Generic Name: Darunavir
Class: HIV Protease Inhibitors
VA Class: AM800
Chemical Name: [(1S,2R) - 3 - [[(4 - Aminophenyl)sulfonyl](2 - methylpropyl)amino] - 2 - hydroxy - 1 - (phenylmethyl)propyl] - carbamic acid (3R,3aS,6aR)-hexahydrofuro[2,3-b]furan-3-yl ester
Molecular Formula: C27H37N3O7SC27H37N3O7S•C2H5OH
CAS Number: 206361-99-1
Introduction
Antiretroviral; HIV protease inhibitor (PI).1 2 3
Uses for Prezista
Treatment of HIV Infection
Treatment of HIV infection.1 Used in conjunction with low-dose ritonavir (ritonavir-boosted darunavir) and other antiretroviral agents.1
Ritonavir-boosted darunavir is a preferred PI for initial treatment regimens in adults.4
Treatment-experienced patients: Use of ritonavir-boosted darunavir should be guided by genotypic and phenotypic viral resistance testing and the individual’s prior antiretroviral treatment.1
Prezista Dosage and Administration
Administration
Oral Administration
Administer orally in conjunction with low-dose ritonavir (ritonavir-boosted darunavir).1 4 Do not use without low-dose ritonavir.1
Take darunavir and low-dose ritonavir at same time and with food.1
Administered once daily in treatment-naive adults.1
Administered twice daily in pediatric patients and treatment-experienced adults.1
Ensure that pediatric patients can swallow tablets; those unable to swallow tablets are not candidates for ritonavir-boosted darunavir therapy.1
Dosage
Available as darunavir ethanolate; dosage expressed in terms of darunavir.1
Pediatric Patients
Treatment of HIV Infection
To avoid medication errors, use extra care in calculating the dose, transcribing the medication order, dispensing the prescription, and providing dosing instructions.1
Dosage of ritonavir-boosted darunavir in children 6–<18 years of age weighing at least 20 kg is based on weight.1
Body weight | Darunavir dosage | Ritonavir dosage |
---|---|---|
20 to < 30 kg | 375 mg twice daily | 50 mg twice daily |
30 to < 40 kg | 450 mg twice daily | 60 mg twice daily |
≥ 40 kg | 600 mg twice daily | 100 mg twice daily |
Adults
Treatment of HIV Infection
Treatment-naive Adults
Oral
800 mg once daily boosted with low-dose ritonavir (100 mg once daily).1
Treatment-experienced Adults
Oral
600 mg twice daily boosted with low-dose ritonavir (100 mg twice daily).1
Prescribing Limits
Pediatric Patients
Treatment of HIV Infection
Oral
Do not exceed dosage for treatment-experienced adults.1
Special Populations
Hepatic Impairment
Dosage adjustment not needed in patients with mild to moderate hepatic impairment (Child-Pugh class A or B).1 4 Do not use in those with severe hepatic impairment (Child-Pugh class C).1 4
Renal Impairment
Some experts state that dosage adjustments are not necessary.4
Geriatric Patients
Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.1
Cautions for Prezista
Contraindications
Concomitant use with drugs highly dependent on CYP3A for metabolism and for which elevated plasma concentrations are associated with serious and/or life-threatening events and other drugs that may lead to loss of virologic response (e.g., cisapride, ergot alkaloids, lovastatin, oral midazolam, pimozide, rifampin, simvastatin, St. John’s wort [Hypericum perforatum], triazolam).1 (See Specific Drugs under Interactions.)
