Sunday, September 27, 2009

Flugestone




In some countries, this medicine may only be approved for veterinary use.

Scheme

Rec.INN

CAS registry number (Chemical Abstracts Service)

0000337-03-1

Chemical Formula

C21-H29-F-O4

Molecular Weight

364

Therapeutic Category

Progestin

Chemical Name

Pregn-4-ene-3,20-dione, 9-fluoro-11,17-dihydroxy-, (11ß)-

Foreign Names

  • Flugestonum (Latin)
  • Flugeston (German)
  • Flugestone (French)
  • Flugestona (Spanish)

Generic Names

  • Flugestone (OS: BAN, DCIT)
  • Fluorogestone (IS)
  • Flugestone Acetate (OS: BANM)
  • Flurogestone Acetate (OS: USAN)
  • SC 9880 (IS)

Brand Names

  • Chrono Gest (veterinary use)
    Intervet, Netherlands; Organon Vet, Portugal


  • Chronogest (veterinary use)
    Intervet, France; Intervet, United Kingdom; Intervet, Ireland; Intervet / Schering-Plough Animal Health, New Zealand; Intervet International B.V., Luxembourg; Intervet/Schering-Plough Animal Health, Australia


  • Crono-Gest Spugne (veterinary use)
    Intervet, Italy


  • Ova Gest (veterinary use)
    Bioniche Animal Health A/Asia, Australia


  • Syncro Part (veterinary use)
    Ceva, France

International Drug Name Search

Glossary

BANBritish Approved Name
BANMBritish Approved Name (Modified)
DCITDenominazione Comune Italiana
ISInofficial Synonym
OSOfficial Synonym
Rec.INNRecommended International Nonproprietary Name (World Health Organization)
USANUnited States Adopted Name

Click for further information on drug naming conventions and International Nonproprietary Names.

Tuesday, September 22, 2009

Bonmax




Bonmax may be available in the countries listed below.


Ingredient matches for Bonmax



Raloxifene

Raloxifene hydrochloride (a derivative of Raloxifene) is reported as an ingredient of Bonmax in the following countries:


  • India

  • Myanmar

International Drug Name Search

Sunday, September 13, 2009

duloxetine



doo-LOX-e-teen


Oral route(Capsule, Delayed Release)

Increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants for major depressive disorder (MDD) and other psychiatric disorders. Short term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24, and there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. This risk must be balanced with the clinical need. Monitor patients closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Duloxetine hydrochloride is not approved for use in pediatric patients .



Commonly used brand name(s)

In the U.S.


  • Cymbalta

Available Dosage Forms:


  • Capsule

  • Capsule, Delayed Release

Therapeutic Class: Antidepressant


Pharmacologic Class: Serotonin/Norepinephrine Reuptake Inhibitor


Uses For duloxetine


Duloxetine is used to treat depression and anxiety. It is also used for pain caused by nerve damage associated with diabetes (diabetic peripheral neuropathy).


Duloxetine is also used to treat fibromyalgia (muscle pain and stiffness) and chronic (long-lasting) pain that is related to muscles and bones.


Duloxetine belongs to a group of medicines known as selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). These medicines are thought to work by increasing the activity of chemicals called serotonin and norepinephrine in the brain.


duloxetine is available only with your doctor's prescription.


Before Using duloxetine


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 duloxetine, the following should be considered:


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to duloxetine 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 duloxetine 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 duloxetine in the elderly. However, elderly patients may be more sensitive to the effects of duloxetine than younger adults, and are more likely to have hyponatremia (low sodium in the blood) which may require caution in patients receiving duloxetine.


Pregnancy








Pregnancy CategoryExplanation
All TrimestersCAnimal 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 duloxetine, 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 duloxetine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.


  • Isocarboxazid

  • Linezolid

  • Methylene Blue

  • Metoclopramide

  • Procarbazine

  • Rasagiline

  • Selegiline

  • Thioridazine

  • Tranylcypromine

Using duloxetine 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.


  • Abciximab

  • Almotriptan

  • Anagrelide

  • Aspirin

  • Cifenline

  • Cilostazol

  • Citalopram

  • Clopidogrel

  • Clozapine

  • Cyclobenzaprine

  • Desvenlafaxine

  • Dextromethorphan

  • Dipyridamole

  • Eletriptan

  • Encainide

  • Epoprostenol

  • Eptifibatide

  • Escitalopram

  • Flecainide

  • Fluoxetine

  • Fluvoxamine

  • Frovatriptan

  • Iloprost

  • Indecainide

  • Lamifiban

  • Lexipafant

  • Lithium

  • Lorcainide

  • Milnacipran

  • Naratriptan

  • Paroxetine

  • Propafenone

  • Recainam

  • Rizatriptan

  • Sertraline

  • Sibrafiban

  • St John's Wort

  • Sulfinpyrazone

  • Sulodexide

  • Sumatriptan

  • Tapentadol

  • Ticlopidine

  • Tirofiban

  • Tramadol

  • Trazodone

  • Tryptophan

  • Venlafaxine

  • Vilazodone

  • Xemilofiban

  • Zolmitriptan

Using duloxetine 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.


