HIV Drugs: Warnings and Safety
Warning for all NRTIs - answers lactic acidosis
hepatomegaly
steatosis (fatty liver)
nZidovudine Boxed Warning - answers lactic acidosis
hepatomegaly
steatosis (fatty liver)
nCommon ADE for ALL NRTIs - answers nausea, diarrhea, headache, ↑ LFTs
nBoxed warning for Emtricitabine, Lamivudine, and Tenofovir containing products with
HBV/HIV co-infection - answers Do not d/c abruptly, can cause severe acute HBV
exacerbation
nAbacavir boxed warning - answers Risk for hypersensitivity reaction: screen for HLA-
B*5701 allele before starting
*Never re-challenge if history of hypersensitivity reaction
nAbacavir warning with CVD - answers ↑ risk of MI
nEmtricitabine - answers hyperpigmentation of palms and soles
nZidovudine - answers myopathy
hematologic toxicity (neutropenia and anemia)
↑ MCV is sign of adherence
nWhich formulation of tenofovir has higher risk ADEs - answers TDF
nTenofovir (both) ADEs - answers renal impairment/renal failure (Fanconi Syndrome)
↓ bone mineral density
nTenofovir (both) renal warning - answers ↓ dose with renal impairment
avoid other nephrotoxic drugs
nWhat needs to be monitored when switching from TAF to TDF? - answers lipids
nBictegravir - answers ↑ SCr
nBictegravir and Dolutegravir D/D interactions - answers polyvalent cations (ok if taken
with food, otherwise avoid)
nDolutegravir - answers ↑ SCr, ↑ CPK, myopathy, rhabdomyolysis, HSR,
hepatotoxicity (especially co-infection with Hep B&C)
nDrug of choice for pregnant patients - answers Dolutegravir
nGeneral rule for INSTIs taken with polyvalent cations - answers take 2 hours prior or
6 hours after
nRaltegravir - answers ↑ CPK, myopathy, rhabdo, HSR
nAll INSTIs - answers headache, insomnia, diarrhea, weight gain, depression/suicidal
ideation in patients with psychiatric conditions
Warning for all NRTIs - answers lactic acidosis
hepatomegaly
steatosis (fatty liver)
nZidovudine Boxed Warning - answers lactic acidosis
hepatomegaly
steatosis (fatty liver)
nCommon ADE for ALL NRTIs - answers nausea, diarrhea, headache, ↑ LFTs
nBoxed warning for Emtricitabine, Lamivudine, and Tenofovir containing products with
HBV/HIV co-infection - answers Do not d/c abruptly, can cause severe acute HBV
exacerbation
nAbacavir boxed warning - answers Risk for hypersensitivity reaction: screen for HLA-
B*5701 allele before starting
*Never re-challenge if history of hypersensitivity reaction
nAbacavir warning with CVD - answers ↑ risk of MI
nEmtricitabine - answers hyperpigmentation of palms and soles
nZidovudine - answers myopathy
hematologic toxicity (neutropenia and anemia)
↑ MCV is sign of adherence
nWhich formulation of tenofovir has higher risk ADEs - answers TDF
nTenofovir (both) ADEs - answers renal impairment/renal failure (Fanconi Syndrome)
↓ bone mineral density
nTenofovir (both) renal warning - answers ↓ dose with renal impairment
avoid other nephrotoxic drugs
nWhat needs to be monitored when switching from TAF to TDF? - answers lipids
nBictegravir - answers ↑ SCr
nBictegravir and Dolutegravir D/D interactions - answers polyvalent cations (ok if taken
with food, otherwise avoid)
nDolutegravir - answers ↑ SCr, ↑ CPK, myopathy, rhabdomyolysis, HSR,
hepatotoxicity (especially co-infection with Hep B&C)
nDrug of choice for pregnant patients - answers Dolutegravir
nGeneral rule for INSTIs taken with polyvalent cations - answers take 2 hours prior or
6 hours after
nRaltegravir - answers ↑ CPK, myopathy, rhabdo, HSR
nAll INSTIs - answers headache, insomnia, diarrhea, weight gain, depression/suicidal
ideation in patients with psychiatric conditions
