Delavirdine

Delavirdine (Rescriptor) is approved for the treatment of HIV-1 infection in adults and adolescents over age 16 as part of a combination therapy. Rash accompanied by pruritus is the most frequent adverse effect of this agent; however, it usually resolves within several weeks of treatment. Severe skin reactions are rare. Headache, nausea, vomiting, diarrhea, fatigue, and elevated hepatic enzymes also may be associated with delavirdine administration.

Drugs that decrease stomach acidity (e.g., antacids, H2 receptor blockers, and proton pump inhibitors) de crease the absorption of delavirdine. In vivo and in vitro studies have shown that delavirdine is metabolized by and inhibits CYP3A4. In vitro studies have shown that it also is metabolized by CYP2D6 and inhibits CYP2C9, CYP2D6, and CYP2C19. Delavirdine should not be used in combination with alprazolam, cisapride, ergot alkaloids, midazolam, or triazolam because of the potential for serious adverse reactions. Delavirdine increases serum concentrations of certain protease inhibitors and may reverse the resistance of zidovudine-resistant HIV.

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