Pregnancy Risk Category C
How supplied
Tablets: 100 mg
Action
A nonnucleoside reverse-transcriptase inhibitor of HIV-1. Drug binds directly to reverse transcriptase and blocks RNA- and DNA-dependent DNA polymerase activities.
Indications & dosage
HIV-1 infection when therapy is warranted-
Adults: 400 mg P.O. t.i.d. with other appropriate antiretroviral agents.
Adverse reactions
CNS: abnormal coordination, agitation, amnesia, anxiety, change in dreams, cognitive impairment, confusion, depression, disorientation, dizziness, emotional lability, fatigue, hallucinations, headache, hyperesthesia, hyperreflexia, hypoesthesia, impaired concentration, lethargy, malaise, insomnia, manic symptoms, migraine, nervousness, neuropathy, nightmares, pallor, paralysis, paranoid symptoms, paresthesia, restlessness, somnolence, tingling, tremor, vertigo, weakness.
CV: bradycardia, chest pain, edema, orthostatic hypotension, palpitation, syncope, tachycardia, vasodilation.
EENT: blepharitis, conjunctivitis, diplopia, dry eyes, ear pain, epistaxis, nystagmus, pharyngitis, photophobia, rhinitis, sinusitis, taste perversion, tinnitus.
GI: anorexia, aphthous stomatitis, bloody stools, colitis, constipation, decreased appetite, diarrhea, diverticulitis, duodenitis, dry mouth, dyspepsia, dysphagia, enteritis, esophagitis, fecal incontinence, flatulence, gagging, gastritis, gastroesophageal reflux, GI bleeding, gingivitis, gum hemorrhage, increased thirst and appetite, increased saliva, mouth ulcer, nausea, nonspecific hepatitis, pancreatitis, rectal disorder, sialadenitis, stomatitis, tongue edema or ulceration, vomiting, abdominal cramps, distention, or pain, weight gain or loss.
GU: epididymitis, hematuria, hemospermia, impotence, renal calculi, renal pain, metrorrhagia, nocturia, polyuria, proteinuria, vaginal candidiasis.
Hematologic: anemia, ecchymosis, eosinophilia, granulocytosis, neutropenia, pancytopenia, petechiae, prolonged PTT, purpura, spleen disorder, thrombocytopenia.
Hepatic: increased ALT and AST levels.
Metabolic: alcohol intolerance; bilirubinemia; hyperkalemia; hyperuricemia; hypocalcemia; hyponatremia; hypophosphatemia; peripheral edema; increased gamma glutamyl transpeptidase, lipase, serum alkaline phosphatase, serum amylase, serum CK, and serum creatinine levels.
Musculoskeletal: bone disorder, arthralgia or arthritis of single and multiple joints, asthenia, bone pain, back pain, flank pain, leg cramps, muscle cramps, muscular weakness, myalgia, neck rigidity, tendon disorder, tenosynovitis.
Respiratory: chest congestion, bronchitis, dyspnea, laryngismus, cough, upper respiratory tract infection.
Skin: alopecia, angioedema, dermal leukocytoblastic vasculitis, dermatitis, desquamation, diaphoresis, dry skin, epidermal cyst, erythema, erythema multiforme, folliculitis, fungal dermatitis, maculopapular rash, nail disorder, petechial rash, pruritus, rash, sebaceous cyst, seborrhea, skin nodule, Stevens-Johnson syndrome, urticaria, vesiculobullous rash.
Other: allergic reaction, breast enlargement, chills, decreased libido, fever, flulike syndrome, lip edema, pain, trauma, tetany.
Interactions
Drug-drug. Amphetamines, benzodiazepines, calcium channel blockers, cisapride, ergot alkaloid preparations, quinidine: may result in potentially serious or life-threatening adverse effects. Avoid concomitant use.
Antacids: reduced absorption of delavirdine. Separate doses by at least 1 hour.
Carbamazepine, phenobarbital, phenytoin, rifampin: substantially decreased plasma delavirdine levels. Avoid coadministration.
Clarithromycin: increased concentrations of both drugs. Monitor carefully.
Dapsone, warfarin: delavirdine increases plasma concentrations of these drugs. Monitor carefully.
Didanosine: coadministration with delavirdine results in a 20% decrease in absorption of both drugs. Separate administration by at least 1 hour.
Fluoxetine, ketoconazole: increased delavirdine trough levels. Monitor patient.
H2-receptor antagonists: may reduce absorption of delavirdine. Chronic use of these drugs with delavirdine isn't recommended.
Indinavir: increased plasma levels of indinavir. A lower dosage of indinavir should be considered.
Rifabutin: decreased delavirdine levels and increased rifabutin levels. Use together cautiously.
Saquinavir: fivefold increase in systemic levels of saquinavir. Monitor AST and ALT levels frequently when used together.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to drug's formulation.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING