Nucleoside reverse transcriptase inhibitors

MHRA Drug Safety Update (July 2009). Abacavir-containing medicines should be used in line with current treatment guidelines and with caution in patients with high cardiovascular risk factors. Action should be taken to minimise all modifiable risk factors (e.g. smoking, high blood pressure, hyperlipidaemia, and diabetes).

Abacavir

• Tablets 300mg
• Oral solution 20mg/ml

Atripla

(Efavirenz with emtricitabine and tenofovir disoproxil)

• Tablets 600mg/200mg/245mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Biktarvy

(Bictegravir with emtricitabine and tenofovir alafenamide)

• Tablets 50mg/200mg/25mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)
2. NHS England clinical commissioning policy: Bictegravir-emtricitabine-tenofovir alafenamide for the treatment of HIV-1 in adults (July 2019)

Combivir

(Lamivudine with zidovudine)

• Tablets 150mg/300mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Descovy

(Emtriciabine with tenofovir alafenamide)

• Tablets 200mg/10mg, 200mg/25mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Didanosine

• Tablets 25mg, 100mg, 150mg
• Enteric coated capsules 125mg, 200mg, 250mg, 400mg
• Oral solution 10mg/ml (Unlicensed)

Emtricitabine

• Capsules 200mg
• Oral solution 50mg/5ml

Eviplera

(Emtricitabine with rilpivirine and tenofovir disoproxil)

• Tablets 200mg/25mg/245mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Genvoya

(Elvitegravir with cobicistat, emtricitabine and tenofovir alafenamide)

• Tablets 150mg/150mg/200mg/10mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)
2. MHRA Drug Safety Update (April 2019): Elvitegravir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1
3. NHS England Clinical Commissioning Policy: Elvitegravir/cobicistat/ emtricitabine/tenofovir for treatment of HIV in adults (July 2015)

Kivexa

(Abacavir with lamivudine)

• Tablets 600mg/300mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Lamivudine

• Tablets 100mg, 150mg, 300mg
• Oral solution 10mg/ml

Odefsey

(Emtricitabine with rilpivirine and tenofovir alafenamide)

• Tablets 200mg/25mg/25mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Stribild

(Elvitegravir with cobicistat, emtricitabine and tenofovir disoproxil)

• Tablets 150mg/150mg/200mg/245mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)
2. MHRA Drug Safety Update (April 2019): Elvitegravir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1
3. NHS England Clinical Commissioning Policy: Stribild for the treatment of HIV-1 infection in adults (September 2013)

Tenofovir disoproxil

• Tablets 245mg
• Granules 33mg/1g

Notes

• NICE TA173: Tenofovir disoproxil, within its marketing authorisation, is recommended as an option for the treatment of people with chronic HBeAg-positive or HBeAg-negative hepatitis B in whom antiviral treatment is indicated (July 2009)

Triumeq

(Abacavir with dolutegravir and lamivudine)

• Tablets 600mg/50mg/300mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)
2. MHRA Drug Safety Update (October 2020): Dolutegravir (Tivicay, Triumeq, Juluca): updated advice on increased risk of neural tube defects.
   1. Updated safety recommendations have been issued as part of the European review evaluating cases of neural tube defects in babies born to mothers who became pregnant while taking the HIV medicine dolutegravir.
   2. Evidence collected as more women have given birth while on dolutegravir treatment shows a smaller increased risk than previously thought, almost comparable to other HIV drugs.
   3. The previous restrictions against use in pregnancy are no longer in place – inform women of the potential risk of neural tube defects with dolutegravir, including consideration of effective contraceptive methods, and discuss the benefits and risks of continuing treatment if a woman plans pregnancy.
3. See resources for: contraception for drugs with teratogenic potential, and prescribing in pregnancy and lactation

Trizivir

(Abacavir with lamivudine and zidovudine)

• Tablets 300mg/150mg/300mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Truvada

(Emtricitabine with tenofovir disoproxil)

• Tablets 200mg/245mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Zidovudine

