darunavir (Prezista, DRV/r)
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Introduction
Tradenames: Prezista
Indications
- HIV patients resistant to other protease inhibitors
- also FDA-approved for treatment-naive patients[4]
- MUST be taken with ritonavir or atazanavir
Contraindications
Dosage
- 200 mg PO BID together with ritonavir 100 mg PO BID
- 800 mg daily plus 100 mg ritonavir daily for treatment naive patients[4]
Tablets: 300, 400, 600 mg[2][4]
Monitor
- serum AST, serum ALT (& serum alkaline phosphatase, Canada) at basline, every 2 weeks for the 1st month of therapy, then monthly[5]
Adverse effects
- diarrhea
- nausea
- headache
- skin rash (7%)
- hepatotoxicity[3]
- cumulative use of ritonavir-boosted darunavir is associated with an increasing cardiovascular risk[7]
- drug adverse effects of antiretroviral protease inhibitors
- drug adverse effects of antiretroviral agents
Drug interactions
- ritonavir increases plasma darunavir levels
- hepatotoxicity observed in combination with ritonavir[3]
- drug interaction(s) of fluticasone with HIV1 protease inhibitors
- drug interaction(s) of antiretroviral protease inhibitor in combination with ritonavir
- drug interaction(s) of boceprevir in combination with ritonavir & darunavir
- drug interaction(s) of statins with antiviral protease inhibitors
- drug interaction(s) of antibiotics with warfarin
Laboratory
Notes
Cost 2008 $13.70/400 mg tablet
More general terms
Additional terms
References
- ↑ Prescriber's Letter 13(8): 2006 Recent Changes in HIV Drug Therapy FDA Approves New HIV Treatment for Patients Who Do Not Respond to Existing Drugs Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=220808&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 2.0 2.1 FDA, HIV/AIDS List Serve Archive Feb 25, 2008 http://www.fda.gov/oashi/aids/listserve/listserve2008.html
- ↑ 3.0 3.1 3.2 FDA MedWatch http://www.fda.gov/medwatch/safety/2008/safety08.htm#Prezista
Prezista (darunavir) tablets [prescribing information]. Raritan, NJ: Tibotec, Inc; 2008 http://tinyurl.com/yuuva9 - ↑ 4.0 4.1 4.2 4.3 4.4 Prezista (darunavir) tablets [prescribing information]. Raritan, NJ: Tibotec, Inc.; 2008 http://www.prezista.com/prezista/documents/us_package_insert.pdf
- ↑ 5.0 5.1 Prescriber's Letter 17(7): 2010 Recommended Lab Monitoring for Common Medications Liver Function Test Scheduling Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260704&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 6.0 6.1 Zuger A Use of Antiretroviral Drugs in Pregnancy. Physician's First Watch, April 22, 2014 David G. Fairchild, MD, MPH, Editor-in-Chief Massachusetts Medical Society http://www.jwatch.org
Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States. 2014. AIDSinfo. Clinical Guidelines Portal. March 28, 2014. http://aidsinfo.nih.gov/Guidelines/HTML/3/perinatal-guidelines/0 (corresponding NGC guideline withdrawn March 2016) - ↑ 7.0 7.1 Boggs W. Increased Risk of Cardiovascular Disease With Darunavir. Medscape - May 21, 2018. https://www.medscape.com/viewarticle/896983