Rilpivirine Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for HIV Infection

25 mg orally once a day

Use: In combination with other antiretroviral agents, for the treatment of HIV-1 infection in antiretroviral therapy-naive patients with HIV-1 RNA 100,000 copies/mL or less at the start of therapy

Renal Dose Adjustments

Mild or moderate renal dysfunction: No adjustment recommended.
Severe renal dysfunction, end-stage renal disease: Caution and increased monitoring for side effects are recommended.

Liver Dose Adjustments

Mild or moderate liver dysfunction (Child-Pugh A or B): No adjustment recommended.
Severe liver dysfunction (Child-Pugh C): Data not available

Dose Adjustments

If used with rifabutin: Increase dose to 50 mg orally once a day; when rifabutin is stopped, decrease dose to 25 mg orally once a day.

Precautions

Safety and efficacy have not been established in patients younger than 18 years; this drug is not recommended for use in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Comments: This drug is highly protein-bound; significant removal via hemodialysis or peritoneal dialysis is not likely.

Other Comments

Administration advice:
-Administer with a meal; a protein drink alone does not replace a meal.
-Use in combination with other antiretroviral drugs.
-Administer antacids (e.g., aluminum/magnesium hydroxide, calcium carbonate) at least 2 hours before or at least 4 hours after this drug; administer H2-receptor antagonists at least 12 hours before or at least 4 hours after this drug.
-Consult the manufacturer product information regarding missed doses.

Storage requirements:
-Store in original bottle to protect from light

General:
The following should be considered when starting this drug:
-More patients starting this drug with HIV-1 RNA greater than 100,000 copies/mL had virologic failure (HIV-1 RNA at least 50 copies/mL) compared to those with HIV-1 RNA 100,000 copies/mL or less.
-Regardless of HIV-1 RNA at start of therapy, more patients using this drug with CD4+ cell count less than 200 cells/mm3 had virologic failure compared to those with CD4+ cell count at least 200 cells/mm3.
-The observed virologic failure rate in patients using this drug conferred a higher rate of overall treatment resistance and cross-resistance to the NNRTI class compared to efavirenz.
-More patients using this drug developed tenofovir and lamivudine/emtricitabine associated resistance compared to efavirenz.

Monitoring:
-Hepatic: Liver function tests (before and during therapy) and for hepatotoxicity (during therapy) in patients with underlying hepatic disease or marked baseline transaminase elevations; liver enzymes in patients with no preexisting hepatic dysfunction or other risk factors

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