Doravirine

What is doravirine?

Doravirine is a medication used to treat HIV, marketed under the brand name Pifeltro. It is taken in combination with other antiretroviral drugs.

Each pill contains 100mg of doravirine in a white tablet with '700' on one side of the tablet.

Doravirine is also available in a combination pill with lamivudine and tenofovir disoproxil, marketed as Delstrigo.

How does doravirine work?

Doravirine is a non-nucleoside reverse transcriptase inhibitor. Your doctor will prescribe doravirine as part of your HIV treatment, along with antiretrovirals from another class of drugs. It is important to take all the drugs as prescribed, every day. Each drug class works against HIV in a different way.

The aim of HIV treatment is to reduce the level of HIV in your body (viral load). Ideally, your viral load should become so low that it is undetectable – usually less than 50 copies of virus per ml of blood. Taking HIV treatment and having an undetectable viral load protects your immune system and stops HIV being passed on to someone else during sex.

How do I take doravirine?

You should take doravirine once a day. Doravirine can be taken with or without food.

HIV treatment works best if you take it every day, ideally at the same time each day. It may help to set an alarm, e.g. on your mobile phone, to remind you. If you forget to take a dose of doravirine and realise within 12 hours of the time you usually take it, take it as soon as possible, then take your next dose at your usual time. If you realise more than 12 hours late, don’t take a double dose, just skip the dose you’ve forgotten and then carry on with your normal routine.

What are the possible side-effects of doravirine?

All medicines have possible side-effects. It’s a good idea to talk to a doctor, nurse or pharmacist about what to expect before you start taking any medication, and how to manage any side-effects which occur.

A full list of side-effects, including less common side-effects, can be found in the patient information leaflet that comes with doravirine.

Side-effects can be described as:

  • Common – a side-effect that occurs in at least one in a hundred people (more than 1%) who take this drug.
  • Rare – a side-effect that occurs in fewer than one in a hundred people (less than 1%) who take this drug.

Glossary

antiretroviral (ARV)

A substance that acts against retroviruses such as HIV. There are several classes of antiretrovirals, which are defined by what step of viral replication they target: nucleoside reverse transcriptase inhibitors; non-nucleoside reverse transcriptase inhibitors; protease inhibitors; entry inhibitors; integrase (strand transfer) inhibitors.

viral load

Measurement of the amount of virus in a blood sample, reported as number of HIV RNA copies per milliliter of blood plasma. The VL is an important indicator of HIV progression and of how well treatment is working. 

 

undetectable viral load

A level of viral load that is too low to be picked up by the particular viral load test being used or below an agreed threshold (such as 50 copies/ml or 200 copies/ml). An undetectable viral load is the first goal of antiretroviral therapy.

drug interaction

When a person is taking more than one drug, and drug A interferes with the functioning of drug B. Blood levels of the drug may be lowered or raised, potentially interfering with effectiveness or making side-effects worse. Also known as a drug-drug interaction.

symptom

Any perceptible, subjective change in the body or its functions that signals the presence of a disease or condition, as reported by the patient.

 

Common side-effects of doravirine include: abnormal dreams, difficulty in sleeping, nightmare, depression, headache, dizziness, drowsiness, nausea, diarrhoea, abdominal pain, vomiting, rash, tiredness.

Does doravirine interact with other drugs?

You should always tell your doctor and pharmacist about any other drugs or medication you are taking. That includes anything prescribed by another doctor, medicines you have bought from a high-street chemist, herbal and alternative treatments, and recreational or party drugs.

Some medicines or drugs are not safe if taken together – the interaction could cause increased, dangerous levels, or it could stop one or both of the drugs from working. Other drug interactions are less dangerous but still need to be taken seriously. If levels of one drug are affected, you may need to change the dose you take. This must only be done on the advice of your HIV doctor.

You should not take doravirine if you are currently taking the following medicines:

  • carbamazepine, oxcarbazepine, phenobarbital, phenytoin (drugs used to treat epilepsy and seizures)
  • rifampicin, rifapentine (treatment for tuberculosis)
  • St John's wort (Hypericum perforatum) (a herbal remedy used for depression and anxiety)
  • mitotane (a cancer treatment)
  • enzalutamide (a treatment for prostate cancer)
  • lumacaftor (treatment for cystic fibrosis).

Can I take doravirine in pregnancy?

If you are considering having a baby, or think you might be pregnant, talk to your doctor as soon as possible about which combination of anti-HIV medications would be right for you. It is important to take antiretroviral treatment during pregnancy to prevent passing HIV from mother to baby.

Doravirine is not usually used by women who are pregnant or want to get pregnant as it has not been studied in women who are pregnant.

Can children take doravirine?

Doravirine is not licensed for use in children.

Talking to your doctor

If you have any concerns about your treatment or other aspects of your health, it’s important to talk about these. For example, if you have any symptom or side-effect which may be from your treatment, or if you are finding it difficult to take your medication every day, one of your healthcare team will be able to help.

Building a relationship with a doctor may take time. You may feel very comfortable talking to your doctor, but some people find it more difficult, particularly when talking about sex, mental health, or symptoms they find embarrassing. It’s also easy to forget things you wanted to talk about.

Preparing for an appointment can be very helpful. Take some time to think about what you are going to say. You might find it helpful to talk to someone else first, or to make some notes and bring them to your appointment. 

For detailed information on this drug, visit the doravirine pages in the A-Z of antiretroviral medications.

 

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