II. Mechanism
- Bind directly to reverse transcriptase
- Prevents RNA conversion to DNA
- Completely different mechanism than nRTI
III. Preparations: First Generation
- Delavirdine (Rescriptor)
- Efavirenz (Sustiva, EFV)
- Nevirapine (Viramune, NVP)
IV. Preparations: Second Generation
-
Etravirine (Intelence)
- Approved in treatment experienced patients
- Rilpivirine (Endurant)
- FDA approved in 2011 for treatment-naive patients
- Available as oral agent and monthly IM Injection (as part of Cabenuva therapy)
V. Adverse Reaction
- See specific agents
- Hyperlipidemia
- Rash is common (especially with Nevirapine)
- More common and more severe in women
- Reduced Incidence if start dose slowly over 2 weeks
- Prophylaxis not recommended (e.g. Corticosteroids)
- Switching to a different Drug Class may be needed
- My progress to Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, Erythema Multiforme
- Severe rash is especially more common with Etravirine and especially in women