Home Drug Guide Darunavir Ethanolate

Drug Guide

Generic Name

Darunavir Ethanolate

Brand Names Prezista

Classification

Therapeutic: Antiretroviral (HIV protease inhibitor)

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 the Gag-Pol protein precursors. This results in the production of immature, non-infectious viral particles, thereby reducing viral load.

Dosage and Administration

Adult: 600 mg twice daily with food; may be adjusted based on patient's response and concomitant medications

Pediatric: Not approved for pediatric use

Geriatric: No specific dose adjustment recommended; consider renal and hepatic function

Renal Impairment: Use with caution; dosage adjustments may be necessary

Hepatic Impairment: Use with caution in patients with severe hepatic impairment; no specific dose adjustment established

Pharmacokinetics

Absorption: Well absorbed with bioavailability enhanced by food

Distribution: Extensively distributed in body tissues; protein binding approximately 95%

Metabolism: Primarily metabolized by CYP3A enzymes in the liver

Excretion: Primarily excreted in feces; minor amount in urine

Half Life: Approximately 15 hours

Contraindications

  • Hypersensitivity to darunavir or any component of the formulation

Precautions

  • Use with caution in patients with hypersensitivity reactions; may cause hepatotoxicity; monitor liver function; caution in patients with cardiovascular disease

Adverse Reactions - Common

  • Nausea (Common)
  • Headache (Common)
  • Rash (Uncommon)

Adverse Reactions - Serious

  • Allergic reactions including skin rash, pruritus, and hypersensitivity (Less common)
  • Hepatotoxicity including elevated liver enzymes (Uncommon)

Drug-Drug Interactions

  • Rifampin, which decreases darunavir levels; other CYP3A inhibitors and inducers affecting its levels

Drug-Food Interactions

  • Avoid high-fat meals which may alter absorption

Drug-Herb Interactions

  • Potential interactions with St. John’s Wort and other herbal products affecting CYP3A activity

Nursing Implications

Assessment: Monitor for signs of hypersensitivity, rash, and hepatotoxicity; assess liver function tests regularly

Diagnoses:

  • Risk for ineffective tissue perfusion related to adverse drug reactions

Implementation: Administer with food; instruct patient to adhere to prescribed schedule; monitor for adverse reactions and interactions

Evaluation: Evaluate viral load suppression, monitor for side effects, and liver function tests regularly

Patient/Family Teaching

  • Take medication with food at the same times daily
  • Report any rash, allergic reactions, or signs of liver problems immediately
  • Complete full course of therapy and do not stop medication without consulting healthcare provider

Special Considerations

Black Box Warnings:

  • Potential for hepatitis B exacerbation upon discontinuation

Genetic Factors: None specified

Lab Test Interference: May cause increases in serum cholesterol and triglycerides

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, etc.

Treatment: Supportive care; no specific antidote; contact poison control; monitor vital signs and provide symptomatic treatment

Storage and Handling

Storage: Store at 25°C (77°F); Keep container tightly closed

Stability: Stable at room temperature for at least 24 months

🛡️ 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.