How does this medication work? What will it do for me?
Etravirine belongs to the class of medications called antiretrovirals, or more specifically, non-nucleoside reverse transcriptase inhibitors (NNRTIs). It is used in combination with other antiretroviral medications to treat human immunodeficiency virus type 1 (HIV-1) when other antiretroviral medications have not worked, and when HIV-1 is resistant to other antiretroviral medications.
Etravirine works by blocking an enzyme called HIV reverse transcriptase, which the virus needs to multiply. When used with other antiretroviral medications, etravirine reduces the amount of HIV in the blood and increases CD4 (T) cell counts.
Etravirine does not cure HIV infection or AIDS, but it may improve your immune system and decrease the risk of infection. Etravirine does not reduce the risk of passing HIV to others through sexual contact, sharing needles, or being exposed to infected blood.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each white-to-off-white, oval, scored tablet debossed with "T125" on one side contains 25 mg of etravirine. Nonmedicinal ingredients: hypromellose, microcrystalline cellulose, colloidal anhydrous silica, croscarmellose sodium, magnesium stearate, and lactose monohydrate.
Each white-to-off-white, oval tablet, debossed with "T125" on one side and "100" on the other side, contains 100 mg of etravirine. Nonmedicinal ingredients: colloidal silicon dioxide, croscarmellose sodium, hypromellose, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.
Each white-to-off-white, biconvex, oblong tablet debossed with "T200" on one side contains 200 mg of etravirine. Nonmedicinal ingredients: hypromellose, colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, silicified microcrystalline cellulose, and microcrystalline cellulose.
How should I use this medication?
The usual adult dose of etravirine is 200 mg taken by mouth, twice daily following a meal. For children 6 to 18 years old, weighing at least 16 kg, the dose is based on body weight. Your doctor will determine the appropriate dose for your child.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
This medication works better when it is taken after a meal. Avoid taking etravirine on an empty stomach as it may not work as well. Try to take the doses of etravirine at the same time each day.
Swallow the tablets whole with some liquid, such as water. Do not crush or chew the tablets. If you or your child are unable to swallow tablets whole, dissolve the tablet in 5 mL (1 teaspoon) of water until the water looks milky. This solution may be added to a small amount of orange juice or milk. Drink it immediately. Rinse the glass several times with water and swallow the rinse each time, to make sure all the medication is taken.
Do not use grapefruit juice, warm drinks, or carbonated beverages.
It is important to take this medication exactly as prescribed by your doctor. If you stop taking this medication, your HIV infection could get worse. Take the medication exactly as prescribed by your doctor, and do not stop taking the medication without checking with your doctor first. If you miss a dose by less than 6 hours, take the missed dose after food, as soon as possible. If you miss a dose by more than 6 hours, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication in the original packaging at room temperature, protect it from light and moisture, and keep it out of the reach of children. Keep the desiccant packets in the bottle.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not take this medication if you are allergic to etravirine or any ingredients of the medication.
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- abdominal pain
- changes in fat distribution (increased fat in the upper back and neck, breasts, and trunk; and loss of fat from the arms, legs, and face)
- night sweats
- tingling or pain in the hands or feet
- trouble sleeping
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- muscle pain, tenderness or weakness
- signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
- signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
- signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
- skin rash
- symptoms of diabetes (e.g., excessive thirst, urination, or eating; unexplained weight loss; poor wound healing; infections)
- symptoms of high blood pressure (e.g., headache, dizziness, blurred vision, nausea)
- symptoms of kidney problems (e.g., nausea, loss of appetite, weakness, passing little or no urine, breathlessness)
- symptoms of liver problems (e.g., abdominal pain, persistent vomiting, feeling unwell, fever, itching, yellowing of the skin and eyes, dark urine)
Stop taking the medication and seek immediate medical attention if any of the following occur:
- signs of a heart attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
- signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
- symptoms of a severe allergic reaction (e.g., hives; shortness of breath; or swelling of the face, lips, or tongue)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breastfeeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Blood tests: Etravirine can cause changes in your blood test results, such as red blood cell count, platelet count, cholesterol level, and sugar level. Your doctor will explain these to you and monitor your blood levels.
Fat redistribution: Over time, this medication may change how fat is distributed in your body and may change your body shape. You may notice increased fat in the upper back, neck, and breast, as well as around the back, chest, and stomach area. You may also notice loss of fat from the legs, arms, and face. The long-term effects of this are not known.
