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Etravirine
Etravirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) used as part of combination antiretroviral therapy (ART) for the treatment of HIV-1 infection in adults and children. It is typically prescribed for patients who have experienced treatment failure with other HIV medications due to drug resistance. By inhibiting the reverse transcriptase enzyme, which is essential for viral replication, etravirine helps reduce the viral load in the blood, improving immune function and reducing the risk of HIV-related complications.
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Frequently Asked Questions
How long does it take for Etravirine to work?
Etravirine begins working to lower the viral load shortly after starting treatment. However, it may take weeks to months of consistent use in combination with other antiretrovirals to achieve a significantly reduced viral load.
Can Etravirine be used alone to treat HIV?
No, etravirine is not effective as a standalone treatment. It must be used in combination with other antiretroviral medications to effectively manage HIV infection.
What should I do if I miss a dose of Etravirine?
If you miss a dose and it is still early, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Can Etravirine cause liver problems?
Yes, Etravirine can cause liver toxicity in some patients. Signs of liver issues include yellowing of the skin or eyes (jaundice), dark urine, or upper abdominal pain. Regular liver function tests are recommended, especially in patients with pre-existing liver conditions.
Does Etravirine cure HIV?
No, Etravirine does not cure HIV. It helps manage the infection by reducing the viral load, improving immune function, and reducing the risk of complications. Long-term, consistent treatment is necessary to keep the virus under control.
Comprehensive Drug Guide
How Does Etravirine Work?
Etravirine works by inhibiting the reverse transcriptase enzyme, a key enzyme used by HIV-1 to replicate its genetic material and infect human cells. By blocking this enzyme, etravirine prevents HIV from making copies of itself, thereby reducing the viral load (amount of HIV in the blood) and helping the immune system function better.
Common Dosages
- For adults: The usual dose is 200 mg twice daily, taken with food.
- For children aged 6 years and older: The dose is based on weight, with dosing typically ranging from 25 mg to 200 mg twice daily, depending on the child's weight. Etravirine must be taken with food to ensure proper absorption.
Typical Dosing
FDA Approved Indications
Treatment of HIV-1 infection: As part of combination antiretroviral therapy in patients who are treatment-experienced and have evidence of HIV strains resistant to other NNRTIs or antiretroviral agents.
Who Shouldn't Take Etravirine?
- Known hypersensitivity to etravirine or any of its components.
- Severe hepatic impairment, as it may exacerbate liver function issues.
Advice From The Pharmacist
- Take etravirine with food to improve absorption and maximize its effectiveness.
- If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not double up on doses to make up for a missed one.
- Do not stop taking etravirine or any part of your HIV treatment regimen without consulting your healthcare provider, as this can lead to drug resistance and a worsening of your condition.
- Inform your healthcare provider about any new medications or supplements, as etravirine has several drug interactions.
Side Effects of Etravirine
Common Side Effects
- Rash
- Nausea
- Diarrhea
- Fatigue
- Headache
Uncommon/Severe Side Effects
- Severe rash or Stevens-Johnson syndrome (painful skin rash, blisters, fever)
- Liver toxicity (jaundice, dark urine, upper abdominal pain)
- Immune reconstitution syndrome: A condition where the immune system becomes stronger and starts to fight hidden infections, potentially causing symptoms.
Risks and Warnings of Etravirine
- Severe Skin Reactions: Etravirine can cause severe rashes, including Stevens-Johnson syndrome or toxic epidermal necrolysis, which may be life-threatening. Contact your healthcare provider immediately if you experience skin rash, blisters, or fever.
- Liver Toxicity: Etravirine can cause liver issues, especially in people with existing liver conditions or co-infection with hepatitis B or C. Monitor liver function tests regularly.
- Immune Reconstitution Syndrome: Some patients may experience an inflammatory response as the immune system begins to recover, leading to previously hidden infections becoming active.
Interactions with Etravirine
Common Drug Interactions
- CYP3A4 inducers: Drugs such as rifampin, phenobarbital, and carbamazepine may decrease the effectiveness of etravirine by increasing its metabolism.
- Protease inhibitors: Some protease inhibitors, such as ritonavir, can affect etravirine levels and may require dosage adjustments.
- Antifungal medications (e.g., ketoconazole): May increase levels of etravirine, requiring close monitoring for side effects.
Alternatives to Etravirine
- Efavirenz (Sustiva): Another NNRTI used to treat HIV, but typically used in treatment-naïve patients.
- Rilpivirine (Edurant): An NNRTI used as part of combination therapy for HIV.
- Doravirine (Pifeltro): A newer NNRTI used for HIV treatment in patients without resistance to this class of drugs.
- Integrase inhibitors (e.g., dolutegravir): An alternative class of antiretroviral medications used in combination HIV therapy.