• Capsules 100mg, 250mg
• Oral solution 50mg/5ml
• Injection 10mg/ml, 20ml vial

Protease inhibitors

MHRA Drug Safety Update (October 2018): Ritonavir-containing products: reports of interaction with levothyroxine leading to reduced thyroxine levels. Monitor thyroid-stimulating hormone (TSH) in patients treated with levothyroxine for at least the first month after the start and end of ritonavir treatment

Atazanavir

• Capsules 150mg, 200mg, 300mg

Darunavir

• Tablets 400mg, 600mg, 800mg
• Suspension 100mg/ml

Evotaz

(Atazanavir with cobicistat)

• Tablets 300mg/150mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Indinavir

• Capsules 200mg, 400mg

Kaletra

(Lopinavir with ritonavir)

• Tablets 100mg/25mg, 200mg/50mg
• Oral solution 80mg/20mg/1ml

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)

Nelfinavir

• Tablets 250mg

Rezolsta

(Darunavir with cobicistat)

• Tablets 800mg/150mg

Notes

1. Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients)
2. MHRA drug safety update (July 2018): Darunavir boosted with cobicistat: avoid use in pregnancy due to risk of treatment failure and maternal-to-child transmission of HIV-1. Refer to update for further details.

Ritonavir

• Tablets 100mg
• Powder for oral suspension 100mg

Non-nucleoside reverse transcriptase inhibitors

Doravirine

• Tablets 100mg

Notes

1. For use in line with the NHS England Clinical Commissioning Policy (November 2019)

Efavirenz

• Tablets 600mg
  

Etravirine

• Tablets 200mg

Nevirapine

• Tablets 200mg
• Modified-release tablets 400mg
• Suspension 50mg/5ml

Rilpivirine

• Edurant tablets 25mg
• Rekambys prolonged-release suspension for injection vials 900mg/3ml

Notes

1. NICE TA757: Cabotegravir (Vocabria) with rilpivirine (Rekambys) is recommended, within its marketing authorisation, as an option for treating HIV 1 infection in adults (January 2022):
   1. with virological suppression (HIV 1 RNA fewer than 50 copies/ml) on a stable antiretroviral regimen and
   2. without any evidence of viral resistance to, and no previous virological failure with, any non-nucleoside reverse transcriptase inhibitors or integrase inhibitors
   3. It is recommended only if the company provides it according to the commercial arrangement

Other antiretrovirals

Cabotegravir

• Tablets 30mg
• Prolonged-release suspension for injection vials 600mg/3ml

Notes

1. NICE TA757: Cabotegravir (Vocabria) with rilpivirine (Rekambys) is recommended, within its marketing authorisation, as an option for treating HIV 1 infection in adults (January 2022):
   1. with virological suppression (HIV 1 RNA fewer than 50 copies/ml) on a stable antiretroviral regimen and
   2. without any evidence of viral resistance to, and no previous virological failure with, any non-nucleoside reverse transcriptase inhibitors or integrase inhibitors
   3. It is recommended only if the company provides it according to the commercial arrangement

Dolutegravir

• Tablets 50mg

Notes

1. MHRA Drug Safety Update (October 2020): Dolutegravir (Tivicay, Triumeq, Juluca): updated advice on increased risk of neural tube defects.
   1. Updated safety recommendations have been issued as part of the European review evaluating cases of neural tube defects in babies born to mothers who became pregnant while taking the HIV medicine dolutegravir.
   2. Evidence collected as more women have given birth while on dolutegravir treatment shows a smaller increased risk than previously thought, almost comparable to other HIV drugs.
   3. The previous restrictions against use in pregnancy are no longer in place – inform women of the potential risk of neural tube defects with dolutegravir, including consideration of effective contraceptive methods, and discuss the benefits and risks of continuing treatment if a woman plans pregnancy.
2. See resources for: contraception for drugs with teratogenic potential, and prescribing in pregnancy and lactation

Maraviroc

• Tablets 150mg, 300mg

Raltegravir

• Tablets 400mg