Home Drug Guide Rilpivirine Hydrochloride

Drug Guide

Generic Name

Rilpivirine Hydrochloride

Brand Names Edurant, Edurant Ped

Classification

Therapeutic: Antiretroviral, HIV-1 reverse transcriptase inhibitor

Pharmacological: Non-nucleoside reverse transcriptase inhibitor (NNRTI)

FDA Approved Indications

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

Mechanism of Action

Rilpivirine binds to the non-nucleoside reverse transcriptase enzyme, causing direct inhibition of viral replication by non-competitively binding to the enzyme and causing conformational changes that inhibit DNA synthesis.

Dosage and Administration

Adult: 25 mg orally once daily with a meal

Pediatric: Not indicated for pediatric use

Geriatric: No specific dosage adjustment required, but caution advised due to comorbidities

Renal Impairment: No dosage adjustment necessary

Hepatic Impairment: Use with caution; no specific dosage recommendations available

Pharmacokinetics

Absorption: Rapidly absorbed, food increases absorption

Distribution: High protein binding (~99%)

Metabolism: Primarily hepatic via CYP3A4 enzyme

Excretion: Fecal excretion (major), minimal renal clearance

Half Life: 39 hours

Contraindications

  • Concurrent use with certain drugs that induce CYP3A4 or with drugs that prolong QT interval

Precautions

  • Cautious use in patients with history of QT prolongation, cardiac arrhythmias, or concomitant medications that affect QT interval; hepatic impairment; pregnancy category B

Adverse Reactions - Common

  • Headache (Common)
  • Insomnia (Common)
  • Nausea (Common)
  • rash (Common)

Adverse Reactions - Serious

  • QT prolongation (Less common)
  • Drug hypersensitivity reactions including hypersensitivity syndrome (Rare)

Drug-Drug Interactions

  • Concurrent use with strong CYP3A4 inducers (e.g., rifampin, carbamazepine) reduces effectiveness of rilpivirine.
  • CYP3A4 inhibitors (e.g., ketoconazole) may increase rilpivirine levels.

Drug-Food Interactions

  • Food enhances absorption; take with a meal.

Drug-Herb Interactions

  • Avoid St. John’s Wort (CYP3A4 inducer).

Nursing Implications

Assessment: Monitor for symptoms of HIV breakthrough, check for history of cardiac arrhythmias or QT prolongation.

Diagnoses:

  • Risk for ineffective tissue perfusion r/t cardiac arrhythmias.

Implementation: Advise to take consistently with a meal. Monitor for adverse reactions such as rash, mood changes.

Evaluation: Assess viral load periodically to evaluate effectiveness.

Patient/Family Teaching

  • Take medication with food to enhance absorption.
  • Report any symptoms of arrhythmia, such as palpitations or dizziness.
  • Inform about potential side effects and when to seek medical attention.

Special Considerations

Black Box Warnings:

  • None specific for rilpivirine.

Genetic Factors: Genetic variations affecting CYP3A4 activity may influence drug levels.

Lab Test Interference: May interfere with certain laboratory tests, consult lab for specifics.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, somnolence, seizures.

Treatment: Supportive care; no specific antidote. Contact poison control for guidance.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F). Keep in original container.

Stability: Stable for the duration of the labeled expiration date if stored properly.

🛡️ 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.