RALTEGRAVIR • Pale Yellow Chewable Tablet (Orange- Your Immune System Will Be Further Banana Flavoured)

Total Page:16

File Type:pdf, Size:1020Kb

RALTEGRAVIR • Pale Yellow Chewable Tablet (Orange- Your Immune System Will Be Further Banana Flavoured) RALTEGRAVIR • Pale yellow chewable tablet (orange- your immune system will be further banana flavoured). Each tablet contains damaged. A few missed doses can be 25 mg of raltegravir. enough for raltegravir to stop being active, a Other NAMES: Isentress phenomenon known as resistance . When The usual adult dose of raltegravir is 400 this happens, other antiretrovirals that work mg twice daily, with or without food. The in a similar way as raltegravir may also WHY is this drug prescribed? drug must be taken in a combination become inactive. Therefore, missing regimen with other antiretrovirals. doses of raltegravir can decrease Raltegravir is an antiretroviral (anti-HIV) treatment options for the future. Please drug that is used together with other Your dosage is: do not stop raltegravir or change your dose antiretrovirals to delay the progression of without talking to your doctor first. HIV-1 infection. It works by blocking the PINK tablet (raltegravir 400 mg): enzyme integrase. By taking this drug in What SIDE EFFECTS can this drug combination with other antiretroviral agents ____ tablet (___mg) ___ times a day with cause? What should you do about your doctor has prescribed, your immune + or without food. them? system should improve (increase in CD4 count) better protecting you against Pale ORANGE tablet (raltegravir 100 mg): Some people taking raltegravir will have infections and your viral load should symptoms such as dizziness, nausea, decrease because the enzyme needed to ____ tablets (___mg) ___ times a day with vomiting, diarrhea, fatigue, difficulty produce more viruses is being blocked. or without food. sleeping, rash, cough and fever. At the start of using raltegravir, some patient’s Raltegravir does not cure AIDS or Pale YELLOW tablet (raltegravir 25 mg): develop an inflammatory response or show completely kill the HIV virus, but helps to evidence of an underlying infection prevent further damage by slowing down ____ tablets (___mg) ___ times a day with (pneumonia, herpes, or tuberculosis). Talk the production of new viruses. ou should or without food. to your doctor or pharmacist if you develop always use appropriate precautions to unusual symptoms, as they signal a need prevent passing HIV on to others. for evaluation and treatment. What should you do if you FORGET a dose? It is important that you keep your doctor HOW should this drug be taken? appointments and come for your laboratory If you miss a dose of raltegravir, take it as tests so that your progress can be followed. Raltegravir is currently available in 3 soon as you remember and carry on with different formulations: your regular schedule. What other PRECAUTIONS should you • Pink film coated tablet. Each tablet follow while using this drug? contains 400 mg of raltegravir. Why should you not forget to take this drug? Certain drugs can increase or decrease the • Pale orange chewable tablet (orange- effect of raltegravir. The dose of raltegravir banana flavoured). Each tablet contains If you miss doses of raltegravir, the amount may need to be increased if you are taking 100 mg of raltegravir. of virus in your blood (known as the HIV certain drugs such as rifampin. viral load) will start increasing again and • Antacids containing aluminum or If you have any questions or concerns magnesium (e.g., liquid Maalox , about this drug or if you are Diovol , Mylanta , etc) should NOT be experiencing adverse effects, please used with raltegravir because they may discuss them with your pharmacist, decrease the effect of raltegravir. doctor or nurse. • Antacids containing calcium carbonate Write questions or concerns down to (e.g., Tums ) may be taken at the ensure they are addressed. RALTEGRAVIR same time as raltegravir. (Isentress ) The following pharmacist is available to Inform your doctor and pharmacist of all answer questions: prescribed and non-prescribed drugs you are taking. As well, you should inform them Pharmacist: __________________ of natural products or recreational (street Telephone: __________________ MEDICATION drugs) you are taking. If you wish to start a new drug or natural product, please consult with your pharmacist before doing so. FACT SHEET Please inform your doctor if you are pregnant or if you wish to become pregnant in the near future. Your doctor can recommend the appropriate treatment to help reduce the risk of passing the HIV virus on to your baby. Breastfeeding is NOT recommended if you have HIV as you can transmit the virus to your baby through your breast milk. How should this drug be STORED? Raltegravir should be stored in a cool (15- 30 °C) dry place, protected from light and well out of the reach of children. Ensure that the drug has not expired by checking the Reference: expiry date (“EXP”) shown on the outside of Merck Frosst Canada Ltd, Product Monograph Isentress the package. (raltegravir). Kirkland, QC, Canada: January 20, 2015. Additional medication fact sheets and updates may be found at: www.hivclinic.ca .