Warnings/Precautions
Warnings
Hepatic Effects
Acute hepatitis reported in clinical studies.1 Liver injury (in some cases fatal) reported during postmarketing surveillance; liver injury generally occurred in patients with advanced HIV infection who were receiving multiple concomitant drugs, who were coinfected with hepatitis B virus (HBV) or hepatitis C virus (HCV), and/or were developing immune reconstitution syndrome.1
Conduct appropriate laboratory tests before starting darunavir; monitor periodically thereafter.1 Consider increased AST/ALT monitoring in patients with hepatitis, cirrhosis, or elevated transaminase values prior to therapy, especially during the first several months of therapy.1
Consider interrupting or discontinuing darunavir in patients who develop manifestations suggestive of hepatic impairment (e.g., fatigue, anorexia, nausea, jaundice, dark urine, liver tenderness, hepatomegaly, clinically important increases in hepatic enzyme concentrations).1
Interactions
Darunavir is administered concomitantly with low-dose ritonavir (ritonavir-boosted darunavir).1 Failure to administer with recommended low-dose ritonavir will result in subtherapeutic darunavir concentrations and inadequate antiviral response.1 The usual cautions, precautions, and contraindications associated with ritonavir should be considered.1
Concomitant use with certain drugs is not recommended or requires particular caution (e.g., sildenafil, tadalafil, vardenafil).1 4 (See Specific Drugs under Interactions.)
Hyperglycemic and Diabetogenic Effects
Hyperglycemia (potentially persistent), new-onset diabetes mellitus, or exacerbation of preexisting diabetes mellitus reported with use of PIs; diabetic ketoacidosis has occurred.1
Initiate or adjust antidiabetic therapy (e.g., insulin, oral hypoglycemic agents) as needed.1
Sensitivity Reactions
Sulfonamide Sensitivity
Darunavir contains a sulfonamide moiety; use with caution in patients with known sulfonamide allergy.1
Dermatologic Reactions
Severe skin reactions, including Stevens-Johnson syndrome reported;1 fever and increased serum transaminase concentrations also may occur.1
Discontinue darunavir if severe rash occurs.1
General Precautions
Hemophilia A and B
Spontaneous bleeding reported with PIs;1 causal relationship not established.1
Use with caution in patients with history of hemophilia A or B.1 Increased hemostatic therapy (e.g., antihemophilic factor) may be needed.1
Adipogenic Effects
Possible redistribution or accumulation of body fat, including central obesity, dorsocervical fat enlargement (buffalo hump), peripheral wasting, facial wasting, breast enlargement, and general cushingoid appearance.1
Immune Reconstitution Syndrome
During initial treatment, patients who respond to antiretroviral therapy may develop an inflammatory response to indolent or residual opportunistic infections (e.g., Mycobacterium avium complex [MAC], M. tuberculosis, cytomegalovirus [CMV], Pneumocystis jiroveci [formerly P. carinii]; this may necessitate further evaluation and treatment.1
HIV Resistance
Possibility of cross-resistance to other PIs not evaluated.1 Effect of ritonavir-boosted darunavir therapy on subsequent therapy with other PIs unknown.1
Specific Populations
Pregnancy
Category C.1
Antiretroviral Pregnancy Registry at 800-258-4263.1
Some experts state safety and pharmacokinetic data insufficient to recommend ritonavir-boosted darunavir in pregnant women.7
Lactation
Distributed into milk in rats;1 not known whether distributed into human milk.1
Instruct HIV-infected women not to breast-feed because of risk of HIV transmission and risk of adverse effects in the infant.1
Pediatric Use
Adverse effects in children 6–<18 years of age similar to those reported in adults.1
Safety, efficacy, and pharmacokinetic profile not established in children 3 to <6 years of age.1
Should not be used in children <3 years of age because of toxicity and mortality in juvenile rats.1
Geriatric Use
Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults.1
Use with caution and monitor because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.1
Hepatic Impairment
