raltegravir (Oral route)

ral-TEG-ra-vir

Commonly used brand name(s)

In the U.S.

• Isentress

Available Dosage Forms:

• Tablet

Therapeutic Class: Antiretroviral Agent

Uses For raltegravir

Raltegravir is used together with other medicines to treat human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS). raltegravir is usually given to patients who have already received HIV medicines in the past.

Raltegravir will not cure or prevent HIV infection or AIDS. It helps keep HIV from reproducing and appears to slow down the destruction of the immune system. This may help delay problems that are usually related to AIDS or HIV disease from occurring. Raltegravir will not keep you from spreading HIV to other people. People who receive raltegravir may continue to have other problems usually related to AIDS or HIV disease.

raltegravir is available only with your doctor's prescription.

Before Using raltegravir

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For raltegravir, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to raltegravir or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of raltegravir in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of raltegravir in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving raltegravir.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking raltegravir, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using raltegravir with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Fosamprenavir

Using raltegravir with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Etravirine
• Omeprazole
• Rifampin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of raltegravir. Make sure you tell your doctor if you have any other medical problems, especially:

• Infections—May decrease your body's ability to fight infection.

• Liver disease, severe—Use with caution. raltegravir has not been studied in patients with severe liver problems.

Proper Use of raltegravir

Take raltegravir exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

raltegravir comes with a patient package insert. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

It is important to take raltegravir together with other medicines for HIV. Be sure to take all of the medicines your doctor ordered, and to take them at the right times.

Do not change or stop using raltegravir without checking first with your doctor. When your supply of raltegravir is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of raltegravir.

You may take raltegravir with or without food.

Dosing

The dose of raltegravir will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of raltegravir. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For treatment of HIV infection:
    • Adults—400 milligrams (mg) two times a day.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of raltegravir, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using raltegravir

It is very important that your doctor check your progress at regular visits to make sure raltegravir is working properly. Blood tests may be needed to check for unwanted effects. .

When you start taking HIV medicines, your immune system may get stronger. If you have infections that are hidden in your body, such as pneumonia or tuberculosis, you may notice new symptoms when your body tries to fight them. If this occurs, tell your doctor immediately.

raltegravir will not keep you from giving HIV to your partner during sex. Make sure you understand this and practice safe sex, even if your partner also has HIV, by using a latex condom or other barrier method. raltegravir will also not keep you from giving HIV to other people if they are exposed to your blood. Do not re-use or share needles with anyone. .

raltegravir Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Rare

• Bloating
• body aches
• chest pain
• chills
• cough
• darkened urine
• decreased appetite
• decreased frequency or amount of urine
• difficult or painful urination
• fast heartbeat
• fever
• general feeling of discomfort
• increased thirst
• lethargy
• loss of appetite
• painful cold sores or blisters on the lips, nose, eyes, or genitals
• pains in the stomach, side, or abdomen, possibly radiating to the back
• shortness of breath
• sore throat
• swelling of the face, fingers, or lower legs
• trouble breathing
• unusual bleeding or bruising
• unusual tiredness or weakness
• weight gain
• yellow eyes or skin

Incidence not known

• Black, tarry stools
• bleeding gums
• blistering, peeling, or loosening of the skin
• blood in the urine or stools
• diarrhea
• itching
• joint pain
• muscle cramps or spasms
• muscle pain or stiffness
• pinpoint red spots on the skin
• red, irritated eyes
• red skin lesions, often with a purple center
• sores, ulcers, or white spots in the mouth or on the lips

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

• Dizziness
• headache
• lack or loss of strength
• nausea
• redistribution or accumulation of the body fat
• stomach pain
• vomiting

Incidence not known

• Delusions of persecution, mistrust, suspiciousness, and/or combativeness
• fear or nervousness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: raltegravir side effects (in more detail)

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