  • Aceclofenac

  • Acemetacin

  • Acenocoumarol

  • Alclofenac

  • Benoxaprofen

  • Bromfenac

  • Bufexamac

  • Carprofen

  • Celecoxib

  • Clonixin

  • Dexketoprofen

  • Diclofenac

  • Diflunisal

  • Dipyrone

  • Droxicam

  • Etodolac

  • Etofenamate

  • Etoricoxib

  • Felbinac

  • Fenbufen

  • Fenoprofen

  • Fentiazac

  • Floctafenine

  • Flufenamic Acid

  • Flurbiprofen

  • Ibuprofen

  • Indomethacin

  • Indoprofen

  • Isoxicam

  • Ketoprofen

  • Ketorolac

  • Lornoxicam

  • Meclofenamate

  • Mefenamic Acid

  • Meloxicam

  • Morniflumate

  • Nabumetone

  • Naproxen

  • Niflumic Acid

  • Nimesulide

  • Oxaprozin

  • Parecoxib

  • Phenprocoumon

  • Phenylbutazone

  • Pirazolac

  • Piroxicam

  • Pirprofen

  • Propyphenazone

  • Proquazone

  • Rofecoxib

  • Sulindac

  • Suprofen

  • Tenidap

  • Tenoxicam

  • Tiaprofenic Acid

  • Tolmetin

  • Valdecoxib

  • Warfarin

  • Zomepirac

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 duloxetine. Make sure you tell your doctor if you have any other medical problems, especially:


  • Alcohol abuse, history of or

  • Bipolar disorder (mood disorder with alternating episodes of mania and depression), or risk of or

  • Kidney disease, severe or

  • Liver disease (including cirrhosis) or

  • Narrow-angle glaucoma, uncontrolled—Should not be used in patients with these conditions.

  • Bleeding problems or

  • Diabetes or

  • Digestion problems or

  • Heart disease or

  • Hypertension (high blood pressure) or

  • Hyponatremia (low sodium in the blood) or

  • Mania, history of or

  • Narrow-angle glaucoma, controlled or

  • Seizures, history of or

  • Urinating problems (e.g., urinary retention or trouble urinating)—Use with caution. May make these conditions worse.

  • Kidney disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of duloxetine


Take duloxetine only as directed by your doctor to benefit your condition as much as possible. 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.


duloxetine comes with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.


Swallow the delayed-release capsule whole with or without food. Do not chew, crush, or break the capsule. Do not open the capsule and sprinkle the contents on food or in liquids.


You will need to use duloxetine for several weeks before you begin to feel better. Keep using the medicine even if you feel you are not getting better, and talk to your doctor if you have any questions.


Dosing


The dose of duloxetine 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 duloxetine. 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 (delayed-release capsules):
    • For treatment of anxiety:
      • Adults—At first, 60 milligrams (mg) once a day. Some patients may start at 30 mg once a day for one week before increasing the dose to 60 mg once a day. Your doctor may increase your dose as needed. However, the dose is usually not more than 120 mg per day.

      • Children—Use and dose must be determined by your doctor.


    • For treatment of chronic muscle pain:
      • Adults—60 milligrams (mg) once a day. Some patients may start at 30 mg once a day for one week before increasing the dose to 60 mg once a day.

      • Children—Use and dose must be determined by your doctor.


    • For treatment of depression:
      • Adults—40 milligrams (mg) per day (given as 20 mg two times per day) to 60 mg per day (given either once a day or as 30 mg two times per day). Your doctor may increase your dose as needed. However, the dose is usually not more than 120 mg per day.

      • Children—Use and dose must be determined by your doctor.


    • For treatment of diabetic peripheral neuropathy:
      • Adults—60 milligrams (mg) once a day.

      • Children—Use and dose must be determined by your doctor.


    • For treatment of fibromyalgia:
      • Adults—60 milligrams (mg) once a day. Some patients may start at 30 mg once a day for one week before increasing the dose to 60 mg once a day.

      • Children—Use and dose must be determined by your doctor.



Missed Dose


If you miss a dose of duloxetine, 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 duloxetine


It is important that your doctor check your progress at regular visits to allow for changes in your dose and to help prevent any unwanted effects.


It is important to tell your doctor if you are pregnant or trying to become pregnant. Your doctor may want you to join a pregnancy registry for patients taking duloxetine.


You will need to have your blood pressure measured before starting duloxetine and while you are using it. If you notice any change to your recommended blood pressure, call your doctor right away. If you have questions about this, talk to your doctor.


Duloxetine has not been shown to add to the effects of alcohol. However, use of alcohol is not recommended in patients who are taking duloxetine.


Duloxetine may cause some teenagers and young adults to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies or to become more depressed. Some people may have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. If you or your caregiver notice any of these unwanted effects, tell your doctor right away. Let the doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.


duloxetine can cause serious liver problems. If you experience symptoms such as dark urine, general tiredness and weakness, light-colored stools, nausea and vomiting, upper right stomach pain, or yellow eyes and skin, contact your doctor right away.


Do not suddenly stop taking duloxetine without checking first with your doctor. If you have been instructed to stop taking duloxetine, ask your doctor how to slowly decrease the dose. This will decrease your chance of having withdrawal symptoms such as dizziness, nausea, headaches, vomiting, increased sweating, irritability, nightmares, or prickling or tingling feelings.


Do not take duloxetine if you have taken an monoamine oxidase (MAO) inhibitor (e.g., isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], or tranylcypromine [Parnate®]) in the past 2 weeks. Do not start taking an MAO inhibitor within 5 days of stopping duloxetine. If you do, you may develop confusion, agitation, restlessness, stomach or intestinal symptoms, sudden high body temperature, extremely high blood pressure, or severe convulsions.


Make sure your doctor knows about all the other medicines you are using. Duloxetine may cause serious conditions called serotonin syndrome or neuroleptic malignant syndrome (NMS)-like reactions if taken with certain medicines such as linezolid (Zyvox®), lithium (Eskalith®, Lithobid®), tryptophan, St. John's wort, or some pain medicines (e.g., tramadol [Ultram®], sumatriptan [Imitrex®], zolmitriptan [Zomig®], or rizatriptan [Maxalt®]). Check with your doctor first before taking any other medicines.


