RILPIVIRINE

Rilpivirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) used in the treatment of Human Immunodeficiency Virus (HIV-1) infection. It works by inhibiting the reverse transcriptase enzyme, preventing HIV from multiplying and reducing viral load in the body.

Indications

- Treatment of HIV-1 infection in adults and adolescents (?12 years and weighing ?35 kg) - Typically used in combination with other antiretroviral agents as part of Highly Active Antiretroviral Therapy (HAART)

Dosage

- Adults: 25 mg orally once daily with a meal - Should be taken with water and with food to improve absorption - Not recommended for treatment-naïve patients with high viral load (>100,000 copies/mL)

Contra-Indications

- Hypersensitivity to rilpivirine or any component of the formulation - Concurrent use with drugs that induce CYP3A4 strongly (e.g., rifampicin, carbamazepine)

Special Precautions

- Not recommended in patients with severe liver impairment - Monitor for depressive disorders, mood changes, or suicidal thoughts - Caution in patients with a history of QT prolongation or cardiac arrhythmias - Should be taken with a meal; avoid taking with proton pump inhibitors

Side Effects

- Common: headache, insomnia, rash, depression, nausea, and fatigue - Rare but serious: QT prolongation, severe skin reactions, liver toxicity

Drug Interactions

- Avoid strong CYP3A4 inducers (e.g., phenytoin, rifampicin, St. John’s Wort) - May interact with antacids or acid-reducing agents; take rilpivirine with a meal at least 2 hours after antacids