Recommended publications
  • Vitekta Pi.Pdf
    HIGHLIGHTS OF PRESCRIBING INFORMATION -----------------------DOSAGE FORMS AND STRENGTHS-------------------- These highlights do not include all the information needed to use Tablets: 85 mg and 150 mg (3) VITEKTA safely and effectively. See full prescribing information for VITEKTA. --------------------------------CONTRAINDICATIONS------------------------------ VITEKTA® (elvitegravir) tablets, for oral use There are no contraindications to VITEKTA. (4) Initial U.S. Approval: 2012 Due to the need to use VITEKTA with a protease inhibitor coadministered with ritonavir, consult prescribing information of -------------------------------INDICATIONS AND USAGE------------------------- coadministered protease inhibitor and ritonavir for their VITEKTA is a human immunodeficiency virus type 1 (HIV-1) integrase contraindications. (4) strand transfer inhibitor used in combination with an HIV protease inhibitor coadministered with ritonavir and with other antiretroviral -------------------------WARNINGS AND PRECAUTIONS---------------------- drug(s) indicated for the treatment of HIV-1 infection in antiretroviral Do not use with protease inhibitors coadministered with cobicistat. treatment-experienced adults. (1) (5.2) Do not use with other elvitegravir-containing drugs, including Limitations of Use: STRIBILD. (5.2) There are no comparative pharmacokinetic or clinical data Immune reconstitution syndrome: May necessitate further evaluation evaluating VITEKTA with cobicistat as single entities compared to and treatment. (5.3) STRIBILD®. (1) --------------------------------ADVERSE REACTIONS----------------------------- VITEKTA coadministered with protease inhibitors and cobicistat is The most common adverse drug reaction to VITEKTA (all grades) is not recommended. (1) diarrhea. (6.1) Coadministration of VITEKTA with dosage regimens or HIV-1 protease inhibitors other than those presented in Table 1 is not To report SUSPECTED ADVERSE REACTIONS, contact Gilead recommended. (1) Sciences, Inc. at 1-800-GILEAD-5 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
    [Show full text]
  • Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis
    Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis Centers for Disease Control and Prevention Office of Infectious Diseases National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Tuberculosis Elimination June 2013 This document is accessible online at http://www.cdc.gov/tb/TB_HIV_Drugs/default.htm Suggested citation: CDC. Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis [online]. 2013. Available from URL: http://www.cdc.gov/tb/TB_HIV_Drugs/default.htm Table of Contents Introduction 1 Methodology for Preparation of these Guidelines 2 The Role of Rifamycins in Tuberculosis Treatment 4 Managing Drug Interactions with Antivirals and Rifampin 5 Managing Drug Interactions with Antivirals and Rifabutin 9 Treatment of Latent TB Infection with Rifampin or Rifapentine 10 Treating Pregnant Women with Tuberculosis and HIV Co-infection 10 Treating Children with HIV-associated Tuberculosis 12 Co-treatment of Multidrug-resistant Tuberculosis and HIV 14 Limitations of these Guidelines 14 HIV-TB Drug Interaction Guideline Development Group 15 References 17 Table 1a. Recommendations for regimens for the concomitant treatment of tuberculosis and HIV infection in adults 21 Table 1b. Recommendations for regimens for the concomitant treatment of tuberculosis and HIV infection in children 22 Table 2a. Recommendations for co-administering antiretroviral drugs with RIFAMPIN in adults 23 Table 2b. Recommendations for co-administering antiretroviral drugs with RIFAMPIN in children 25 Table 3. Recommendations for co-administering antiretroviral drugs with RIFABUTIN in adults 26 ii Introduction Worldwide, tuberculosis is the most common serious opportunistic infection among people with HIV infection.
