delavirdine, Rescriptor

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Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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GENERIC NAME: delavirdine

BRAND NAME: Rescriptor

DRUG CLASS AND MECHANISM: Delavirdine is an oral medication that is used for the treatment of infections with the human immunodeficiency virus (HIV). It is similar to efavirenz (Sustiva) and nevirapine (Viramune). Delavirdine is in a class of drugs called reverse transcriptase inhibitors which also includes zalcitabine (Hivid), zidovudine (Retrovir), didanosine (Videx), and lamivudine (Epivir). During infection with HIV, the HIV virus multiplies within the body's cells. The newly-formed viruses then are released from the cells and spread throughout the body where they infect other cells. In this manner, the infection spreads to new, uninfected cells that the body is continually producing, and HIV infection is perpetuated. When producing new virus, the HIV virus must manufacture new DNA for each virus. Reverse transcriptase is the enzyme that the virus uses to form this new DNA. Delavirdine directly inhibits the activity of reverse transcriptase and blocks the production of DNA and new virus. Delavirdine does not kill existing HIV virus, and it is not a cure for HIV. Delavirdine was approved by the FDA in April 1997.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets: 100 and 200 mg

STORAGE: Delavirdine should be stored at room temperature, 15 C to 30 C (59 F to 86 F).

PRESCRIBED FOR: Delavirdine is used together with other anti-HIV drugs for the treatment of HIV infection.

DOSING: The recommended dose for adults is 400 mg three times daily. To administer as a solution four 100 mg tablets in at least 3 oz of water should stand for a few minutes. It then shoud be mixed and consumed in its entirety immediately. Delavirdine may be administered without regard to meals since food does not reduce its absorption.

DRUG INTERACTIONS: Delavirdine has many drug interactions because it reduces the activity of certain liver enzymes that breakdown many drugs, and the breakdown of delavirdine is reduced by other drugs.

Some examples of delavirdine interactions include:

• Rifampin (Rifadin), rifabutin (Mycobutin), saquinavir (Invirase), anticonvulsants (for example, phenytoin [Dilantin], carbamazepine [Tegretol], phenobarbitol) decrease blood concentrations of delavirdine and should not be combined with delavirdine since decreased blood concentrations may reduce the effectiveness of delavirdine. Antacids and didanosine (Videx) also decrease blood concentrations of delavirdine. Therefore, the administration of delavirdine with antacids or didanosine should be separated by at least one hour.
• Clarithromycin (Biaxin), ketoconazole (Nizoral) and fluoxetine (Prozac) increase blood concentrations of delavirdine, and this can cause increased side effects from delavirdine.
• Delavirdine increases the blood concentration of indinavir (Crixivan), saquinavir (Invirase), warfarin (Coumadin), quinidine (Cardioquin, Quinaglute), clarithromycin (Biaxin), benzodiazepines (for example, diazepam [Valium], lorazepam [Ativan]), nifedipine (Adalat, Procardia), lovastatin (Mevacor, Altoprev), simvastatin (Zocor), pimozide (Orap), and ergot derivatives (for example, ergonovine, ergotamine, methlyergonovine). Administration of delavirdine with these agents could increase the risk of serious side effects from these agents. Delavirdine should not be combined with lovastatin, simvastatin, pimozide, ergot derivatives, Valium, and Ativan.
• St. John's wort also should not be combined with delavirdine because it may reduce the effect of delavirdine by decreasing its blood levels.
• Delavirdine may increase blood levels of warfarin, leading to an increased risk of bleeding.

Report Problems to the Food and Drug Administration You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088. Need help identifying pills and medications? Use the pill identifier tool on RxList.