Home Drug Guide Darunavir

Drug Guide

Generic Name

Darunavir

Brand Names Prezista

Classification

Therapeutic: Antiretroviral agent for HIV infection

Pharmacological: Protease inhibitor

FDA Approved Indications

  • Treatment of HIV-1 infection in combination with other antiretroviral agents

Mechanism of Action

Darunavir inhibits the HIV-1 protease enzyme, preventing the cleavage of precursor polypeptides into mature, functional proteins, thereby inhibiting viral replication.

Dosage and Administration

Adult: 600 mg twice daily with food or 800 mg once daily with food in combination with other antiretrovirals.

Pediatric: Not approved for use in children under 3 years old.

Geriatric: No specific dosage adjustment needed; evaluate renal and hepatic function.

Renal Impairment: No dose adjustment necessary for mild to moderate impairment; caution in severe impairment.

Hepatic Impairment: Use with caution; dose adjustment may be necessary, especially in severe hepatic impairment.

Pharmacokinetics

Absorption: Complete absorption when taken with food.

Distribution: Widely distributed in body tissues; highly protein-bound (~95%).

Metabolism: Primarily metabolized by CYP3A enzymes in the liver.

Excretion: Metabolites excreted mainly via feces; minor urinary excretion.

Half Life: Approximately 15 hours.

Contraindications

  • Hypersensitivity to darunavir or any component of the formulation.

Precautions

  • Use with caution in patients with liver impairment, especially hepatitis B or C co-infection.
  • Assess for hypersensitivity reactions.

Adverse Reactions - Common

  • Rash (Common)
  • Nausea (Common)
  • Diarrhea (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Severe skin reactions (e.g., Stevens-Johnson syndrome) (Rare)
  • Hepatotoxicity (Uncommon)
  • Clostridioides difficile-associated diarrhea (Uncommon)

Drug-Drug Interactions

  • Ritonavir, which is used as a booster.
  • Other drugs that are CYP3A inducers or inhibitors.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of hypersensitivity, rash, liver function tests.

Diagnoses:

  • Risk of infection due to HIV,

Implementation: Administer with food, monitor adherence, and interact with other medications as per guidelines.

Evaluation: Assess viral load and CD4 counts to gauge efficacy.

Patient/Family Teaching

  • Take medication with food to enhance absorption.
  • Do not alter dose or frequency without consulting a healthcare provider.
  • Report any rash, jaundice, or severe side effects immediately.
  • Maintain adherence to prevent resistance.

Special Considerations

Black Box Warnings:

  • Potential for serious skin reactions and hepatotoxicity.

Genetic Factors: HLA-B*57:01 testing not specifically required for darunavir but important for abacavir.

Lab Test Interference: May cause changes in liver function tests.

Overdose Management

Signs/Symptoms: Nausea, dizziness, hypotension.

Treatment: Supportive care; no specific antidote exists. Dialysis unlikely to be effective due to high protein binding.

Storage and Handling

Storage: Store at room temperature (15-30°C).

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.