Serious skin reactions can occur during treatment with duloxetine, including erythema multiforme and Stevens-Johnson Syndrome (SJS). Stop using duloxetine and check with your doctor right away if you have blistering, peeling, or loosening of the skin; red skin lesions; severe acne or skin rash; sores or ulcers on the skin; or fever or chills while you are using duloxetine.


duloxetine may affect blood sugar levels. If you are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor.


Duloxetine may cause some people to become drowsy or have blurred vision. Make sure you know how you react to duloxetine before you drive, use machines, or do anything else that could be dangerous if you are not alert or able to see clearly. You may also feel lightheaded when getting up suddenly from a lying or sitting position, so get up slowly. If these symptoms are bothering you or keeping you from doing your daily activities, tell your doctor right away.


duloxetine may increase your risk for bleeding problems. Make sure your doctor knows if you are also taking other medicines that thin the blood, such as aspirin, nonsteroidal anti-inflammatory agents also called NSAIDs (e.g., ibuprofen, naproxen, Advil®, Aleve®, Celebrex®, or Motrin®) or warfarin (Coumadin®).


Hyponatremia (low sodium in the blood) may occur with duloxetine. Stop using the medicine and check with your doctor right away if you have confusion, difficulty concentrating, headaches, memory problems, weakness, and unsteadiness.


duloxetine 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:


Incidence not known
  • Abdominal or stomach pain

  • area rash

  • blindness

  • blistering, peeling, or loosening of the skin

  • blurred vision

  • change in consciousness

  • chills

  • clay-colored stools

  • cold sweats

  • confusion

  • convulsions

  • dark urine

  • decreased urine output

  • decreased vision

  • difficulty swallowing

  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

  • eye pain

  • fainting

  • fast or irregular heartbeat

  • general tiredness or weakness

  • hives or welts

  • hives, itching, puffiness, or swelling of the eyelids or around the eyes, face, lips, or tongue

  • increased thirst

  • itching

  • joint or muscle pain

  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

  • light-colored stools

  • loss of consciousness

  • red skin lesions, often with a purple center

  • red, irritated eyes

  • redness of the skin

  • shortness of breath

  • skin rash

  • sores, ulcers, or white spots in the mouth or on the lips

  • swelling of the face, ankles, or hands

  • tearing

  • tightness in the chest

  • unpleasant breath odor

  • upper right stomach pain

  • vomiting of blood

  • wheezing

  • yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur:


Symptoms of overdose
  • Agitation

  • diarrhea

  • fever

  • loss of bladder control

  • muscle spasm or jerking of all extremities

  • overactive reflexes

  • poor coordination

  • restlessness

  • shivering

  • sleepiness or unusual drowsiness

  • sudden loss of consciousness

  • sweating

  • talking or acting with excitement you cannot control

  • trembling or shaking

  • twitching

  • unusual tiredness or weakness

  • vomiting

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:


More common
  • Body aches or pain

  • cough

  • difficulty having a bowel movement (stool)

  • difficulty with breathing

  • dry mouth

  • ear congestion

  • frequent urination

  • headache

  • lack or loss of strength

  • loss of appetite

  • loss of voice

  • muscle aches

  • nausea

  • sleepiness or unusual drowsiness

  • sleeplessness

  • sneezing

  • sore throat

  • stuffy or runny nose

  • sweating increased

  • trouble sleeping

  • unable to sleep

  • weight loss

Less common
  • Abnormal orgasm

  • acid or sour stomach

  • belching

  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

  • change in taste

  • change or problem with discharge of semen

  • decreased interest in sexual intercourse

  • difficulty with moving

  • fear

  • feeling of warmth or redness of the face, neck, arms, and occasionally, upper chest

  • heartburn

  • inability to have or keep an erection

  • indigestion

  • joint pain

  • longer than usual time to ejaculation of semen

  • loose stools

  • loss in sexual ability, desire, drive, or performance

  • loss of taste

  • muscle aching or cramping

  • muscle pains or stiffness

  • nervousness

  • shakiness in the legs, arms, hands, or feet

  • stomach discomfort, upset, or pain

  • sudden sweating

  • swollen joints

  • trembling or shaking of the hands or feet

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: duloxetine side effects (in more detail)



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More duloxetine resources


  • Duloxetine Side Effects (in more detail)
  • Duloxetine Use in Pregnancy & Breastfeeding
  • Duloxetine Drug Interactions
  • Duloxetine Support Group
  • 479 Reviews for Duloxetine - Add your own review/rating


  • Cymbalta Consumer Overview

  • Cymbalta Prescribing Information (FDA)

  • Duloxetine Delayed-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

  • Duloxetine Monograph (AHFS DI)



Compare duloxetine with other medications


  • Anxiety
  • Back Pain
  • Bipolar Disorder
  • Chronic Fatigue Syndrome
  • Depression
  • Diabetic Nerve Damage
  • Dysthymia
  • Fibromyalgia
  • Generalized Anxiety Disorder
  • Hot Flashes
  • Osteoarthritis
  • Pain
  • Peripheral Neuropathy
  • Urinary Incontinence

Wednesday, September 9, 2009

Timolol Dorf




Timolol Dorf may be available in the countries listed below.