    [Show full text]
  • Review CCR5 Antagonists: Host-Targeted Antiviral Agents for the Treatment of HIV Infection, 4 Years On
    Antiviral Chemistry & Chemotherapy 2010 20:179–192 (doi: 10.3851/IMP1507) Review CCR5 antagonists: host-targeted antiviral agents for the treatment of HIV infection, 4 years on Mike Westby1* and Elna van der Ryst1 1Pfizer Global Research and Development, Sandwich, Kent, UK *Corresponding author: e-mail: [email protected] The chemokine coreceptor 5 (CCR5) antagonists are anti- are in various stages of clinical development. In 2005, we retroviral agents with an extracellular, host-targeted reviewed the limited clinical data then available on CCR5 mechanism of action against HIV. Maraviroc, the first- antagonists. In this follow-up review, we revisit the field and in-class CCR5 antagonist, received regulatory approval in assess the clinical and virological data that have emerged 2007, becoming the first oral antiretroviral from a new in the 4 years since, with particular reference to maraviroc class in more than 10 years. Other compounds in this class for which the most comprehensive data currently exist. Introduction Chemokine coreceptor 5 (CCR5) antagonists are a new supporting the current and future role of small-molecule class of antiretroviral agents that inhibit HIV replica- CCR5 antagonists in the treatment of HIV infection. tion by binding to CCR5 on the surface of host target cells and preventing entry of viral strains reliant on this Status of CCR5 antagonists in clinical coreceptor for infection. The first and only currently development in 2005 approved agent within this class, maraviroc, received marketing authorisation in the USA, Europe and other Of the three small-molecule CCR5 antagonists in regions of the world in 2007, with an indication for clinical development in 2005, only maraviroc (Figure treatment-experienced adult patients with only CCR5- 1A) is currently approved for clinical use.
    [Show full text]
  • Of 43 Reference ID: 4711890 FULL PRESCRIBING INFORMATION: CONTENTS*
    HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use DOLUTEGRAVIR, EMTRICITABINE and TENOFOVIR -----------------------WARNINGS AND PRECAUTIONS------------------------ ALAFENAMIDE TABLETS safely and effectively. See full prescribing • Hypersensitivity reactions characterized by rash, constitutional findings, information for DOLUTEGRAVIR, EMTRICITABINE and and sometimes organ dysfunction, including liver injury have been TENOFOVIR ALAFENAMIDE TABLETS. reported. Discontinue dolutegravir, emtricitabine and tenofovir alafenamide tablets and other suspect agents immediately if signs or DOLUTEGRAVIR, EMTRICITABINE and TENOFOVIR symptoms of hypersensitivity reactions develop. (5.2) ALAFENAMIDE tablets, for oral use • Hepatotoxicity has been reported in patients receiving a dolutegravir- containing regimen. Monitoring for hepatotoxicity is recommended. WARNING: POST-TREATMENT ACUTE EXACERBATION OF (5.3) HEPATITIS B • Embryo-fetal toxicity may occur when used at the time of conception and in early pregnancy. An alternative treatment to dolutegravir, See full prescribing information for complete boxed warning. emtricitabine and tenofovir alafenamide tablets should be considered at the time of conception through the first trimester of pregnancy due to the Severe acute exacerbations of hepatitis B virus (HBV) have been reported risk of neural tube defects. Counsel adolescents and adults of in HBV-infected patients who have discontinued products containing childbearing potential to use effective contraception.
    [Show full text]
  • MSF Comment on Raltegravir
    International Office Rue de Lausanne 78 CP 116 1211 Geneva 21 Switzerland Phone: +41 (0)22 8498400 Fax: +41 (0) 22 849 84 04 www.msf.org Raltegravir (granules for oral suspension, 100 mg/packet) MSF supports the inclusion of raltegravir granules for oral suspension, 100 mg/packet, as a new formulation in both the WHO Essential Medicines List and the WHO Essential Medicines List for Children, for treatment of HIV among infants and children and living with HIV/AIDS. Raltegravir was the first approved drug in the pharmacological class of integrase inhibitors. In the current WHO Essential Medicines List, raltegravir is included as 400 mg tablet, 25 mg and 100 mg chewable tablet. Raltegravir granules for oral suspension was approved by the US FDA for use in neonates and young infants in December 2013 and by the EMA in June 2018. Raltegravir granules for oral suspension can be used from birth to 4 weeks of age and in young infant beginning antiretroviral treatment. In the 2018 WHO HIV Interim Guidelines “Updated Recommendations on First-Line and Second-Line Antiretroviral Regimens and Post-Exposure Prophylaxis and Recommendations on Early Infant Diagnosis of HIV”, a raltegravir-based regimen may be recommended as an alternative first-line regimen for infants and children for whom approved dolutegravir dosing is not available and a raltegravir-based regimen is recommended as the preferred first-line regimen for neonates. In the 2018 Optimal Formulary and Limited-use List for Paediatric ARVs, raltegravir-based regimens are recommended as preferred first-line treatment (with zidovudine + lamivudine) for neonates, as an alternative first-line treatment for infants (with abacavir + lamivudine), and used “for the shortest time possible, until a solid formulation of lopinavir + ritonavir or dolutegravir can be used.” Raltegravir granules for oral suspension, as preferred first-line treatment for neonates, was also added to Limit-use List for this time-limited purpose.