Risk for liver function abnormalities, including severe adverse hepatic effects, in patients with preexisting hepatic impairment, including those with HBV or HCV infection.1
Pharmacokinetics not altered in individuals with mild (Child-Pugh class A) or moderate (Child-Pugh class B) hepatic impairment.1
Use not recommended in patients with severe hepatic impairment.1
Renal Impairment
Pharmacokinetics not altered in patients with Clcr≥30 mL/minute.1 Not studied in patients with severe renal impairment or end-stage renal disease.1
Common Adverse Effects
Diarrhea,1 9 nausea,1 9 headache,1 9 abdominal pain.1
Interactions for Prezista
Darunavir metabolized principally by CYP3A.1
Darunavir and ritonavir inhibit CYP3A4 and CYP2D6.1
Drugs Affecting or Metabolized by Hepatic Microsomal Enzymes
Pharmacokinetic interactions likely with drugs that are inhibitors or inducers of CYP3A4 with possible alteration in metabolism of darunavir or ritonavir.1
Potential pharmacokinetic interaction with drugs metabolized by CYP3A or CYP2D6 with possible altered metabolism of drug metabolized by CYP3A or CYP2D6.1
Specific Drugs
Drug | Interaction | Comments |
---|---|---|
Abacavir | Pharmacokinetic interaction not expected1 No in vitro evidence of antagonistic antiretroviral effects 1 | |
Antiarrhythmic agents (amiodarone, flecainide, systemic lidocaine, propafenone, quinidine) | Possible increased plasma concentrations of antiarrhythmic agents1 | Monitor antiarrhythmic concentrations1 |
Anticoagulants | Decreased warfarin concentrations1 | Monitor INR 1 |
Anticonvulsants (carbamazepine, phenobarbital, phenytoin) | Carbamazepine: Increased carbamazepine concentrations1 Phenobarbital, phenytoin: Decreased concentrations of the anticonvulsant1 | Carbamazepine: Dosage adjustment not needed; monitor carbamazepine concentrations and adjust dose to achieve appropriate clinical effect1 Phenobarbital, phenytoin: Monitor anticonvulsant concentrations1 |
Antifungals (itraconazole, ketoconazole, voriconazole) | Itraconazole: Increased darunavir and itraconazole concentrations1 Ketoconazole: Increased darunavir and ketoconazole concentrations1 Voriconazole: Decreased voriconazole concentrations1 | Itraconazole: Dosage >200 mg daily not recommended1 4 Ketoconazole: Dosage >200 mg daily not recommended 1 4 Voriconazole: Concomitant use not recommended unless benefits outweigh risks1 4 |
Antimycobacterials, rifamycins (rifabutin, rifampin, rifapentine) | Rifabutin: Increased rifabutin and darunavir concentrations1 Rifampin: Decreased darunavir concentrations; possible decreased antiretroviral activity1 | Rifabutin: Reduce rifabutin dosage to 150 mg once every other day (further reduction may be needed); monitor for adverse effects1 4 Rifampin: Concomitant use contraindicated 1 4 Rifapentine: Concomitant use not recommended4 |
Atazanavir | Plasma concentration of atazanavir with ritonavir-boosted darunavir similar to ritonavir-boosted atazanavir; no change in darunavir concentrations1 No in vitro evidence of antagonistic antiretroviral effects1 | Manufacturer and some experts state atazanavir 300 mg once daily can be used with ritonavir-boosted darunavir1 4 |
β-Adrenergic blocking agents (metoprolol, timolol) | Metoprolol, timolol: Possible increased concentrations of the β-adrenergic blocking agent1 | Metoprolol, timolol: Caution; dose reduction of the β-adrenergic blocking agent may be needed1 |
Benzodiazepines (e.g., midazolam, triazolam) | Possible increased concentrations of midazolam or triazolam; potential for serious and/or life-threatening effects (e.g., prolonged or increased sedation or respiratory depression)1 | Concomitant use with oral midazolam or triazolam contraindicated;1 some experts state a single parenteral dose of midazolam can be used with caution in a monitored situation for procedural sedation4 |
Calcium-channel blocking agents (e.g., felodipine, nicardipine, nifedipine) | Increased concentrations of calcium-channel blocking agents 1 | Use concomitantly with caution; clinical monitoring recommended1 |
Cisapride | Potential for serious and/or life-threatening effects such as cardiac arrhythmias 1 | Concomitant use contraindicated1 |
