Rescriptor® (Delavirdine)

Who should take this?

Rescriptor can be taken by adults. It is not known what its effects on an unborn fetus are.  A woman who is or plans to become pregnant should talk to a doctor before taking Rescriptor.  Treating HIV/AIDS during pregnancy is important to help lower the risk of infecting the baby.  A woman should discuss treatment options before becoming pregnant.  Women who are HIV-positive should not breast feed their babies.  The virus can be passed onto the baby through the milk.

A person who is having surgery (including dental surgery) should tell the doctor or dentist that he or she is taking delavirdine.

How is it taken? / Dosage

Delavirdine comes in a tablet to be swallowed.  It should be taken with a full glass of water, with or without food.  It is usually taken three times a day.

A person who has difficulty swallowing tablets can dissolve the delavirdine tablets in water.  The tablets and water should be mixed until the delavirdine is evenly blended throughout the water.  The mixture should be drunk right away.  The glass should be rinsed and the rinse water swallowed to make sure that the entire dose has been taken.

A person who has low levels of stomach acid (achlorhydria) may be told by the doctor to take Rescriptor with an acidic drink like orange or cranberry juice.

Avoid taking delavirdine within an hour before or after taking didanosine (Videx or ddI) or antacids.

It is important to follow the doctor’s directions about taking Rescriptor.  Do not change the dose without consulting a healthcare professional. If a dose is missed, take it right away.  If it is nearly time for the next dose, skip the missed one and go back to the regular schedule.

Side Effects

Along with its desired effects, delavirdine can cause some unwanted effects.  The most important sign to watch for in this or any other drug is an allergic reaction.  Signs of this include difficulty breathing, throat closing, swelling of the face, tongue or lips and irregular heartbeat, chest pain, hives, fainting or severe skin rash accompanied by fever, blistering, oral lesions, red eyes, swelling, or muscle or joint pain

Other side effects that may lessen or disappear over time include:

• A rash on the upper body and arms for the first week to three weeks of taking Rescriptor
• Changes of body fat (lipodystrophy or redistribution of fat from legs, arms and fact to back neck and breast)
• Diarrhea
• Headache
• Nausea or vomiting
• Unusual tiredness

If these symptoms are troubling or don’t go away, talk to a doctor.

Drug Interactions

Sometimes drugs taken together have effects that none has when taken alone.  Rescriptor is a powerful drug.  It sometimes interacts with other drugs that a person with HIV must take.

Just because two or more drugs interact doesn’t mean that a person shouldn’t take them.  What it does mean is that a person should work with his her doctor to avoid interactions as much as possible.  This means taking drugs as directed and making sure that the doctor knows all prescription and nonprescription drugs or supplement the patient is taking.

A doctor may need to change the doses or schedule of the drugs he or she prescribes to make sure that the combination is as effective as possible with the fewest side effects.

Drugs to be particularly careful about when taking Rescriptor include:

• Anti-acid or heartburn drugs, such as Propulsid® (cisapride), Tagamet® (cimetidine), Zantac® (ranitidine), Pepcid® (famotidine) or Axid® (nizatidine)
• Agenerase® (amprenavir)
• Antihistamines Hismanal® (astemizole) or Seldane® (terfenadine)
• Anti-anxiety drugs or sedatives, such as Versed® (midazolam), Halcion® (triazolam) and Xanax® (alprazolam)
• Antibiotics such as Rifadin® (rifampin), Mycobutin® (rifabutin) and Biaxin® (clarithromycin)
• Anti-depressants such as Prozac® or Sarafem® (fluoxetine)
• Anti-seizures drugs such as Carbatrol®, Epitol® or Tegretol® (carbamazepine); Dilantin® or Phenytek® (phenytoin) and Luminal® or Solfoton® (phenobarbital) valproic acid (Depakene®, Depakote®),
• Blood thinners such as warfarin (Coumadin®)
• Calcium channel blockers given for heart disease.  These include Cardizem® (diltiazem), Plendil®/Lexxel® (felodipine), Cardene® (nicardipine), Sular® (nisoldipine) or Calan®/Verelan® (verapamil), Vascor® (bepridil), Norvasc® (amlodipine), DynaCirc® (isradipine), Adalat® or Procardia® (nifedipine) or Nimotop® (nimodipine)
• Erectile dysfunction treatments, such as Viagra® (sildenafil), Levitra® (vardenafil) and Cialis® (tadalafil).
• Heartbeat regulating drugs such as Quinidex® (quinidine)
• Migraine headache drugs such as Methergine®, Methylergometrine® (methylergonovine); Ergostat®, Cafergot®, Ercaf®, Wigraine® (ergotamine), Ergotrate®, Methergine® (ergonovine), Migranal® (dihydroergotamine), Germinal® or Hydergine® (ergoloid mesylates) or methysergide (Sansert)
• Skin infection treatments such as dapsone (Avlosulfon®)

Resistance

HIV can adapt and change (mutate).  When this happens drugs that once were effective against HIV no longer are.  The virus has found a way to grow even when the drug is taken properly. A sign of resistance is an HIV viral load that doesn’t drop.

Drug resistance is a particular worry with nonnucleoside reverse transcriptase inhibitors (NNRTIs).  A single change (mutation) in the reverse transcriptase gene can produce a virus that rests all NNRTIs.

The best way to prevent possible drug resistance is to take all medications exactly as prescribed by the doctor. This makes them most effective against HIV infection.