The human immunodeficiency virus (HIV) requires a complicated treatment regimen to keep in check. Rilpivirine (TMC278, trade name Edurant) is one of the drugs that can be used as part of a treatment program. It is a non-nucleoside reverse transcriptase inhibitor (NNRTI) made by the New Jersey based Tibotec Therapeutics.
As of 2011, HIV was not curable, but it could be controlled through drugs. The virus can replicate itself enough, in the absence of antiviral drugs, to cause acquired immunodeficiency syndrome (AIDS). Rilpivirine targets one of the enzymes that the virus produces for this process. It is suitable as a primary treatment for new HIV diagnoses.
It was approved by the U.S. Food and Drug Administration (FDA) in May 2011. Edurant is approved for people living with HIV starting antiretroviral therapy for the first time. It is not approved for people living with HIV who have already used antiretrovirals.
Edurant works by blocking HIV’s reverse transcriptase enzyme. After HIV’s genetic material is deposited inside a cell, its RNA must be converted (reverse transcribed) into DNA. NNRTIs stop this process and prevent HIV from infecting the CD4 cell and producing new virus particles. HIV mutates easily and gains resistance to the antiviral drugs, so rilpivirine is never used alone. Instead, it forms part of a treatment regimen that includes other drugs. This combination of drugs might be able to prevent the amount of viral particles in the body from increasing and therefore halt the progression of the disease.
Several medicines, such as the antibiotic rifampin, the steroid dexamethasone or the herbal product St. John’s wort are not safe to take with this drug. Patients who have also suffered from depression or mental illness should inform their doctors prior to taking the drug. Kidney, liver or heart trouble are also important for a doctor to know before he or she can prescribe the drug.
The Rilpivirine (4-Aminobenzonitrile is one of its intermediates) dose is one 25 mg tablet taken by mouth once a day. It should be taken with a high-fat meal (e.g., breakfast and dinner). Some medicines, such as antacids, can interfere with the action of this medication, so these should be taken at different times to the drug.
Side effects such as gastrointestinal issues are possible, and these can be severe. It can cause depression or mood changes. Be sure to contact your health care provider immediately if you are feeling said or hopeless, feeling anxious or restless, or have thoughts of hurting yourself (suicide) or have tried to hurt yourself.