Clarithromycin | Increased clarithromycin concentrations1 | Modification of usual clarithromycin dosage not necessary in patients with normal renal function; reduce clarithromycin dosage by 50% if Clcr 30–60 mL/minute and reduce by 75% if Clcr <30 mL/minute 1 |
Corticosteroids (dexamethasone, fluticasone) | Fluticasone nasal spray/oral inhalation: Increased fluticasone concentrations with ritonavir-boosted darunavir resulting in decreased cortisol concentrations1 4 Dexamethasone: Decreased darunavir concentration; possible decreased antiretroviral efficacy1 | Fluticasone nasal spray/oral inhalation: Consider alternatives to fluticasone, especially when long-term corticosteroid use anticipated1 4 |
Delavirdine | No in vitro evidence of antagonistic antiretroviral effects 1 | |
Didanosine | Didanosine delayed-release capsules: No change in didanosine or darunavir concentrations1 Conflicting administration instructions with didanosine and food1 No in vitro evidence of antagonistic antiretroviral effects 1 | Administer darunavir with low-dose ritonavir (with food) 1 hour after or 2 hours before didanosine (without food)1 |
Digoxin | Increased digoxin concentrations1 | Use lowest possible initial dose of digoxin; monitor digoxin concentrations and adjust dose as clinically indicated1 |
Dextromethorphan | Increased dextromethorphan concentrations1 | |
Efavirenz | Decreased darunavir AUC; increased efavirenz AUC1 4 No in vitro evidence of antagonistic antiretroviral effects 1 | Clinical importance unknown4 Some experts suggest usual dosages can be used with close monitoring; consider monitoring plasma darunavir and efavirenz concentrations4 |
Emtricitabine | Pharmacokinetic interaction not expected1 No in vitro evidence of antagonistic antiretroviral effects 1 | |
Etravirine | Decrease in AUC of etravirine; no change in darunavir concentrations; safety and efficacy of ritonavir-boosted darunavir and etravirine established in clinical studies1 4 | Dosage adjustment not needed1 4 |
Enfuvirtide | No in vitro evidence of antagonistic antiretroviral effects1 | |
Ergot alkaloids (dihydroergotamine, ergonovine, ergotamine, methylergonovine) | Potential for serious or life-threatening adverse effects (e.g., peripheral vasospasm, ischemia of extremities)1 | Concomitant use contraindicated 1 If treatment of uterine atony and excessive postpartum bleeding is indicated in a woman receiving darunavir, use methylergonovine maleate (Methergine) only if alternative treatments cannot be used and if potential benefits outweigh risks; use methylergonovine at lowest dosage and shortest duration possible7 |
Fosamprenavir | Data not available regarding pharmacokinetic interaction1 | Concomitant use not recommended pending further data1 |
Histamine H2- receptor antagonists (e.g., ranitidine) | Ranitidine: Pharmacokinetic interaction not expected1 4 | Dosage adjustment not necessary1 |
HMG-CoA reductase inhibitors | Lovastatin, simvastatin: Increased risk of serious adverse reactions (e.g., myopathy, rhabdomyolysis)1 Increased concentrations of certain HMG-CoA reductase inhibitors (i.e., atorvastatin, pravastatin, rosuvastatin)1 4 | Concomitant use with lovastatin or simvastatin contraindicated1 If used with atorvastatin, pravastatin, or rosuvastatin, use lowest possible dosage of the HMG-CoA reductase inhibitor and monitor carefully; consider using fluvastatin1 |
Hormonal contraceptives (estrogens or progestins) | Decreased ethinyl estradiol and norethindrone concentrations with oral contraceptive preparations1 | Use alternative nonhormonal contraception methods1 |
Immunosuppressive agents (cyclosporine, sirolimus, tacrolimus) | Potential for increased immunosuppressive agent concentrations1 | Monitor plasma concentrations of immunosuppressive agent if used concomitantly1 |
Indinavir | Increased darunavir and indinavir concentrations1 No in vitro evidence of antagonistic antiretroviral effects1 | Appropriate dosages for concomitant use not established1 |
Lamivudine | Pharmacokinetic interaction unlikely1 No in vitro evidence of antagonistic antiretroviral effects1 | |
Lopinavir | No change in lopinavir concentrations; decreased darunavir concentrations1 No in vitro evidence of antagonistic antiretroviral effects1 | Concomitant use not recommended1 4 |