Ingredient matches for Timolol Dorf



Timolol

Timolol maleate (a derivative of Timolol) is reported as an ingredient of Timolol Dorf in the following countries:


  • Argentina

International Drug Name Search

Tuesday, September 8, 2009

Darunavir


Class: HIV Protease Inhibitors
VA Class: AM800
Chemical Name: [(1S,2R) - 3 - [[(4 - Aminophenyl)sulfonyl](2 - methylpropyl)amino] - 2 - hydroxy - 1 - (phenylmethyl)propyl] - carbamic acid (3R,3aS,6aR)-hexahydrofuro[2,3-b]furan-3-yl ester
Molecular Formula: C27H37N3O7SC27H37N3O7S•C2H5OH
CAS Number: 206361-99-1
Brands: Prezista

Introduction

Antiretroviral; HIV protease inhibitor (PI).1 2 3


Uses for Darunavir


Treatment of HIV Infection


Treatment of HIV infection.1 Used in conjunction with low-dose ritonavir (ritonavir-boosted darunavir) and other antiretroviral agents.1


Ritonavir-boosted darunavir is a preferred PI for initial treatment regimens in adults.4


Treatment-experienced patients: Use of ritonavir-boosted darunavir should be guided by genotypic and phenotypic viral resistance testing and the individual’s prior antiretroviral treatment.1


Darunavir Dosage and Administration


Administration


Oral Administration


Administer orally in conjunction with low-dose ritonavir (ritonavir-boosted darunavir).1 4 Do not use without low-dose ritonavir.1


Take darunavir and low-dose ritonavir at same time and with food.1


Administered once daily in treatment-naive adults.1


Administered twice daily in pediatric patients and treatment-experienced adults.1


Ensure that pediatric patients can swallow tablets; those unable to swallow tablets are not candidates for ritonavir-boosted darunavir therapy.1


Dosage


Available as darunavir ethanolate; dosage expressed in terms of darunavir.1


Pediatric Patients


Treatment of HIV Infection

To avoid medication errors, use extra care in calculating the dose, transcribing the medication order, dispensing the prescription, and providing dosing instructions.1


Dosage of ritonavir-boosted darunavir in children 6–<18 years of age weighing at least 20 kg is based on weight.1















Table 1: Dosage for Ritonavir-boosted Darunavir for Pediatric Patients 6–<18 Years of Age1

Body weight



Darunavir dosage



Ritonavir dosage



20 to < 30 kg



375 mg twice daily



50 mg twice daily



30 to < 40 kg



450 mg twice daily



60 mg twice daily



≥ 40 kg



600 mg twice daily



100 mg twice daily


Adults


Treatment of HIV Infection

Treatment-naive Adults

Oral

800 mg once daily boosted with low-dose ritonavir (100 mg once daily).1


Treatment-experienced Adults

Oral

600 mg twice daily boosted with low-dose ritonavir (100 mg twice daily).1


Prescribing Limits


Pediatric Patients


Treatment of HIV Infection

Oral

Do not exceed dosage for treatment-experienced adults.1


Special Populations


Hepatic Impairment


Dosage adjustment not needed in patients with mild to moderate hepatic impairment (Child-Pugh class A or B).1 4 Do not use in those with severe hepatic impairment (Child-Pugh class C).1 4


Renal Impairment


Some experts state that dosage adjustments are not necessary.4


Geriatric Patients


Select dosage with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.1


Cautions for Darunavir


Contraindications



  • Concomitant use with drugs highly dependent on CYP3A for metabolism and for which elevated plasma concentrations are associated with serious and/or life-threatening events and other drugs that may lead to loss of virologic response (e.g., cisapride, ergot alkaloids, lovastatin, oral midazolam, pimozide, rifampin, simvastatin, St. John’s wort [Hypericum perforatum], triazolam).1 (See Specific Drugs under Interactions.)



Warnings/Precautions


Warnings


Hepatic Effects

Acute hepatitis reported in clinical studies.1 Liver injury (in some cases fatal) reported during postmarketing surveillance; liver injury generally occurred in patients with advanced HIV infection who were receiving multiple concomitant drugs, who were coinfected with hepatitis B virus (HBV) or hepatitis C virus (HCV), and/or were developing immune reconstitution syndrome.1


Conduct appropriate laboratory tests before starting darunavir; monitor periodically thereafter.1 Consider increased AST/ALT monitoring in patients with hepatitis, cirrhosis, or elevated transaminase values prior to therapy, especially during the first several months of therapy.1


Consider interrupting or discontinuing darunavir in patients who develop manifestations suggestive of hepatic impairment (e.g., fatigue, anorexia, nausea, jaundice, dark urine, liver tenderness, hepatomegaly, clinically important increases in hepatic enzyme concentrations).1


Interactions

Darunavir is administered concomitantly with low-dose ritonavir (ritonavir-boosted darunavir).1 Failure to administer with recommended low-dose ritonavir will result in subtherapeutic darunavir concentrations and inadequate antiviral response.1 The usual cautions, precautions, and contraindications associated with ritonavir should be considered.1


Concomitant use with certain drugs is not recommended or requires particular caution (e.g., sildenafil, tadalafil, vardenafil).1 4 (See Specific Drugs under Interactions.)