Immune reconstitution syndrome: This medication may cause immune reconstitution syndrome, where signs and symptoms of inflammation from previous infections appear. These symptoms occur soon after starting anti-HIV medication and can vary. They are thought to occur as a result of the immune system improving and being able to fight infections that have been present without symptoms, such as pneumonia, herpes, or tuberculosis. Report any new symptoms to your doctor immediately.
Lactose intolerance: This medication contains lactose. If you have galactose intolerance (galactosemia, glucose-galactose malabsorption, or Lapp lactase deficiency) you should not take this medication. Talk to your doctor about other alternatives.
Liver function: Etravirine may reduce liver function and can cause liver failure. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
If you have severe liver problems or decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Pancreatitis: This medication may rarely cause inflammation of the pancreas (pancreatitis). If you have a history of or are at risk for developing pancreatitis, you should be closely monitored by your doctor while taking this medication. If you develop signs of pancreatitis (e.g., upper left abdominal pain, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen), contact your doctor.
Skin rashes: This medication can cause skin rash, which is usually mild to moderate in severity. However, etravirine can also cause severe skin reactions. If you develop a skin rash while taking this medication, contact your doctor immediately. If the rash is severe and you also have a fever, muscle or joint aches, blisters, or facial swelling, stop taking the medication and get immediate medical attention.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if etravirine passes into breast milk. Women who have HIV are cautioned against breast-feeding because of the risk of passing HIV to a baby who does not have the infection.
Children: The safety and effectiveness of using this medication have not been established for children less than 6 years of age.
Seniors: Seniors are more likely to have reduced kidney, liver and heart function or other diseases, which may cause an increase in side effects. Lower than the usual adult doses may be needed.
What other drugs could interact with this medication?
There may be an interaction between etravirine and any of the following:
- alpha blockers (e.g., alfuzosin, doxazosin, tamsulosin)
- antiarrythmics (e.g., amiodarone, disopyramide, mexiletine, propafenone)
- anti-cancer medications (e.g., cabazitaxel, docetaxel, doxorubicin, etoposide, ifosfamide, irinotecan, vincristine)
- anti-psychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
- "azole" antifungals (e.g., itraconazole, ketoconazole, voriconazole)
- barbiturates (e.g., phenobarbital, secobarbital)
- benzodiazepines (e.g., clonazepam, diazepam, lorazepam)
- calcium channel blockers (e.g., amlodipine, diltiazem, nifedipine, verapamil)
- ergot alkaloids (e.g., dihydroergotamine, ergonovine, ergotamine, methylergonovine)
- estrogens (e.g., conjugated estrogen, estradiol, ethinyl estradiol)
- hepatitis C antivirals (e.g., daclatasvir, dasabuvir, ledipasvir, paritaprevir, ombitasvir, simeprevir, sofosbuvir)
- HIV protease inhibitors (e.g., indinavir, atazanavir, lopinavir, nelfinavir, ritonavir)
- macrolide antibiotics (e.g., clarithromycin, erythromycin)
- narcotic pain relievers (e.g., fentanyl, hydrocodone, oxycodone)
- nitrates (e.g., isosorbide dinitrate, isosorbide mononitrate)
- other HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, nevirapine)
- phosphodiesterase 5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
- progestins (e.g., dienogest, levonorgestrel, medroxyprogesterone, norethindrone)
- proton pump inhibitors (e.g., lansoprazole, omeprazole
- rifabutin (when given along with a protease inhibitor such as darunavir, ritonavir, saquinavir)
- St. John's wort
- seizure medications (e.g., carbamazepine, gabapentin, levetiracetam, phenytoin, topiramate)
- selective serotonin reuptake inhibitors (SSRIS; e.g., citalopram, fluoxetine, paroxetine, sertraline)
- "statin" anti-cholesterol medications (e.g., atorvastatin, lovastatin, simvastatin)
- sulfonamide antibiotics (‘sulfas'; e.g., sulfisoxazole, sulfamethoxazole)
- sulfonylureas (e.g., gliclazide, glyburide, tolbutamide)
- tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
- tyrosine kinase inhibitors (e.g., bosutinib, dabrafenib, imatinib, lapatinib)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
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