Maraviroc | Increased maraviroc concentrations4 | Recommended dosage of maraviroc is 150 mg twice daily when used with ritonavir-boosted darunavir4 |
Methadone | Decreased methadone concentrations1 | Adjustment in the methadone dosage not needed; closely monitor for signs of opiate withdrawal and adjust methadone dosage if needed1 |
Nelfinavir | Data not available regarding pharmacokinetic interaction1 No in vitro evidence of antagonistic antiretroviral effects1 | Concomitant use not recommended pending further data1 |
Nevirapine | Increased plasma nevirapine concentrations; unchanged plasma darunavir concentrations1 4 No in vitro evidence of antagonistic antiretroviral effects1 | Dosage adjustment not necessary1 4 |
Proton pump inhibitors | Omeprazole: Decreased omeprazole concentrations1 | Dosage adjustment not necessary1 |
Psychotherapeutic agents (e.g., desipramine, pimozide, risperidone, thioridazine, trazodone, SSRIs) | Pimozide: Potential for serious and/or life-threatening adverse effects (e.g., cardiac arrhythmias)1 Desipramine, trazodone: Potential for increased concentrations of the antidepressant; 1 increased risk of nausea, dizziness, hypotension, syncope1 SSRIs: Decreased concentrations of paroxetine and sertraline; unchanged darunavir concentrations1 4 Risperidone, thioridazine: Potential for increased concentrations of the psychotherapeutic agent1 | Pimozide: Concomitant use contraindicated1 Desipramine, trazodone: Caution; reduced dosage of the antidepressant may be needed1 SSRIs: Titrate dosage of paroxetine or sertraline and monitor for clinical response1 4 Risperidone, thioridazine: Reduced dosage of the psychotherapeutic agent may be needed1 |
Ritonavir | Increased plasma darunavir concentrations and AUC;1 2 4 concomitant low-dose ritonavir used to therapeutic advantage (ritonavir-boosted darunavir)1 2 4 No in vitro evidence of antagonistic antiretroviral effects1 | |
St. John’s wort (Hypericum perforatum) | Potential decreased darunavir concentration; possible decreased antiretroviral efficacy1 | Concomitant use contraindicated1 |
Saquinavir | Decreased darunavir concentrations; unchanged saquinavir concentrations1 No in vitro evidence of antagonistic antiretroviral effects1 | Concomitant use not recommended1 4 |
Sildenafil | Possible increased sildenafil concentrations and increased risk of sildenafil-associated adverse effects (e.g., hypotension, visual changes, prolonged erection)1 | Do not exceed sildenafil dosage of 25 mg once every 48 hours; closely monitor for adverse effects (e.g., hypotension, syncope, visual changes, prolonged erection)1 4 |
Stavudine | Pharmacokinetic interaction unlikely1 No in vitro evidence of antagonistic antiretroviral effects1 | |
Tadalafil | Possible increased tadalafil concentrations and increased risk of tadalafil-associated adverse effects (e.g., hypotension, visual changes, prolonged erection)1 | Use with caution and with reduced tadalafil dosage (initial dosage of 5 mg and do not exceed a single dose of 10 mg in 72 hours);4 closely monitor for adverse effects1 4 |
Tenofovir | Increased plasma tenofovir concentrations; unchanged plasma darunavir concentrations1 4 No in vitro evidence of antagonistic antiretroviral effects1 | Manufacturer of darunavir recommends usual dosage of tenofovir with ritonavir-boosted darunavir 1 Some experts state clinical importance unknown; monitor for tenofovir toxicity4 |
Tipranavir | No in vitro evidence of antagonistic antiretroviral effects 1 | Concomitant use not recommended1 |
Vardenafil | Possible increased vardenafil concentrations and increased risk of vardenafil-associated adverse effects (e.g., hypotension, visual changes, prolonged erection)1 | Do not exceed vardenafil dosage of 2.5 mg once every 72 hours; closely monitor for adverse effects (e.g., hypotension, syncope, visual changes, prolonged erection)1 4 |
Zidovudine | Pharmacokinetic interaction unlikely1 No in vitro evidence of antagonistic antiretroviral effects1 |
Prezista Pharmacokinetics
Absorption
Bioavailability
Darunavir administered concomitantly with low-dose ritonavir (ritonavir-boosted darunavir).1 Ritonavir decreases metabolism of darunavir, resulting in increased plasma darunavir concentrations.1