    [Show full text]
  • ISENTRESS (Raltegravir) for Oral Suspension ------CONTRAINDICATIONS ------Initial U.S
    HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use --------------------- DOSAGE FORMS AND STRENGTHS --------------------- ISENTRESS safely and effectively. See full prescribing information Film-Coated Tablets: 400 mg (3). for ISENTRESS. Film-Coated Tablets: 600 mg (3). ISENTRESS® (raltegravir) film-coated tablets, for oral use Chewable Tablets: 100 mg scored and 25 mg (3). ® ISENTRESS HD (raltegravir) film-coated tablets, for oral use For Oral Suspension: Single-use packet of 100 mg (3). ISENTRESS® (raltegravir) chewable tablets, for oral use ® ISENTRESS (raltegravir) for oral suspension ------------------------------- CONTRAINDICATIONS ------------------------------- Initial U.S. Approval: 2007 None (4). ----------------------------INDICATIONS AND USAGE ---------------------------- ----------------------- WARNINGS AND PRECAUTIONS ----------------------- Adult Patients: Severe, potentially life-threatening and fatal skin reactions have been ISENTRESS and ISENTRESS HD are human immunodeficiency virus reported. This includes cases of Stevens-Johnson syndrome, integrase strand transfer inhibitors (HIV-1 INSTI) indicated in hypersensitivity reaction and toxic epidermal necrolysis. Immediately combination with other antiretroviral agents for the treatment of HIV-1 discontinue treatment with ISENTRESS or ISENTRESS HD and infection in adult patients (1). other suspect agents if severe hypersensitivity, severe rash, or rash Pediatric Patients: with systemic symptoms or liver aminotransferase
    [Show full text]
  • Raltegravir with Optimized Background Therapy for Resistant HIV-1 Infection Joseph A
    retroviral agents. The purpose of this study was to eval- and preferably 2 effective agents in the optimized back- uate a CCR5 antagonist, maraviroc, in the treatment of ground regimen to maximize the effect of maraviroc. In HIV-infected adults. addition, in the secondary analysis of the results, pre- existing CXCR4-using HIV essentially eliminated any STUDY POPULATION. Two double-blind, placebo-controlled benefit of maraviroc. The development of CXCR4-using studies were conducted. More than 1000 patients were HIV after primary infection with CCR5-using virus is a randomly assigned to receive either maraviroc or pla- matter of time and chance. Approximately 50% of cebo in combination with investigator-chosen optimized heavily pretreated, long-term HIV-infected adults have background therapy. Most patients were resistant to CXCR4-using virus and thus would be completely resis- multiple classes of antiretroviral agents; mean baseline tant to maraviroc therapy. Currently, maraviroc is ap- viral loads were Ͼ72 000 copies per mL, and median proved for patients who are known to be resistant to CD4ϩ cell counts were 169 cells per mm3. multiple other drugs. Perhaps maraviroc and similar METHODS. Subjects were assigned to receive maraviroc or chemokine receptor blockers would best be used before placebo in addition to optimized background therapy the likely development of CXCR4-using virus. Studies based on treatment history and drug resistance testing. are underway to evaluate the use of this novel agent in Safety and efficacy were assessed after 48 weeks. patients naive to antiretroviral therapy. RESULTS. The demographic and baseline characteristics of URL: www.pediatrics.org/cgi/doi/10.1542/peds.2009-1870EEEE patients were similar between the 2 study groups (pla- Joseph A.
