Northwest AIDS Education and Training Center Educating health care professionals to provide quality HIV care

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1 Northwest AIDS Education and Training Center Educating health care professionals to provide quality HIV care The Northwest AIDS Education and Training Center (NW AETC), located at the University of Washington, offers HIV treatment education, clinical consultation, capacity building, and technical assistance to health care professionals and agencies in Washington, Alaska, Montana, Idaho, and Oregon. The purpose of the NW AETC is to increase providers capacity to provide high quality HIV/AIDS care within the region s health care systems. Our program offers a variety of educational opportunities for health care providers and organizations to meet their specific HIV/AIDS education needs through in-person and distance-based training, clinical consultation, and technical assistance. Please visit our websites to learn more about NW AETC training opportunities and additional educations resources: Or visit our Facebook page at: HIV Entry Inhibitors Nucleoside RTI Integrase Inhibitors Nucleus CCR5 CD4 genomic RNA HIV HIV RNA CXCR4 HIV DNA mrna Myr Host Cell Gag Protease Inhibitors Gag-Pol Non-Nucleoside RTI For specific and detailed information regarding dosing recommendations, drug-drug interactions and adverse effects, see the guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents at Entry Inhibitors Enfuvirtide (T20) Fuzeon 90 mg/ml Administered dose: 90 mg/ml subcutaneously (SQ) 2 times a day (108 mg vial diluted with 1.1 ml sterile water) Store at controlled room temperature Injection site reaction: pain/discomfort, induration, erythema, nodule Other: diarrhea, nausea, vomiting, fatigue, insomnia Maraviroc (MVC) Selzentry 150 mg (With NRTIs, tipranavir/ritonavir, nevirapine, and weak CYP3A inhibitors or CYP3A inducers) 1 x 150 mg tablet 2 times a day (When given with strong CYP3A inhibitors with or without CYP3A inducers) Liver toxicity, cough, fever, upper respiratory infection, rash, musculoskeletal symptoms, stomach pain, dizziness Other: Use with caution in those with liver disease or at risk for cardiovascular events 2 x tablets 2 times a day (With CYP3A inducers including efavirenz, without a strong CYP3A inhibitor)

2 The Northwest AETC Antir This chart is funded by Health Resources and Services Administra Abacavir (ABC) Ziagen Nucleos(t)ide Reverse Transcriptase Inhibitors (NRTI) 2 x tablets 1 time a day symptoms may include: fever, rash, nausea, vomiting, malaise or fatigue, respiratory difficulties DO NOT RECHALLENGE!! Didanosine (ddi) Videx 250 mg 1 x capsule 1 time a day Reduce dose for weight < 60 kg Take on an empty stomach Note: When combined with tenofovir, reduce didanosine to 250 mg 1 time a day; may be taken with food. Peripheral neuropathy, pancreatitis, nausea, diarrhea Emtricitabine (FTC) Emtriva 1 x capsule 1 time a day Headaches, fatigue, nausea (3TC) Epivir 150 mg 1 x 150 mg tablet 2 times a day 1 x tablet 1 time a day Headaches, fatigue, nausea Stavudine (d4t) Zerit 30 mg 40 mg 1 x 40 mg capsule 2 times a day Reduce dose for weight < 60 Kg 1 x 30 mg capsule 2 times a day Peripheral neuropathy, Tenofovir DF (TDF) Viread 1 x tablet 1 time a day Renal insufficiency (uncommon), nausea, upset stomach Zidovudine (ZDV) Retrovir Abacavir + Epzicom 100 mg ABC 600 mg/3tc 3 x 100 mg capsules 2 times a day Combination NRTIs Anemia, neutropenia, headaches, nausea, body aches, insomnia (as above), refer to adverse effects listed for DO NOT RECHALLENGE! Abacavir + + Zidovudine Trizivir ABC /3TC 150 mg/ AZT 1 tablet 2 times a day (as above), refer to adverse effects listed for DO NOT RECHALLENGE! Emtricitabine Truvada TDF /FTC Zidovudine + Combivir AZT /3TC 150 mg 1 tablet 2 times a day NRTI Class Adverse Reactions: lactic acidosis with hepatic steatosis (rare, but potentially life threatening reaction with use of NRTIs)