Peak plasma darunavir concentrations attained approximately 2.5–4 hours after a dose.1
Food
Compared with administration in the fasting state, administration of ritonavir-boosted darunavir with food increases peak darunavir concentrations and AUC approximately 30%.1
Distribution
Extent
Not known whether distributed into human milk;1 distributed into milk in rats.1
Plasma Protein Binding
95%.1
Binds principally to α1-acid-glycoprotein.1
Elimination
Metabolism
Darunavir extensively metabolized by CYP3A.1
Elimination Route
Following administration of ritonavir-boosted darunavir, eliminated principally in feces as unchanged darunavir.1 Approximately 80% of darunavir dose excreted in feces and 14% excreted in urine.1
Half-life
15 hours.1
Special Populations
Moderate renal impairment (Clcr 30–60 mL/minute): Pharmacokinetics not affected.1
Severe renal impairment or end-stage renal disease: No pharmacokinetic data.1
Unlikely to be removed by hemodialysis or peritoneal dialysis.1
Hepatic impairment: Pharmacokinetics in individuals with mild hepatic impairment (Child-Pugh class A) or moderate hepatic impairment (Child-Pugh class B) similar to values in individuals with normal hepatic function.1 Pharmacokinetics not evaluated in those with severe hepatic impairment.1
HBV or HCV coinfection: No effect on darunavir exposure.1
Higher darunavir concentrations reported in females compared with males; dosage adjustments not required.1
Stability
Storage
Oral
Tablets
25°C (may be exposed to 15–30°C).1
Actions and SpectrumActions
Darunavir is administered in conjunction with low-dose ritonavir (ritonavir-boosted darunavir).1
Darunavir is extensively metabolized by CYP3A; ritonavir is a potent inhibitor of CYP3A.1 Concomitant use of these drugs results in decreased metabolism and increased plasma concentrations of darunavir.1
Antiretroviral activity is due to darunavir.1
Active against HIV-1.1
Darunavir inhibits replication of HIV-1 by interfering with HIV proteases.1
Darunavir-resistant HIV-1, including strains with decreased susceptibility to other PIs, has been reported.1 3
Advice to Patients
Critical nature of compliance with HIV therapy.1 Importance of using darunavir with low-dose ritonavir; importance of using these 2 drugs in conjunction with other antiretrovirals.1
Antiretroviral therapy is not a cure for HIV infection, and opportunistic infections still may occur.1 HIV transmission via sexual contact or sharing needles is not prevented by antiretrovirals.1
Importance of reading patient information provided by the manufacturer.1
Importance of taking darunavir with food and at the same time as ritonavir.1 Importance of swallowing the darunavir tablets whole with a drink (e.g., water, milk); the tablets should not be chewed.1 If also taking didanosine, administer didanosine dose 1 hour before or 2 hours after ritonavir-boosted darunavir.1
If a dose of darunavir or ritonavir is missed by <6 hours, administer the dose as soon as it is remembered and the next dose at the regularly scheduled time.1 If a dose of darunavir or ritonavir is missed by >6 hours, omit the dose and administer the next dose at the regularly scheduled time.1 Do not administer a double dose to make up for a missed dose.1
Importance of patient informing their clinician if they are allergic to sulfonamides.1
Redistribution/accumulation of body fat may occur with antiretroviral therapy, with as yet unknown long-term health effects.1
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and herbal products (e.g., St. John’s wort), and any concomitant illnesses.1
Advise patients receiving selective phosphodiesterase (PDE) inhibitors (e.g., sildenafil, tadalafil, vardenafil) that they may be at increased risk of PDE inhibitor-associated adverse effects (e.g., hypotension, visual changes, priapism) and that any symptoms should be promptly reported to their clinician.1
Importance of women using a reliable nonhormonal (e.g., barrier) method of contraception because of the potential interaction with hormonal contraceptives.1
Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1
Importance of advising patients of other important precautionary information.1 (See Cautions.)
