Etravirine

Aka: Etravirine, Intelence

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II. Indications

  1. HIV Infection with Anti-Retroviral Therapy experienced patients (combination therapy)
    1. Indicated in HIV resistance (especially K103N) to first-generation NNRTI (Efavirenz or Nevirapine)
    2. NNRTIs carry a high risk of induced HIV resistance
      1. Never use NNRTIs as monotherapy in HIV Infection

III. Mechanism

  1. See Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI)
  2. Second generation, diarylpyrimidine NNRTI

IV. Dosing

  1. Indicated as part of combination therapy in Anti-Retroviral Therapy experienced patients
  2. Adult (or child weight >=30 kg)
    1. Take 200 mg orally twice daily after meals
  3. Child (age >= 2 years)
    1. Weight 10 to 20 kg: 100 mg orally twice daily after meals
    2. Weight 20 to 25 kg: 125 mg orally twice daily after meals
    3. Weight 25 to 30 kg: 150 mg orally twice daily after meals
    4. Weight >=30 kg: 200 mg orally twice daily after meals (adult dose)

V. Adverse Effects

  1. See NNRTI for class related adverse effects
  2. Rash (20% of patients)
    1. Stop the agent and do not rechallenge
    2. Higher risk in women (30%) than men (18%)
    3. Risk of serious reactions (1-2%)
      1. Stevens-Johnson Syndrome
      2. Toxic Epidermal Necrolysis
      3. Eythema multiforme
  3. Nausea
  4. Peripheral Neuropathy
  5. Hypertension
  6. Hepatotoxicity
    1. Obtain Liver Function Tests (LFTs) at baseline and periodically
  7. Hyperlipidemia
    1. Obtain baseline lipid panel and periodically

VI. Safety

  1. Avoid in Lactation
  2. Unknown safety in pregnancy (registry exists)
    1. Has been used in pregnancy for Anti-Retroviral Therapy experienced patients (resistance to other NNRTIs)

VII. Drug Interactions

  1. Many significant Drug Interactions
    1. Use formal Drug Interaction application to review
    2. CYP3A4 Inducer and CYP3A4 Substrate
    3. CYP2C9 Inhibitor and CYP2C9 Substrate
    4. CYP2C19 Inhibitor and CYP2C19 Substrate

VIII. Resources

  1. Etravirine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4e009f19-4609-4020-bee1-dc27c504046c

IX. References

  1. (2008) Med Lett Drugs Ther 50(1288): 47-8 [PubMed]
  2. (1998) Med Lett Drugs Ther 40(1041):115 [PubMed]
  3. (2009) Treat Guidel Med Lett 7(78): 11-22 [PubMed]

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Related Studies

Cost: Medications

etravirine (on 6/22/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ETRAVIRINE 200 MG TABLET Generic $17.71 each
intelence (on 4/20/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
INTELENCE 200 MG TABLET Generic $17.71 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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