Hyperglycemic and Diabetogenic Effects

Hyperglycemia (potentially persistent), new-onset diabetes mellitus, or exacerbation of preexisting diabetes mellitus reported with use of PIs; diabetic ketoacidosis has occurred.1


Initiate or adjust antidiabetic therapy (e.g., insulin, oral hypoglycemic agents) as needed.1


Sensitivity Reactions


Sulfonamide Sensitivity

Darunavir contains a sulfonamide moiety; use with caution in patients with known sulfonamide allergy.1


Dermatologic Reactions

Severe skin reactions, including Stevens-Johnson syndrome reported;1 fever and increased serum transaminase concentrations also may occur.1


Discontinue darunavir if severe rash occurs.1


General Precautions


Hemophilia A and B

Spontaneous bleeding reported with PIs;1 causal relationship not established.1


Use with caution in patients with history of hemophilia A or B.1 Increased hemostatic therapy (e.g., antihemophilic factor) may be needed.1


Adipogenic Effects

Possible redistribution or accumulation of body fat, including central obesity, dorsocervical fat enlargement (buffalo hump), peripheral wasting, facial wasting, breast enlargement, and general cushingoid appearance.1


Immune Reconstitution Syndrome

During initial treatment, patients who respond to antiretroviral therapy may develop an inflammatory response to indolent or residual opportunistic infections (e.g., Mycobacterium avium complex [MAC], M. tuberculosis, cytomegalovirus [CMV], Pneumocystis jiroveci [formerly P. carinii]; this may necessitate further evaluation and treatment.1


HIV Resistance

Possibility of cross-resistance to other PIs not evaluated.1 Effect of ritonavir-boosted darunavir therapy on subsequent therapy with other PIs unknown.1


Specific Populations


Pregnancy

Category C.1


Antiretroviral Pregnancy Registry at 800-258-4263.1


Some experts state safety and pharmacokinetic data insufficient to recommend ritonavir-boosted darunavir in pregnant women.7


Lactation

Distributed into milk in rats;1 not known whether distributed into human milk.1


Instruct HIV-infected women not to breast-feed because of risk of HIV transmission and risk of adverse effects in the infant.1


Pediatric Use

Adverse effects in children 6–<18 years of age similar to those reported in adults.1


Safety, efficacy, and pharmacokinetic profile not established in children 3 to <6 years of age.1


Should not be used in children <3 years of age because of toxicity and mortality in juvenile rats.1


Geriatric Use

Insufficient experience in patients ≥65 years of age to determine whether geriatric patients respond differently than younger adults.1


Use with caution and monitor because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.1


Hepatic Impairment

Risk for liver function abnormalities, including severe adverse hepatic effects, in patients with preexisting hepatic impairment, including those with HBV or HCV infection.1


Pharmacokinetics not altered in individuals with mild (Child-Pugh class A) or moderate (Child-Pugh class B) hepatic impairment.1


Use not recommended in patients with severe hepatic impairment.1


Renal Impairment

Pharmacokinetics not altered in patients with Clcr≥30 mL/minute.1 Not studied in patients with severe renal impairment or end-stage renal disease.1


Common Adverse Effects


Diarrhea,1 9 nausea,1 9 headache,1 9 abdominal pain.1


Interactions for Darunavir


Darunavir metabolized principally by CYP3A.1


Darunavir and ritonavir inhibit CYP3A4 and CYP2D6.1


Drugs Affecting or Metabolized by Hepatic Microsomal Enzymes


Pharmacokinetic interactions likely with drugs that are inhibitors or inducers of CYP3A4 with possible alteration in metabolism of darunavir or ritonavir.1


Potential pharmacokinetic interaction with drugs metabolized by CYP3A or CYP2D6 with possible altered metabolism of drug metabolized by CYP3A or CYP2D6.1


Specific Drugs
















































































































































Drug



Interaction



Comments



Abacavir



Pharmacokinetic interaction not expected1


No in vitro evidence of antagonistic antiretroviral effects 1



Antiarrhythmic agents (amiodarone, flecainide, systemic lidocaine, propafenone, quinidine)



Possible increased plasma concentrations of antiarrhythmic agents1



Monitor antiarrhythmic concentrations1



Anticoagulants



Decreased warfarin concentrations1



Monitor INR 1



Anticonvulsants (carbamazepine, phenobarbital, phenytoin)



Carbamazepine: Increased carbamazepine concentrations1


Phenobarbital, phenytoin: Decreased concentrations of the anticonvulsant1



Carbamazepine: Dosage adjustment not needed; monitor carbamazepine concentrations and adjust dose to achieve appropriate clinical effect1


Phenobarbital, phenytoin: Monitor anticonvulsant concentrations1



Antifungals (itraconazole, ketoconazole, voriconazole)



Itraconazole: Increased darunavir and itraconazole concentrations1


Ketoconazole: Increased darunavir and ketoconazole concentrations1


Voriconazole: Decreased voriconazole concentrations1



Itraconazole: Dosage >200 mg daily not recommended1 4


Ketoconazole: Dosage >200 mg daily not recommended 1 4


Voriconazole: Concomitant use not recommended unless benefits outweigh risks1 4



Antimycobacterials, rifamycins (rifabutin, rifampin, rifapentine)



Rifabutin: Increased rifabutin and darunavir concentrations1


Rifampin: Decreased darunavir concentrations; possible decreased antiretroviral activity1



Rifabutin: Reduce rifabutin dosage to 150 mg once every other day (further reduction may be needed); monitor for adverse effects1 4


Rifampin: Concomitant use contraindicated 1 4


Rifapentine: Concomitant use not recommended4



Atazanavir



Plasma concentration of atazanavir with ritonavir-boosted darunavir similar to ritonavir-boosted atazanavir; no change in darunavir concentrations1


No in vitro evidence of antagonistic antiretroviral effects1



Manufacturer and some experts state atazanavir 300 mg once daily can be used with ritonavir-boosted darunavir1 4



β-Adrenergic blocking agents (metoprolol, timolol)



Metoprolol, timolol: Possible increased concentrations of the β-adrenergic blocking agent1



Metoprolol, timolol: Caution; dose reduction of the β-adrenergic blocking agent may be needed1