Preparations
Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
---|---|---|---|---|
Oral | Tablets, film-coated | 75 mg (of darunavir) | Prezista | Tibotec |
150 mg (of darunavir) | Prezista | Tibotec | ||
400 mg (of darunavir) | Prezista | Tibotec | ||
600 mg (of darunavir) | Prezista | Tibotec |
Comparative Pricing
This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.
Prezista 400MG Tablets (CENTOCOR ORTHO BIOTECH PRODUCT): 60/$1060.01 or 120/$2120.03
Prezista 600MG Tablets (CENTOCOR ORTHO BIOTECH PRODUCT): 60/$1100.02 or 180/$3109.97
Disclaimer
This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.
The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.
AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions November 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
References
1. Tibotec. Prezista (darunavir) prescribing information. Raritan, NJ; 2008 Dec.
2. Koh Y, Nakata H, Maeda K et al. Novel bis-tetrahydrofuranylurethane-containing nonpeptidic protease inhibitor (PI) UIC-94017 (TMC114) with potent activity against multi-PI-resistant human immunodeficiency virus in vitro. Antimicrob Agents Chemother. 2003; 47:3123-9. [PubMed 14506019]
3. De Meyer S, Azijn H, Surleraux D et al. TMC114, a novel human immunodeficiency virus type 1 protease inhibitor active against protease inhibitor-resistant viruses, including a broad range of clinical isolates. Antimicrob Agents Chemother. 2005; 49:2314-21. [PubMed 15917527]
4. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents (November 3, 2008). From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website ().
5. Hammer SM, Saag MS, Schechter M, et al. Treatment of adult HIV infection: 2006 recommendations of the International AIDS Society–USA panel. JAMA. 2006; 296:827-43. [PubMed 16905788]
6. Banhegyi D, Esser S, Opravil M, Lefebvre E. TMC114/r outperforms investigator-selected PI(s) in treatment-experienced patients: 24-week primary efficacy and safety analysis of POWER 1. 1st European and Central Asian AIDS conference , Moscow, Russia, 2006 May 15–17. Poster. From Tibotec website ().
7. Perinatal HIV Guidelines Working Group. Public Health Service task force recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV-1 transmission in the United States (April 29, 2009). From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website ().
8. Working Group on Antiretroviral Therapy and Medical Management of HIV-infected Children of the National Resource Center at the François-Xavier Bagnoud Center, Health Resources and Services Administration (HRSA), and National Institutes of Health (NIH). Guidelines for the use of antiretroviral agents in pediatric HIV infection (February 23, 2009). From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website ().
9. Madruga JV, Berger D, McMurchie M et al. Efficacy and safety of darunavir-ritonavir compared with that of lopinavir-ritonavir at 48 weeks in treatment-experienced, HIV-infected patients in TITAN: a randomised controlled phase III trial. Lancet. 2007; 370:49-58. [PubMed 17617272]
10. Ortiz R, DeJesus E, Khanlou H et al. Efficacy and safety of once-daily darunavir/ritonavir versus lopinavir/ritonavir in treatment-naive HIV-1 infected patients at week 48. AIDS. 2008; 22:1389-97. [PubMed 18614861]
11. Tibotec Therapeutics. Intelence (etravirine) tablets prescribing information. Raritan, NJ; 2008 Jan.
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