Delavirdine (trade name Rescriptor) is one of a new class of anti-HIV drugs called non-nucleoside reverse transcriptase inhibitors (NNRTIs). Reverse transcriptase is a part of the HIV virus. When HIV infects cells in your body, it used reverse transcriptase to make more virus. NNRTIs stop the reverse transcriptase from working.

Rescriptor is approved for the treatment of HIV infection in adults. New Public Health Service HIV treatment guidelines say that the best way to use Rescriptor is in combination with other anti-HIV drugs. The guidelines recommend combinations of three or four anti-HIV drugs as first treatment for HIV:

• Two nucleoside analogs (AZT+3TC, d4T+3TC, d4T+ddI, AZT+ddI, or AZT+ddC) with one of the following: Crixivan, Fortovase, Norvir, Sustiva or Norvir and Fortovase combined.

• If one of the above combinations cannot be used, an alternative is two nucleoside analogs (same combinations as listed above) with Viramune or Rescriptor.

To get the best anti-HIV effect from a combination, it should include two new drugs you haven't taken before. Ideally, all three drugs would be new. For someone who's taken a lot of anti-HIV drugs already, it's not always easy to find new anti-HIV drugs to take. Rescriptor may be an option for people in this situation.

Rescriptor and protease inhibitors: In a small safety study in HIV-negative people, Rescriptor raised the amount of the protease inhibitor saquinavir in the body by about five times. The amount of Rescriptor was not affected by saquinavir. Researchers found cases of liver toxicity in some of the HIV-negative people that took saquinavir and Rescriptor in this study. Anyone using this combination should be sure their liver function is carefully monitored.

Rescriptor taken with the protease inhibitor indinavir (Crixivan) caused a large increase in the amount of indinavir in the body. Researchers recommend that the dosage of indinavir be 400 mg or 600 mg every 8 hours if it is taken with Rescriptor. The normal dose of indinavir is 800 mg every 8 hours. Rescriptor amounts in the body were not affected by indinavir.

Researchers have not yet found any effect from taking Rescriptor with the protease inhibitor ritonavir (Norvir), but these drugs have not been studied together at the full dose of ritonavir. If you take Rescriptor with the full dose of ritonavir, be sure your doctor watches for side effects and liver toxicity.

Rescriptor roughly doubles the levels of the protease inhibitor nelfinavir (Viracept) if these two drugs are taken together. A recent study combined Rescriptor and Viracept with d4T and ddI, and showed strong anti-HIV effects after 12 weeks of treatment. The doses used were 600 mg of Rescriptor and 1250mg of Viracept, taken twice a day. This study is ongoing and further results are expected soon.

Drug interactions: The following drugs should not be taken with Rescriptor: terfenadine (Seldane), astemizole (Hismanal), alprazolam, midazolam, triazolam, cisapride (Propulsid), rifabutin (Mycobutin), rifampin, phenytoin, phenobarbital, carbamazepine. There are also certain amphetamines, calcium channel blockers, antiarrhythmics and anti-migraine drugs that should not be used with Rescriptor. Antacids and the drug ddI (Videx) should be taken at least an hour apart from Rescriptor. Use of cimetedine (Tagamet) and other drugs in that class is not recommended because they may lower the amount of Rescriptor in your body. Call (800) 432-4702 for up-to-date medical and drug interaction information for Rescriptor.

Side effects: The major side effect seen with Rescriptor has been a rash, which develops in about one out of five people taking the drug. The rash usually happens 1-3 weeks after starting the drug, and lasts about two weeks. Usually, treatment can be continued and the rash goes away. If the rash is severe it may indicate a serious allergic reaction called Stevens-Johnson Syndrome and the drug should be stopped immediately.

Dosage: The recommended dosage of Rescriptor is 400 mg taken three times a day. The dose of Rescriptor can be dissolved by adding four 100 mg pills to at least half a glass or more of water, letting the mixture stand for a few minutes and then stirring. Rescriptor can be taken with or without food. People with a condition known as achlorhydria (low stomach acid) should take Rescriptor with an acidic drink like orange or cranberry juice.

The manufacturers of Rescriptor, Pharmacia & Upjohn, have set up a patient assistance program for people having difficulty accessing the drug. Call (800) 711-0807 for more information.

The Simple Facts Project is a program of The Network. If you need help finding out whether or not a specific drug or therapy is covered by private or public insurance, contact The Network at (800) 734-7104. This information does not intend to promote or endorse any specific treatment for any health related condition.

Simple Facts indexNetwork home page

The Network copyright © 2000 The Network