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| Trade names | Rescriptor |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a600034 |
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| Routes of administration | By mouth |
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| Pharmacokinetic data | |
| Bioavailability | 85% |
| Protein binding | 98% |
| Metabolism | Liver (CYP3A4- andCYP2D6-mediated) |
| Eliminationhalf-life | 5.8 hours |
| Excretion | Kidney (51%) and feces (44%) |
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| Chemical and physical data | |
| Formula | C22H28N6O3S |
| Molar mass | 456.57 g·mol−1 |
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Delavirdine (DLV) (brand nameRescriptor) is a non-nucleosidereverse transcriptase inhibitor (NNRTI) marketed byViiV Healthcare. It is used as part of highly active antiretroviral therapy (HAART) for the treatment ofhuman immunodeficiency virus (HIV) type 1. It is presented as themesylate. The recommended dosage is 400 mg, three times a day.
Although delavirdine was approved by the U.S.Food and Drug Administration in 1997, its efficacy is lower than other NNRTIs, especiallyefavirenz, and it also has an inconvenient schedule. These factors have led the U.S. DHHS not to recommend its use as part of initial therapy.[1]The risk of cross-resistance across the NNRTI class, as well as its complex set of drug interactions, makes the place of delavirdine in second-line andsalvage therapy unclear, and it is currently rarely used.
Its manufacturing and distribution was discontinued in the United States and Canada.[2][3][4]
Likeritonavir, delavirdine is an inhibitor ofcytochrome P450 isozymeCYP3A4, and interacts with many medications. It should not be administered with a wide range of drugs, includingamprenavir,fosamprenavir,simvastatin,lovastatin,rifampin,rifabutin,rifapentine,St John's wort,midazolam,triazolam,ergot medications, and several medications foracid reflux.[1]
The most common adverse event is moderate to severerash, which occurs in up to 20% of patients.[5] Other common adverse events includefatigue,headache andnausea. Liver toxicity has also been reported.
Modification of the scheme that was done forateviridineq.v. by performing thereductive alkylation with acetone gives2 after removal of the protecting group. Acylation of this amine with the imidazolide from 5-Methylsulfonaminoindole-2-carboxylic acid (1) affords the amide,reverse transcriptase inhibitor, atevirdine.
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