Benzodiazepines (e.g., midazolam, triazolam)



Possible increased concentrations of midazolam or triazolam; potential for serious and/or life-threatening effects (e.g., prolonged or increased sedation or respiratory depression)1



Concomitant use with oral midazolam or triazolam contraindicated;1 some experts state a single parenteral dose of midazolam can be used with caution in a monitored situation for procedural sedation4



Calcium-channel blocking agents (e.g., felodipine, nicardipine, nifedipine)



Increased concentrations of calcium-channel blocking agents 1



Use concomitantly with caution; clinical monitoring recommended1



Cisapride



Potential for serious and/or life-threatening effects such as cardiac arrhythmias 1



Concomitant use contraindicated1



Clarithromycin



Increased clarithromycin concentrations1



Modification of usual clarithromycin dosage not necessary in patients with normal renal function; reduce clarithromycin dosage by 50% if Clcr 30–60 mL/minute and reduce by 75% if Clcr <30 mL/minute 1



Corticosteroids (dexamethasone, fluticasone)



Fluticasone nasal spray/oral inhalation: Increased fluticasone concentrations with ritonavir-boosted darunavir resulting in decreased cortisol concentrations1 4


Dexamethasone: Decreased darunavir concentration; possible decreased antiretroviral efficacy1



Fluticasone nasal spray/oral inhalation: Consider alternatives to fluticasone, especially when long-term corticosteroid use anticipated1 4



Delavirdine



No in vitro evidence of antagonistic antiretroviral effects 1



Didanosine



Didanosine delayed-release capsules: No change in didanosine or darunavir concentrations1


Conflicting administration instructions with didanosine and food1


No in vitro evidence of antagonistic antiretroviral effects 1



Administer darunavir with low-dose ritonavir (with food) 1 hour after or 2 hours before didanosine (without food)1



Digoxin



Increased digoxin concentrations1



Use lowest possible initial dose of digoxin; monitor digoxin concentrations and adjust dose as clinically indicated1



Dextromethorphan



Increased dextromethorphan concentrations1



Efavirenz



Decreased darunavir AUC; increased efavirenz AUC1 4


No in vitro evidence of antagonistic antiretroviral effects 1



Clinical importance unknown4


Some experts suggest usual dosages can be used with close monitoring; consider monitoring plasma darunavir and efavirenz concentrations4



Emtricitabine



Pharmacokinetic interaction not expected1


No in vitro evidence of antagonistic antiretroviral effects 1



Etravirine



Decrease in AUC of etravirine; no change in darunavir concentrations; safety and efficacy of ritonavir-boosted darunavir and etravirine established in clinical studies1 4



Dosage adjustment not needed1 4



Enfuvirtide



No in vitro evidence of antagonistic antiretroviral effects1



Ergot alkaloids (dihydroergotamine, ergonovine, ergotamine, methylergonovine)



Potential for serious or life-threatening adverse effects (e.g., peripheral vasospasm, ischemia of extremities)1



Concomitant use contraindicated 1


If treatment of uterine atony and excessive postpartum bleeding is indicated in a woman receiving darunavir, use methylergonovine maleate (Methergine) only if alternative treatments cannot be used and if potential benefits outweigh risks; use methylergonovine at lowest dosage and shortest duration possible7



Fosamprenavir



Data not available regarding pharmacokinetic interaction1



Concomitant use not recommended pending further data1



Histamine H2- receptor antagonists (e.g., ranitidine)



Ranitidine: Pharmacokinetic interaction not expected1 4



Dosage adjustment not necessary1



HMG-CoA reductase inhibitors



Lovastatin, simvastatin: Increased risk of serious adverse reactions (e.g., myopathy, rhabdomyolysis)1


Increased concentrations of certain HMG-CoA reductase inhibitors (i.e., atorvastatin, pravastatin, rosuvastatin)1 4



Concomitant use with lovastatin or simvastatin contraindicated1


If used with atorvastatin, pravastatin, or rosuvastatin, use lowest possible dosage of the HMG-CoA reductase inhibitor and monitor carefully; consider using fluvastatin1



Hormonal contraceptives (estrogens or progestins)



Decreased ethinyl estradiol and norethindrone concentrations with oral contraceptive preparations1



Use alternative nonhormonal contraception methods1



Immunosuppressive agents (cyclosporine, sirolimus, tacrolimus)



Potential for increased immunosuppressive agent concentrations1



Monitor plasma concentrations of immunosuppressive agent if used concomitantly1



Indinavir



Increased darunavir and indinavir concentrations1


No in vitro evidence of antagonistic antiretroviral effects1



Appropriate dosages for concomitant use not established1



Lamivudine



Pharmacokinetic interaction unlikely1


No in vitro evidence of antagonistic antiretroviral effects1



Lopinavir



No change in lopinavir concentrations; decreased darunavir concentrations1


No in vitro evidence of antagonistic antiretroviral effects1



Concomitant use not recommended1 4



Maraviroc



Increased maraviroc concentrations4



Recommended dosage of maraviroc is 150 mg twice daily when used with ritonavir-boosted darunavir4



Methadone



Decreased methadone concentrations1



Adjustment in the methadone dosage not needed; closely monitor for signs of opiate withdrawal and adjust methadone dosage if needed1



Nelfinavir



Data not available regarding pharmacokinetic interaction1


No in vitro evidence of antagonistic antiretroviral effects1



Concomitant use not recommended pending further data1



Nevirapine



Increased plasma nevirapine concentrations; unchanged plasma darunavir concentrations1 4


