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Why is Pifeltro prescribed?

Pifeltro (Doravirine) is prescribed as part of a combination therapy for the treatment of HIV-1 infection in adults (weight is around 77 lbs. or more). This medication is used in individuals who have no prior antiretroviral treatment history or as a replacement for their current regimen if they are virologically suppressed and have no history of treatment failure.

What does it do?

Pifeltro (Doravirine) works by blocking the action of HIV-1 reverse transcriptase, an enzyme that the virus needs to replicate. By inhibiting this enzyme, Pifeltro prevents HIV from multiplying in the body, helping to reduce the viral load and maintain immune function.

It is part of the non-nucleoside reverse transcriptase inhibitor (NNRTI) class of drugs and is used in combination with other antiretroviral medications to effectively manage HIV-1 infection.

How should I take it?

Take Pifeltro strictly as prescribed by your doctor. This medication should be taken once daily, at the same time each day, with or without food. If you are also taking rifabutin, your doctor may adjust your dose to twice daily, about 12 hours apart.

What if I missed a dose?

If you miss a dose of Pifeltro, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed one and continue with your regular schedule. Do not take double or extra doses to make up for the missed one.

What are the special precautions before taking Pifeltro?

Inform your doctor about all the medications you are taking, your current and previous medical history.

Before taking Pifeltro, here are several important precautions to keep in mind:

• Do not take Pifeltro if you are allergic to Doravirine or any of the ingredients in the medication.
• Avoid taking strong CYP3A enzyme inducers like rifampin, carbamazepine, phenytoin, St. John’s wort, as they can reduce Doravirine levels and make it less effective.
• Discuss your medical history with your doctor, particularly if you have liver disease or a history of immune system disorders.
• The use of this medication is not recommended for pregnant or breastfeeding women, as there is insufficient safety data regarding its effects during pregnancy, and there is a risk of HIV transmission through breast milk.

Does it have any side effects?

It is important to note that all drugs have corresponding side effects and adverse reactions. Additional information may be obtained when you ask your doctor or pharmacist.

Common side effects may include:
• Diarrhea
• Headache
• Nausea
• Dizziness
• Fatigue

Serious side effects may include:
• Immune reconstitution syndrome
• Severe skin rash or blisters
• Yellowing of the skin or eyes (Jaundice)
• Severe allergic reactions such as swelling, or difficulty breathing

This is not a complete list of all possible side effects, and others may occur. For more information about side effects, please consult your healthcare provider.

Is it safe to take it with another drug?

Pifeltro (Doravirine) can interact with various medications, so it's important to check for potential interactions before taking it with another drug.

These drugs can significantly reduce Doravirine levels or cause serious adverse effects:

• Carbamazepine (seizure medication)
• Phenytoin (seizure medication)
• St. John’s Wort (herbal supplement)

These drugs may require dose adjustments or careful monitoring:

• Atorvastatin, Rosuvastatin (cholesterol-lowering drugs)
• Omeprazole, Pantoprazole (acid reducers)
• Metformin (diabetes medication)
• Lisinopril, Losartan (blood pressure medications)

These drugs have low interaction risk, but monitoring is still advised:

• Ibuprofen, Aspirin (pain relievers)
• Gabapentin (nerve pain medication)
• Vitamin D3, Vitamin B12

This is not a complete list of potential drug interactions. Always consult your healthcare provider before before combining Pifeltro with other medications to ensure safety.

How should I store it?

Pifeltro should be stored in its original container at room temperature, ideally between 20°C and 25°C (68°F and 77°F). Keep it away from direct sunlight and out of reach of children

What action should I take in case of overdose?

If you suspect an overdose of Pifeltro (Doravirine), it's important to act quickly and seek immediate medical attention. Contact emergency services or go to the nearest hospital.

Is it safe for pregnant or breastfeeding women?

Pifeltro (Doravirine) has limited data on its safety during pregnancy. As a precaution, some authorities recommend avoiding its use during pregnancy unless the benefits outweigh the risks.

For breastfeeding, Pifeltro is not recommended. It is unknown whether doravirine passes into human milk, and HIV-infected mothers are generally advised not to breastfeed to prevent transmission of the virus to their infants.

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