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delavirdine, Rescriptor

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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 viruses, 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 viruses. Unlike zidovudine, delavirdine does not need to be converted to an active form and it does not compete with the compound (thymidine triphosphate) that is required by HIV virus to make new DNA. 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: Store at room temperature, 15-30°C (59-86°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.

Delavirdine may be administered without regard to meals since food does not reduce its absorption.

DRUG INTERACTIONS: Rifampin (Rifadin), rifabutin (Mycobutin), saquinavir (Invirase), anticonvulsants (e.g., Dilantin, Tegretol) decrease blood concentrations of delavirdine. Decreased blood concentration 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 (e.g., Valium, Ativan), nifedipine (Adalat, Procardia) and ergotamine (Ergostat). Administration of delavirdine with these agents could increase the risk of serious side effects from these agents.

PREGNANCY: The are no adequate studies of the use of delavirdine in pregnant women.

NURSING MOTHERS: It is not known whether delavirdine is secreted in breast milk. HIV infected mothers should not nurse their infants because of the risk of transmitting HIV to an infant that is not infected.

SIDE EFFECTS: The most common side effects of delavirdine are rash, headaches, diarrhea, nausea, vomiting and weakness. Delavirdine also may cause agitation, difficulty sleeping, abdominal cramps and muscle pain.

Reference: FDA Prescribing Information

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