No in vitro evidence of antagonistic antiretroviral effects1



Dosage adjustment not necessary1 4



Proton pump inhibitors



Omeprazole: Decreased omeprazole concentrations1



Dosage adjustment not necessary1



Psychotherapeutic agents (e.g., desipramine, pimozide, risperidone, thioridazine, trazodone, SSRIs)



Pimozide: Potential for serious and/or life-threatening adverse effects (e.g., cardiac arrhythmias)1


Desipramine, trazodone: Potential for increased concentrations of the antidepressant; 1 increased risk of nausea, dizziness, hypotension, syncope1


SSRIs: Decreased concentrations of paroxetine and sertraline; unchanged darunavir concentrations1 4


Risperidone, thioridazine: Potential for increased concentrations of the psychotherapeutic agent1



Pimozide: Concomitant use contraindicated1


Desipramine, trazodone: Caution; reduced dosage of the antidepressant may be needed1


SSRIs: Titrate dosage of paroxetine or sertraline and monitor for clinical response1 4


Risperidone, thioridazine: Reduced dosage of the psychotherapeutic agent may be needed1



Ritonavir



Increased plasma darunavir concentrations and AUC;1 2 4 concomitant low-dose ritonavir used to therapeutic advantage (ritonavir-boosted darunavir)1 2 4


No in vitro evidence of antagonistic antiretroviral effects1



St. John’s wort (Hypericum perforatum)



Potential decreased darunavir concentration; possible decreased antiretroviral efficacy1



Concomitant use contraindicated1



Saquinavir



Decreased darunavir concentrations; unchanged saquinavir concentrations1


No in vitro evidence of antagonistic antiretroviral effects1



Concomitant use not recommended1 4



Sildenafil



Possible increased sildenafil concentrations and increased risk of sildenafil-associated adverse effects (e.g., hypotension, visual changes, prolonged erection)1



Do not exceed sildenafil dosage of 25 mg once every 48 hours; closely monitor for adverse effects (e.g., hypotension, syncope, visual changes, prolonged erection)1 4



Stavudine



Pharmacokinetic interaction unlikely1


No in vitro evidence of antagonistic antiretroviral effects1



Tadalafil



Possible increased tadalafil concentrations and increased risk of tadalafil-associated adverse effects (e.g., hypotension, visual changes, prolonged erection)1



Use with caution and with reduced tadalafil dosage (initial dosage of 5 mg and do not exceed a single dose of 10 mg in 72 hours);4 closely monitor for adverse effects1 4



Tenofovir



Increased plasma tenofovir concentrations; unchanged plasma darunavir concentrations1 4


No in vitro evidence of antagonistic antiretroviral effects1



Manufacturer of darunavir recommends usual dosage of tenofovir with ritonavir-boosted darunavir 1


Some experts state clinical importance unknown; monitor for tenofovir toxicity4



Tipranavir



No in vitro evidence of antagonistic antiretroviral effects 1



Concomitant use not recommended1



Vardenafil



Possible increased vardenafil concentrations and increased risk of vardenafil-associated adverse effects (e.g., hypotension, visual changes, prolonged erection)1



Do not exceed vardenafil dosage of 2.5 mg once every 72 hours; closely monitor for adverse effects (e.g., hypotension, syncope, visual changes, prolonged erection)1 4



Zidovudine



Pharmacokinetic interaction unlikely1


No in vitro evidence of antagonistic antiretroviral effects1


Darunavir Pharmacokinetics


Absorption


Bioavailability


Darunavir administered concomitantly with low-dose ritonavir (ritonavir-boosted darunavir).1 Ritonavir decreases metabolism of darunavir, resulting in increased plasma darunavir concentrations.1


Peak plasma darunavir concentrations attained approximately 2.5–4 hours after a dose.1


Food


Compared with administration in the fasting state, administration of ritonavir-boosted darunavir with food increases peak darunavir concentrations and AUC approximately 30%.1


Distribution


Extent


Not known whether distributed into human milk;1 distributed into milk in rats.1


Plasma Protein Binding


95%.1


Binds principally to α1-acid-glycoprotein.1


Elimination


Metabolism


Darunavir extensively metabolized by CYP3A.1


Elimination Route


Following administration of ritonavir-boosted darunavir, eliminated principally in feces as unchanged darunavir.1 Approximately 80% of darunavir dose excreted in feces and 14% excreted in urine.1


Half-life


15 hours.1


Special Populations


Moderate renal impairment (Clcr 30–60 mL/minute): Pharmacokinetics not affected.1


Severe renal impairment or end-stage renal disease: No pharmacokinetic data.1


Unlikely to be removed by hemodialysis or peritoneal dialysis.1


Hepatic impairment: Pharmacokinetics in individuals with mild hepatic impairment (Child-Pugh class A) or moderate hepatic impairment (Child-Pugh class B) similar to values in individuals with normal hepatic function.1 Pharmacokinetics not evaluated in those with severe hepatic impairment.1


HBV or HCV coinfection: No effect on darunavir exposure.1


Higher darunavir concentrations reported in females compared with males; dosage adjustments not required.1


Stability


Storage


Oral


Tablets

25°C (may be exposed to 15–30°C).1


Actions and SpectrumActions



  • Darunavir is administered in conjunction with low-dose ritonavir (ritonavir-boosted darunavir).1




  • Darunavir is extensively metabolized by CYP3A; ritonavir is a potent inhibitor of CYP3A.1 Concomitant use of these drugs results in decreased metabolism and increased plasma concentrations of darunavir.1




