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Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Darunavir is a protease inhibitor. The frequency of birth defects was not increased among 496 women who took the drug during the first trimester (Antiretroviral Registry, 2018). The registry data is sufficient to rule out a more than twofold increase in the rate of birth defects.
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Published in Caroline Ashley, Aileen Dunleavy, John Cunningham, The Renal Drug Handbook, 2018
Caroline Ashley, Aileen Dunleavy, John Cunningham
Antivirals: absorption of atazanavir reduced (give at least 2 hours before or 1 hour after didanosine tablets); manufacturer of darunavir advises to take didanosine 1 hour before or 2 hours after darunavir; didanosine tablets reduce absorption of indinavir (give at least 1 hour apart); concentration possibly increased by ganciclovir, valganciclovir and tenofovir – avoid with tenofovir; give didanosine and ritonavir at least 2.5 hours apart; increased risk of side effects with ribavirin and stavudine – avoid; concentration reduced by tipranavir (give tipranavir and didanosine capsules at least 2 hours apart); give didanosine 2 hours before or 4 hours after rilpivirine.
Darunavir
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Allen C. Cheng, Ramona Muttucumaru, Suzanne M. Crowe
Darunavir is used solely for the treatment of HIV infection, in combination with other antiretroviral agents. The use of boosted darunavir has been evaluated in both treatment-naive and treatment-experienced adults, adolescents, and children as outlined in this section. The findings from ARTEMIS and ODIN evaluating once-daily darunavir in combination with other antiretroviral drugs provided evidence for revised treatment guidelines for the use of boosted darunavir for treatment-naive and -experienced patients who harbor no darunavir-associated resistance mutations
Understanding the role of chronopharmacology for drug optimization: what do we know?
Published in Expert Review of Clinical Pharmacology, 2023
Akio Fujimura, Kentaro Ushijima
The finding that homing of lymphocytes is enhanced with greater accumulation of lymphocytes in lymph nodes during active periods than during rest periods [74] has led to speculation that the antibody response to vaccination depends on dosing time. Indeed, clinical studies have shown that human antibody responses to influenza [48] and SARS-CoV-2 [49] vaccines are greater after vaccination in the morning than in the afternoon. Therefore, chronotherapy is a promising approach for combatting COVID-19 infection [77]. The effect of antiviral drugs had also been found to be greater after morning dosing in patients with COVID-19 infection. In one study, darunavir 800 mg and ritonavir 100 mg were administered once daily in the morning or evening for 7 days in patients with COVID-19. At the end of treatment, there was a significant reduction in the C-reactive protein level (a biomarker of inflammation) in the morning dosing group but not in the evening dosing group [78]. However, these are preliminary data, and further studies are needed to confirm the benefit of chronotherapy in terms of COVID-19 vaccination and other antiviral therapies.
Possible therapeutic agents for COVID-19: a comprehensive review
Published in Expert Review of Anti-infective Therapy, 2020
Khaled Mosaad Elhusseiny, Fatma Abd-Elshahed Abd-Elhay, Mohamed Gomaa Kamel
Darunavir, an FDA approved antiviral agent for HIV, is an inhibitor of HIV protease enzyme [42]. Darunavir is usually combined with other drugs such as cobicistat or ritonavir [43]. This addition leads to increased half-life and serum level of darunavir because cobicistat suppresses CYP3A4; an enzyme that normally metabolizes darunavir. A computational-based study identified darunavir as a potential inhibitor of SARS-CoV-2 replication. It also suggested that darunavir might, somehow, target the spike protein of SARS-CoV-2 [44]. Of note, darunavir is mostly tolerable with rash, nausea, and diarrhea as the commonest adverse events. Notwithstanding, darunavir should be carefully monitored in patients with hepatitis since its hepatotoxic effect was documented [4546–47]. To date, there is limited evidence about the efficacy of darunavir/cobicistat combination for COVID-19 patients. Therefore, we encourage conducting further preclinical and clinical studies.
Switching strategies in the recent era of antiretroviral therapy
Published in Expert Review of Clinical Pharmacology, 2019
Paula Prieto, Daniel Podzamczer
Although integrase inhibitors are the preferred regimens in most international guidelines, in patients with adherence issues, bPI regimens may be preferable because of their high genetic barrier to viral resistance. Darunavir (DRV) has been used to treat HIV-infected subjects for more than a decade, both in antiretroviral-naïve and experienced subjects [15].The binding affinity of DRV to wild-type HIV-1 protease is more than 100-fold that of other bPIs, with a very slow dissociation rate, thus explaining its potent antiviral activity and high genetic barrier [16]. First-time availability of a single pill administered once daily of a bPI regimen with DRV + cobicistat (COBI) + emtricitabine (FTC) + tenofovir alafenamide (TAF) makes this regimen suitable in a switching scenario, especially for patients in whom adherence may represent a limitation or who experience adverse events with integrase inhibitor-containing regimens.