3 etroviral Medication Chart tion, US Department of Health and Human Services Delavirdine (DLV) Rescriptor Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) 2 x tablets 3 times a day Do not take with antacids Rash, headache, Efavirenz (EFV) Sustiva 600 mg 1 x 600 mg tablet 1 time a day at bedtime 3 x capsules 1 time a day at bedtime Empty stomach recommended (avoid taking with high fat meals) Rash,, dizziness, insomnia, impaired concentration, drowsiness, depression or mood changes Etravirine (ETR) Intelence 100 mg 2 x 100 mg tablet 2 times a day 1 x tablet 2 times a day Nausea, headache, rash Nevirapine (NVP) Viramune Viramune XR 1 x tablet 2 times a day 1 x tablet 1 time a day (start with tablet once daily x 14 days) Rash, headache, Rilpivirine (RPV) Edurant 25 mg 1 x 25 mg tablet 1 time a day Proton pump inhibitors are contraindicated Consult prescribing information for use of antacids and H2-blockers Depression or mood changes, anxious or restless, trouble sleeping, headache, rash Raltegravir (RAL) Isentress Efavirenz Atripla Integrase Inhibitors 1 tablet 2 times a day Single Tablet Regimens TDF /FTC / EFV 600 mg at bedtime Empty stomach recommended Nausea, headache, fever, myopathy or rhabdomyolysis Rilpivirine Complera TDF /FTC / RPV 25 mg Proton pump inhibitors are contraindicated Consult prescribing information for use of antacids and H2-blockers Elvitegravir + Cobicistat Stribild TDF /FTC / EVG 150 mg/cobi 150 mg Note: Should not be initiated in patients with pre-treatment CrCI < 70 ml/min abnormal dreams, headache NRTI Class Adverse Reactions: lactic acidosis with hepatic steatosis (rare, but potentially life threatening reaction with use of NRTIs) NNRTI Class Adverse Reactions: Stevens-Johnson syndrome, hypersensitivity reaction, erythema multiforme (all rare)

4 Produced by: Bradley Kosel, PharmD Robert Loeffelbein, PharmD David Spach, MD Atazanavir (ATV) Reyataz 150 mg Protease Inhibitors (PI) 2 x tablets 1 time a day 1 x tablet with ritonavir 100 mg tablet 1 time a day. Note: Use ritonavir-boosted dose when combined with efavirenz, nevirapine, or tenofovir Take with light meal Consult Reyataz prescribing information for use with antacids, H2-blockers and proton pump inhibitors. rash, abdominal discomfort, increased bilirubin (jaundice), kidney stones Darunavir (DRV) Prezista 600 mg Always use with ritonavir 1 x 600 mg tablet 2 times a day with ritonavir 1 x 100 mg tablet 2 times a day 2 x tablets 1 time a day with ritonavir 1 x 100 mg tablet 1 time a day headache, rash 1 Fosamprenavir (FPV) Lexiva 700 mg PI-naïve patients: 2 x 700 mg tablets 2 times a day 2 x 700 mg tablets 1 time a day with ritonavir 1 or 2 x 100 mg tablet(s) 1 time a day Note: Dose adjustments may be required when used with NNRTIs. headache, rash 1 1 x 700 mg tablet 2 times a day with ritonavir 1 x 100 mg tablet 2 times a day 1 x 700 mg tablet 2 times a day with 1 x 100 mg ritonavir tablet 2 times a day Indinavir (IDV) Crixivan 2 x tablets 2 times a day with ritonavir 1 or 2 x 100 mg tablet(s) 2 times a day Drink at least 1.5 liters of fluid per day Nausea, vomiting, kidney stones, heartburn, increased bilirubin (jaundice) Lopinavir/ Ritonavir (LPV/r) Kaletra LPV /RTV 50 mg PI-naïve patients: 2 tablets 2 times a day 4 tablets 1 time a day 2 tablets 2 times a day 1 time a day not recommended asthenia (lack of strength), headache Note: Use 3 tablets 2 times a day when used with nevirapine or efavirenz Nelfinavir (NFV) Viracept 250 mg 625 mg 2 x 625 mg tablets 2 times a day 5 x 250 mg tablets 2 times a day 3 x 250 mg tablets 3 times a day Always take with food vomiting, abdominal pain Ritonavir (RTV) Norvir 100 mg capsule 100 mg Ritonavir is primarily used in low doses to boost drug levels of other protease inhibitors Capsules should be refrigerated headache Saquinavir (SQV) Invirase 2 x 500 mg tablets 2 times a day with ritonavir 100 mg tablet 2 times a day 5 x tablets 2 times a day with ritonavir 100 mg tablet 2 times a day headache; may cause PR and/or QT interval prolongation Always take with food at same time with ritonavir 500 mg Tipranavir (TPV) Aptivus 250 mg Always use with ritonavir 2 x 250 mg tablets 2 times a day with ritonavir 2 x 100 mg tablets 2 times a day Do not take with antacids Keep refrigerated vomiting, stomach cramps, rash, intracranial hemorrhage 1, 2 PI Class Adverse Reactions: hepatotoxicity, insulin resistance/diabetes mellitus, fat maldistribution, hyperlipidemia, osteonecrosis, 1 Caution in patients with known sulfonamide allergy 2 Increased bleeding episodes in hemophiliac patients Updated October 2012

5 For more Northwest AETC Antiretroviral Medication Charts please complete and return the following Mailing Information: Full Name: Organization: Address: City: State: Zip: Phone: How did you hear about the NW AETC? Please send (circle) Medication Charts.

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