  • Antiretroviral activity is due to darunavir.1




  • Active against HIV-1.1




  • Darunavir inhibits replication of HIV-1 by interfering with HIV proteases.1




  • Darunavir-resistant HIV-1, including strains with decreased susceptibility to other PIs, has been reported.1 3



Advice to Patients



  • Critical nature of compliance with HIV therapy.1 Importance of using darunavir with low-dose ritonavir; importance of using these 2 drugs in conjunction with other antiretrovirals.1




  • Antiretroviral therapy is not a cure for HIV infection, and opportunistic infections still may occur.1 HIV transmission via sexual contact or sharing needles is not prevented by antiretrovirals.1




  • Importance of reading patient information provided by the manufacturer.1




  • Importance of taking darunavir with food and at the same time as ritonavir.1 Importance of swallowing the darunavir tablets whole with a drink (e.g., water, milk); the tablets should not be chewed.1 If also taking didanosine, administer didanosine dose 1 hour before or 2 hours after ritonavir-boosted darunavir.1




  • If a dose of darunavir or ritonavir is missed by <6 hours, administer the dose as soon as it is remembered and the next dose at the regularly scheduled time.1 If a dose of darunavir or ritonavir is missed by >6 hours, omit the dose and administer the next dose at the regularly scheduled time.1 Do not administer a double dose to make up for a missed dose.1




  • Importance of patient informing their clinician if they are allergic to sulfonamides.1




  • Redistribution/accumulation of body fat may occur with antiretroviral therapy, with as yet unknown long-term health effects.1




  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and herbal products (e.g., St. John’s wort), and any concomitant illnesses.1




  • Advise patients receiving selective phosphodiesterase (PDE) inhibitors (e.g., sildenafil, tadalafil, vardenafil) that they may be at increased risk of PDE inhibitor-associated adverse effects (e.g., hypotension, visual changes, priapism) and that any symptoms should be promptly reported to their clinician.1




  • Importance of women using a reliable nonhormonal (e.g., barrier) method of contraception because of the potential interaction with hormonal contraceptives.1




  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1




  • Importance of advising patients of other important precautionary information.1 (See Cautions.)



Preparations


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.




























Darunavir (Ethanolate)

Routes



Dosage Forms



Strengths



Brand Names



Manufacturer



Oral



Tablets, film-coated



75 mg (of darunavir)



Prezista



Tibotec



150 mg (of darunavir)



Prezista



Tibotec



400 mg (of darunavir)



Prezista



Tibotec



600 mg (of darunavir)



Prezista



Tibotec


Comparative Pricing


This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 03/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.


Prezista 400MG Tablets (CENTOCOR ORTHO BIOTECH PRODUCT): 60/$1060.01 or 120/$2120.03


Prezista 600MG Tablets (CENTOCOR ORTHO BIOTECH PRODUCT): 60/$1100.02 or 180/$3109.97



Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.


The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions November 2009. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.




References



1. Tibotec. Prezista (darunavir) prescribing information. Raritan, NJ; 2008 Dec.



2. Koh Y, Nakata H, Maeda K et al. Novel bis-tetrahydrofuranylurethane-containing nonpeptidic protease inhibitor (PI) UIC-94017 (TMC114) with potent activity against multi-PI-resistant human immunodeficiency virus in vitro. Antimicrob Agents Chemother. 2003; 47:3123-9. [PubMed 14506019]



3. De Meyer S, Azijn H, Surleraux D et al. TMC114, a novel human immunodeficiency virus type 1 protease inhibitor active against protease inhibitor-resistant viruses, including a broad range of clinical isolates. Antimicrob Agents Chemother. 2005; 49:2314-21. [PubMed 15917527]



4. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents (November 3, 2008). From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website ().



5. Hammer SM, Saag MS, Schechter M, et al. Treatment of adult HIV infection: 2006 recommendations of the International AIDS Society–USA panel. JAMA. 2006; 296:827-43. [PubMed 16905788]



6. Banhegyi D, Esser S, Opravil M, Lefebvre E. TMC114/r outperforms investigator-selected PI(s) in treatment-experienced patients: 24-week primary efficacy and safety analysis of POWER 1. 1st European and Central Asian AIDS conference , Moscow, Russia, 2006 May 15–17. Poster. From Tibotec website ().



7. Perinatal HIV Guidelines Working Group. Public Health Service task force recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV-1 transmission in the United States (April 29, 2009). From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website ().



8. Working Group on Antiretroviral Therapy and Medical Management of HIV-infected Children of the National Resource Center at the François-Xavier Bagnoud Center, Health Resources and Services Administration (HRSA), and National Institutes of Health (NIH). Guidelines for the use of antiretroviral agents in pediatric HIV infection (February 23, 2009). From the US Department of Health and Human Services HIV/AIDS Information Services (AIDSinfo) website ().



9. Madruga JV, Berger D, McMurchie M et al. Efficacy and safety of darunavir-ritonavir compared with that of lopinavir-ritonavir at 48 weeks in treatment-experienced, HIV-infected patients in TITAN: a randomised controlled phase III trial. Lancet. 2007; 370:49-58. [PubMed 17617272]



10. Ortiz R, DeJesus E, Khanlou H et al. Efficacy and safety of once-daily darunavir/ritonavir versus lopinavir/ritonavir in treatment-naive HIV-1 infected patients at week 48. AIDS. 2008; 22:1389-97. [PubMed 18614861]



11. Tibotec Therapeutics. Intelence (etravirine) tablets prescribing information. Raritan, NJ; 2008 Jan.



More Darunavir resources


  • Darunavir Side Effects (in more detail)
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  • Darunavir MedFacts Consumer Leaflet (Wolters Kluwer)

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