Indications
Darunavir is an antiretroviral medicine used with other HIV medicines to treat HIV-1 infection in adults and children (above a certain age and weight). It must always be taken together with a booster, either Ritonavir or Cobicistat, and with other antiretrovirals. It does not cure HIV but keeps the virus under control so the immune system can recover.
How It Works
Darunavir is a protease inhibitor. HIV uses the protease enzyme to cut long viral proteins into the pieces needed to make new, infectious virus. Darunavir binds tightly to this enzyme and blocks it, so the new virus particles are immature and cannot infect other cells. The booster slows the breakdown of Darunavir so it stays at effective levels.
Dosage and Administration
Take exactly as prescribed by your HIV specialist. Common adult doses are 800 mg once a day with a booster (Ritonavir 100 mg or Cobicistat 150 mg) for people without resistance, or 600 mg twice a day with Ritonavir 100 mg twice a day in some treatment-experienced people. Always take it with food. Children’s doses are based on weight. Do not skip doses.
Interactions
Darunavir with its booster interacts with many medicines. It must not be taken with Rifampicin, St John’s Wort, Simvastatin, Lovastatin, Amiodarone, Quinidine, Ergotamine, oral Midazolam, Triazolam, Pimozide, Lurasidone, Alfuzosin, Sildenafil for lung blood pressure, Carbamazepine, Phenytoin or Phenobarbital (with Cobicistat). It can change levels of hormonal contraceptives, Warfarin, Methadone, some antidepressants, steroids such as Fluticasone and some heart medicines. Always tell your doctor and pharmacist about all medicines and herbal products.
Contraindications
Do not take if you are allergic to Darunavir or its booster, have severe liver disease, or are taking any of the medicines that must not be combined with it.
Side Effects
Common side effects include diarrhoea, nausea, headache, abdominal pain, rash and vomiting. It can raise blood sugar and blood fats. Darunavir contains a sulfonamide group, so people allergic to sulfa medicines should tell their doctor.
Get urgent medical help if you have a severe, spreading or blistering rash, especially with fever, mouth sores or eye redness; swelling of the face or throat; difficulty breathing; or signs of liver problems such as yellowing of the skin or eyes, dark urine, pale stools or pain under the right ribs.
Pregnancy and Lactation
Darunavir boosted with Ritonavir (usually twice daily) can be used in pregnancy when the doctor decides; Cobicistat-boosted Darunavir is not recommended in pregnancy. Breastfeeding advice for mothers living with HIV depends on local guidance; discuss this with your HIV doctor.
Precautions and Warnings
Liver tests are needed, especially in people with hepatitis B or C. Use with caution in diabetes, haemophilia and sulfa allergy. Hidden infections may flare up as the immune system recovers. Use condoms, as HIV can still be passed on if the virus is not suppressed.
Overdose
Experience with overdose is limited. Seek medical help; treatment is supportive.
Therapeutic Class
Antiretroviral (HIV protease inhibitor).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.