix; Estradiol; Norethindrone acetate
- Enzalutamide
- Eslicarbazepine
- Esomeprazole; Naproxen
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Famotidine; Ibuprofen
- Felbamate
- Fluconazole
- Flurbiprofen
- Flutamide
- Fosamprenavir
- Fosphenytoin
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydrocodone; Ibuprofen
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Indinavir
- Indomethacin
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ketoconazole
- Lansoprazole; Naproxen
- Lesinurad
- Lesinurad; Allopurinol
- Leuprolide; Norethindrone
- Levonorgestrel
- Lopinavir; Ritonavir
- Lorlatinib
- Losartan
- Lumacaftor; Ivacaftor
- Maraviroc
- Meloxicam
- Mestranol; Norethindrone
- Metformin; Rosiglitazone
- Methadone
- Mitotane
- Modafinil
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nateglinide
- Nebivolol; Valsartan
- Nelfinavir
- Nevirapine
- Norethindrone
- Norgestrel
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Oral Contraceptives
- Oritavancin
- Oxcarbazepine
- Pazopanib
- Perampanel
- Phenobarbital
- Phentermine; Topiramate
- Phenytoin
- Primidone
- Quinine
- Rifabutin
- Rifampin
- Rifapentine
- Ritonavir
- Rosiglitazone
- Rosuvastatin
- Sacubitril; Valsartan
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Selegiline
- Sodium Bicarbonate
- St. John’s Wort, Hypericum perforatum
- Streptogramins
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Telaprevir
- Telotristat Ethyl
- Terbinafine
- Tipranavir
- Topiramate
- Valsartan
- Vemurafenib
- Warfarin
