Enfuvirtide Brand Name– Fuzeon
What is Enfuvirtide
Enfuvirtide also known as T-20, is the first medication in a class of anti-HIV drugs called fusion inhibitors.
It is a synthetic 36-amino-acid peptide derived from the HIV-1 envelope glycoprotein gp41 and it interferes with the entry of HIV-1 into cells by inhibiting the fusion of viral and cellular membranes.
The drug is indicated to treat HIV infection in antiretroviral-experienced patients with evidence of ongoing viral replication despite ongoing antiretroviral therapy (i.e., show resistance to current HIV treatments).
Enfuvirtide should be used in combination with an individualized antiretroviral regimen. It remains active against HIV strains in patients who have previously received and developed resistance to other classes of antiretroviral agents.
In clinical trials, patients receiving enfuvirtide in addition to an individualized antiretroviral regimen were less likely to experience virologic failure or relapse compared to those receiving an individualized antiretroviral regimen alone; patients whose virus was sensitive to a greater number of antiretroviral drugs did demonstrate a greater sensitivity to enfuvirtide.
During use, at least 98% of patients will develop injection site reactions to varying degrees, with almost 85% of patients developing the reactions within the first week of use. Patients should be appropriately counseled regarding injection site reactions before therapy is initiated.
Indications
- human immunodeficiency virus (HIV)
- human immunodeficiency virus (HIV) infection
- human immunodeficiency virus (HIV) prophylaxis
Side Effects
- abdominal pain
- acute respiratory distress syndrome (ARDS)
- angina
- anorexia
- antibody formation
- anxiety
- asthenia
- chills
- conjunctivitis
- constipation
- cough
- cranial nerve palsies
- cutaneous amyloidosis
- depression
- diarrhea
- dysgeusia
- dyspnea
- ecchymosis
- elevated hepatic enzymes
- eosinophilia
- erythema
- fatigue
- fever
- folliculitis
- glomerulonephritis
- Guillain-Barre syndrome
- hematoma
- hematuria
- hepatitis
- hyperglycemia
- hypertriglyceridemia
- hypotension
- infection
- influenza
- injection site reaction
- insomnia
- lymphadenopathy
- myalgia
- nausea
- neutropenia
- pancreatitis
- paresthesias
- peripheral edema
- peripheral neuropathy
- pruritus
- rash
- renal failure (unspecified)
- renal tubular necrosis
- sinusitis
- steatosis
- suicidal ideation
- thrombocytopenia
- vomiting
- weight loss
- xerostomia
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
- anticoagulant therapy
- autoimmune disease
- breast-feeding
- coagulopathy
- Graves’ disease
- Guillain-Barre syndrome
- hemophilia
- hepatitis B and HIV coinfection
- hepatitis C and HIV coinfection
- human immunodeficiency virus (HIV) infection resistance
- immune reconstitution syndrome
- pregnancy
- pulmonary disease
- respiratory infection
- substance abuse
- tobacco smoking
Interactions
- Tipranavir
Tipranavir: (Moderate) Phase 3 trials showed that the coadministration of enfuvirtide increases tipranavir trough concentrations by 45%; however, the mechanism for this increase is unknown. The manufacturer of tipranavir states that tipranavir dosage adjustments are not recommended
