Home Drug Guide Delavirdine Mesylate

Drug Guide

Generic Name

Delavirdine Mesylate

Brand Names Rescriptor

Classification

Therapeutic: Antiretroviral, NNRTI (Non-Nucleoside Reverse Transcriptase Inhibitor)

Pharmacological: Reverse Transcriptase Inhibitor

FDA Approved Indications

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

Mechanism of Action

Delavirdine binds non-competitively to reverse transcriptase enzyme of HIV-1, inhibiting its activity and thus preventing viral replication.

Dosage and Administration

Adult: 200 mg three times daily, with or without food

Pediatric: Not recommended for pediatric use due to limited data

Geriatric: No specific dosage adjustment, but caution in patients with comorbidities and concurrent medications

Renal Impairment: Use with caution, no specific adjustment recommended

Hepatic Impairment: Use with caution; dose adjustment may be needed in severe hepatic impairment

Pharmacokinetics

Absorption: Well absorbed orally, peak plasma levels in 2-4 hours

Distribution: Extensively bound to plasma proteins (~99%)

Metabolism: Metabolized mainly by CYP3A4 enzyme

Excretion: Primarily via feces, small amount via urine

Half Life: Approximately 5 hours

Contraindications

  • Hypersensitivity to delavirdine or any component of the formulation

Precautions

  • Use with caution in patients with hepatic impairment, adequate liver function monitoring is recommended. May cause hepatotoxicity.
  • Coadministration with drugs highly dependent on CYP3A4 for clearance or that strongly induce or inhibit CYP3A4 can alter delavirdine levels.

Adverse Reactions - Common

  • Rash (Common)
  • Fatigue (Common)
  • Nausea (Common)
  • Headache (Common)

Adverse Reactions - Serious

  • Hepatotoxicity including hepatic failure (Rare)
  • Allergic reactions including angioedema or hypersensitivity (Rare)

Drug-Drug Interactions

  • CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) increase delavirdine levels
  • CYP3A4 inducers (e.g., rifampin, carbamazepine) decrease delavirdine levels
  • Other antiretrovirals and drugs metabolized by CYP enzymes

Drug-Food Interactions

  • None specifically

Drug-Herb Interactions

  • St. John’s Wort and other herbal products that induce CYP3A4 may decrease efficacy

Nursing Implications

Assessment: Monitor liver function tests regularly; observe for signs of hepatotoxicity. Assess for rash or allergic reactions.

Diagnoses:

  • Risk for hepatotoxicity
  • Impaired skin integrity related to rash

Implementation: Administer with or without food, encourage adherence, and educate patient on potential side effects.

Evaluation: Regularly evaluate viral load and CD4 counts to assess therapy effectiveness.

Patient/Family Teaching

  • Take medication exactly as prescribed, at the same times daily.
  • Report any signs of rash, jaundice, abdominal pain, or allergic reactions immediately.
  • Avoid alcohol and hepatotoxic medications.
  • Discuss potential drug interactions, especially with other prescribed drugs.

Special Considerations

Black Box Warnings:

  • Hepatotoxicity, including rare cases of hepatic failure

Genetic Factors: None specified.

Lab Test Interference: No known interference but monitor liver functions closely.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, somnolence, and abnormal liver function tests.

Treatment: Supportive care, monitor liver function, activated charcoal if ingestion was recent, no specific antidote.

Storage and Handling

Storage: Store at room temperature (20-25°C / 68-77°F), protect from moisture and light.

Stability: Stable under recommended storage conditions for at least 2 years.

🛡️ 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.