    [Show full text]
  • Once-Daily Dolutegravir Versus Raltegravir in Antiretroviral-Naive
    Articles Once-daily dolutegravir versus raltegravir in antiretroviral-naive adults with HIV-1 infection: 48 week results from the randomised, double-blind, non-inferiority SPRING-2 study Francois Raffi , Anita Rachlis, Hans-Jürgen Stellbrink, W David Hardy, Carlo Torti, Chloe Orkin, Mark Bloch, Daniel Podzamczer, Vadim Pokrovsky, Federico Pulido, Steve Almond, David Margolis, Clare Brennan, Sherene Min, on behalf of the SPRING-2 study group Summary Background Dolutegravir (S/GSK1349572) is a once-daily HIV integrase inhibitor with potent antiviral activity and a Lancet 2013; 381: 735–43 favourable safety profi le. We compared dolutegravir with HIV integrase inhibitor raltegravir, as initial treatment for Published Online adults with HIV-1. January 8, 2013 http://dx.doi.org/10.1016/ S0140-6736(12)61853-4 Methods SPRING-2 is a 96 week, phase 3, randomised, double-blind, active-controlled, non-inferiority study that See Comment page 705 began on Oct 19, 2010, at 100 sites in Canada, USA, Australia, and Europe. Treatment-naive adults (aged ≥18 years) University of Nantes, Nantes, with HIV-1 infection and HIV-1 RNA concentrations of 1000 copies per mL or greater were randomly assigned (1:1) via France (Prof F Raffi MD); a computer-generated randomisation sequence to receive either dolutegravir (50 mg once daily) or raltegravir (400 mg Sunnybrook Health Sciences twice daily). Study drugs were given with coformulated tenofovir/emtricitabine or abacavir/lamivudine. Randomisation Centre, University of Toronto, was stratifi ed by screening HIV-1 RNA (≤100 000 copies per mL or >100 000 copies per mL) and nucleoside reverse ON, Canada (Prof A Rachlis MD); Infektionsmedizinisches transcriptase inhibitor backbone.
    [Show full text]
  • Differential Effects of Raltegravir, Dolutegravir and Bictegravir on Human Adipocytes
    Differential effects of raltegravir, dolutegravir and bictegravir on human adipocytes Pere Domingo1, Tania Quesada-López2, Joan Villarroya1,2, Mar Gutierrez1, Gracia Mateo1, Isabel Mur1, Noemí Corbacho1, Joan Carles Domingo2, Francesc Villarroya2, Marta Giralt2 1 Department of Infectious Diseases, Hospital de la Santa Creu i Sant Pau, and Institut de Recerca del Hospital de la Santa Creu i Sant Pau, Barcelona, Catalonia; 2 Departament de Bioquímica i Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Catalonia, and CIBER Fisiopatología de la Obesidad y Nutrición, Spain Background Methods Recent data have raised concerns about weight gain Human Simpson Golabi Behmel Syndrome (SGBS) adipose cells were used and cultured associated with the use of integrase strand transfer using standard procedures. In controls, sub-optimal differentiation was achieved with the use inhibitors (INsTI) [1-3]. The pathophysiological basis of 0.5 μM rosiglitazone at the time of differentiation induction. Drugs were included in the of this effect is unknown. differentiation medium at concentrations ranging from 0.1 to 10 μM (which includes Cmin and The goal of our study was to assess the potential Cmax in treated patients. direct effects of raltegravir (RAL), dolutegravir (DTG), Morphological adipogenesis (accumulation of lipid droplets) was followed. and bictegravir (BIC) on human adipose cells. Gene expression for markers of adipogenesis, adipocyte metabolism, adipokines, and cytokines was determined using qRT-PCR twelve days after induction of differentiation. Results Figure 1. Effects of INsTI on human adipose cell differentiation • Morphological differentiation of human adipose cells in culture was None of the three INsTI tested caused substantial effects on unaffected by the presence of BIC, DTG or RAL (Fig.1).
    [Show full text]
  • Reference ID: 4219844
    HIGHLIGHTS OF PRESCRIBING INFORMATION ------------------------------ CONTRAINDICATIONS ----------------------------- These highlights do not include all the information needed to use • Previous hypersensitivity reaction to dolutegravir. (4) DOLUTEGRAVIR, EMTRICITABINE AND TENOFOVIR • Coadministration with dofetilide. (4) ALAFENAMIDE TABLETS safely and effectively. See full prescribing information for DOLUTEGRAVIR, EMTRICITABINE AND ----------------------- WARNINGS AND PRECAUTIONS ----------------------- TENOFOVIR ALAFENAMIDE TABLETS. • Hepatotoxicity has been reported in patients receiving a dolutegravir- containing regimen. Monitoring for hepatotoxicity is recommended. DOLUTEGRAVIR, EMTRICITABINE and TENOFOVIR (5.1) ALAFENAMIDE tablets, for oral use • Hypersensitivity reactions characterized by rash, constitutional findings, and sometimes organ dysfunction, including liver injury, have been WARNING: POST TREATMENT ACUTE EXACERBATION OF reported. Discontinue dolutegravir, emtricitabine and tenofovir HEPATITIS B alafenamide tablets and other suspect agents immediately if signs or See full prescribing information for complete boxed warning. symptoms of hypersensitivity reactions develop, as a delay in stopping treatment may result in a life-threatening reaction. (5.2) • Tenofovir alafenamide, one component of dolutegravir, • Immune reconstitution syndrome has been reported in patients treated emtricitabine and tenofovir alafenamide tablets, is approved for the with combination antiretroviral therapy. (5.5) treatment of chronic hepatitis
    [Show full text]
  • NORVIR (Ritonavir) Label
    HIGHLIGHTS OF PRESCRIBING INFORMATION CONTRAINDICATIONS These highlights do not include all the information needed to use • NORVIR is contraindicated in patients with known hypersensitivity to NORVIR safely and effectively. See full prescribing information for ritonavir (e.g., toxic epidermal necrolysis, Stevens-Johnson syndrome) or NORVIR. any of its ingredients (4) • Co-administration with drugs highly dependent on CYP3A for clearance NORVIR (ritonavir) tablet, for oral use and for which elevated plasma concentrations may be associated with NORVIR (ritonavir) oral solution serious and/or life-threatening events (4) NORVIR (ritonavir) oral powder • Co-administration with drugs that significantly reduce ritonavir (4) Initial U.S. Approval: 1996 WARNINGS AND PRECAUTIONS WARNING: DRUG-DRUG INTERACTIONS LEADING TO The following have been observed in patients receiving NORVIR: POTENTIALLY SERIOUS AND/OR LIFE THREATENING • The concomitant use of NORVIR and certain other drugs may result in REACTIONS known or potentially significant drug interactions. Consult the full See full prescribing information for complete boxed warning prescribing information prior to and during treatment for potential drug Co-administration of NORVIR with several classes of drugs including interactions. (5.1, 7.2) sedative hypnotics, antiarrhythmics, or ergot alkaloid preparations may • Toxicity in preterm neonates: NORVIR oral solution should not be used in result in potentially serious and/or life-threatening adverse events due to preterm neonates in the immediate postnatal period because of possible possible effects of NORVIR on the hepatic metabolism of certain drugs. toxicities. A safe and effective dose of NORVIR oral solution in this patient Review medications taken by patients prior to prescribing NORVIR or population has not been established (2.2, 5.2) when prescribing other medications to patients already taking NORVIR.
    [Show full text]
  • Switching Or Simplifying Antiretroviral Therapy
    © National HIV Curriculum PDF created September 27, 2021, 5:44 am Switching or Simplifying Antiretroviral Therapy This is a PDF version of the following document: Module 3: Antiretroviral Therapy Lesson 4: Switching or Simplifying Antiretroviral Therapy You can always find the most up to date version of this document at https://www.hiv.uw.edu/go/antiretroviral-therapy/switching-antiretroviral-therapy/core-concept/all. Principles of Switching or Simplifying Antiretroviral Therapy Rationale for Switching or Simplifying Antiretroviral Therapy There are many reasons why a patient may potentially benefit from a change of antiretroviral therapy, even when they have consistently suppressed HIV RNA levels (viral loads). Common reasons to consider switching antiretroviral therapy in the setting of virologic suppression include managing or preventing short-term or long-term adverse effects, high pill burden, difficulties with food requirements, or problematic drug interactions.[1,2,3] Additional considerations may include pregnancy, cost, changes to insurance coverage, or a desire to match a partner’s regimen. The reasons for switching an antiretroviral regimen are distinct from the setting of virologic failure with documented antiretroviral resistance, which necessitates transition to a salvage regimen as guided by genotypic drug resistance testing. Currently, clinicians most often switch antiretroviral therapy for the purpose of improved convenience or tolerability than for drug resistance.[4] Updating Antiretroviral Therapy to a Modern Regimen A frequent reason that antiretroviral therapy switches are considered in clinical practice is to “update” a regimen that is no longer recommended as part of first-line antiretroviral therapy. In this situation, a regimen modification may benefit the person with HIV by reducing pill burden and decreasing the risk for long-term adverse effects.
    [Show full text]