| Generic Name (Abbreviation) Trade Name |
Formulation | Dosing Recommendationsa | Use in Pregnancy | Last Reviewed |
|---|---|---|---|---|
| NRTIs NRTIs interfere with HIV reverse transcriptase by competitive inhibition. Nucleoside analogue drugs require three intracellular phosphorylation steps to form the triphosphate nucleoside, which is the active drug moiety. The nucleotide analogue tenofovir contains a monophosphate component attached to the adenine base and requires only two phosphorylation steps to form the active moiety. |
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|
Abacavir (ABC) (ABC/3TC) (ABC/DTG/3TC) (ABC/3TC/ZDV) Note: Generic products are available for some formulations. |
ABC (Ziagen)c Tablet
Oral Solution
ABC/3TC (Epzicom)c
ABC/DTG/3TC (Triumeq)
ABC/3TC/ZDV (Trizivir)c
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about use of combination products in pregnancy, please see the specific sections on other components (i.e., 3TC, ZDV, DTG). Standard Adult Doses ABC (Ziagen)
ABC/3TC (Epzicom)
ABC/DTG/3TC (Triumeq)
ABC/3TC/ZDV (Trizivir)
|
High placental transfer to fetusb No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects) HSRs occur in approximately 5% to 8% of nonpregnant individuals. A small percentage of reactions are fatal, and these fatal reactions are usually associated with re-challenge. Rate of reactions during pregnancy is unknown. Testing for HLA-B*5701 identifies patients at risk of reactions, and a patient’s status should be documented as negative before initiating ABC. Patients should be educated regarding symptoms of HSR. |
January 31, 2023 |
|
Emtricitabine (FTC) (FTC/EFV/TDF) (FTC/BIC/TAF) (FTC/RPV/TDF) (FTC/TAF) (FTC/EVG/c/TAF) (FTC/RPV/TAF) (FTC/EVG/c/TDF) (FTC/DRV/c/TAF) (FTC/TDF) Note: Generic products are available for some formulations. |
FTC (Emtriva) Capsulec
Oral Solution
FTC/EFV/TDF (Atripla)c
FTC/BIC/TAF (Biktarvy)
FTC/RPV/TDF (Complera)
FTC/TAF (Descovy)
FTC/EVG/c/TAF (Genvoya)
FTC/RPV/TAF (Odefsey)
FTC/EVG/c/TDF (Stribild)
FTC/DRV/c/TAF (Symtuza)
FTC/TDF (Truvada)c
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., TDF, TAF, EFV, RPV, DRV, EVG, BIC, COBI). Standard Adult Doses FTC (Emtriva)
FTC/EFV/TDF (Atripla)
FTC/BIC/TAF (Biktarvy)
FTC/RPV/TDF (Complera)
FTC/TAF (Descovy)
FTC/EVG/c/TAF (Genvoya)
FTC/RPV/TAF (Odefsey)
FTC/EVG/c/TDF (Stribild)
FTC/DRV/c/TAF (Symtuza)
FTC/TDF (Truvada)
|
High placental transfer to fetusb No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects) If patient has HBV/HIV coinfection, it is possible that an HBV flare may occur if the drug is stopped; see Hepatitis B Virus/HIV Coinfection. |
January 31, 2023 |
|
Lamivudine (3TC) (3TC/TDF) (3TC/ZDV) (3TC/DOR/TDF) (3TC/DTG) (3TC/ABC) (3TC/EFV/TDF) (3TC/EFV/TDF) (3TC/TDF) (3TC/ABC/DTG) (3TC/ABC/DTG) (3TC/ABC/ZDV) Note: Generic products are available for some formulations. |
3TC (Epivir)c Tablets
Oral Solution
3TC/TDF (Cimduo)
3TC/ZDV (Combivir)c
3TC/DOR/TDF (Delstrigo)
3TC/DTG (Dovato)
3TC/ABC (Epzicom)c
3TC/EFV/TDF (Symfi)c
3TC/EFV/TDF (Symfi Lo)c
3TC/TDF (Temixys)
3TC/ABC/DTG (Triumeq)
3TC/ABC/DTG (Triumeq PD)
3TC/ABC/ZDV (Trizivir)c
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (ABC, DOR, DTG, EFV, TDF, ZDV). Standard Adult Doses 3TC (Epivir)
3TC/TDF (Cimduo)
3TC/ZDV (Combivir)
3TC/DOR/TDF (Delstrigo)
3TC/DTG (Dovato)
3TC/ABC (Epzicom)
3TC/EFV/TDF (Symfi or Symfi Lo)
3TC/TDF (Temixys)
3TC/ABC/DTG (Triumeq)
3TC/ABC/DTG (Triumeq PD)
3TC/ABC/ZDV (Trizivir)
|
High placental transfer to fetusb No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects) If patient has HBV/HIV coinfection, it is possible that an HBV flare may occur if the drug is stopped; see Hepatitis B Virus/HIV Coinfection. 3TC products that were developed specifically for treatment of HBV (e.g., Epivir-HBV) contain a lower dose of 3TC that is not appropriate for treatment of HIV. |
January 31, 2023 |
|
Tenofovir Alafenamide (TAF) (TAF/BIC/FTC) (TAF/FTC) (TAF/EVG/c/FTC) (TAF/FTC/RPV) (TAF/DRV/c/FTC) |
TAF (Vemlidy)
TAF/BIC/FTC (Biktarvy)
TAF/FTC (Descovy)
TAF/EVG/c/FTC (Genvoya)
TAF/FTC/RPV (Odefsey)
TAF/DRV/c/FTC (Symtuza)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., BIC, COBI, DRV, EVG, FTC, RPV). Standard Adult Doses TAF (Vemlidy)
TAF/BIC/FTC (Biktarvy)
TAF/FTC (Descovy)
TAF/EVG/c/FTC (Genvoya)
TAF/FTC/RPV (Odefsey)
TAF/DRV/c/FTC (Symtuza) · One tablet once daily with food |
TAF: low placental transfer to fetusb TFV: high placental transfer to fetus; plasma and cord blood concentrations lower than TDFb No evidence of human teratogenicity (can rule out twofold increase in overall birth defects) Renal function should be monitored because of the potential for renal toxicity. |
January 31, 2023 |
|
Tenofovir Disoproxil Fumarate (TDF) (TDF/EFV/FTC) (TDF/3TC) (TDF/FTC/RPV) (TDF/DOR/3TC) (TDF/EVG/c/FTC) (TDF/EFV/3TC) (TDF/EFV/3TC) (TDF/3TC) (TDF/FTC) Note: Generic products are available for some formulations. |
TDF (Viread) Tabletd
Powder
TDF/EFV/FTC (Atripla)
TDF/3TC (Cimduo)
TDF/FTC/RPV (Complera)
TDF/DOR/3TC (Delstrigo)
TDF/EVG/c/FTC (Stribild)
TDF/EFV/3TC (Symfi)
TDF/EFV/3TC (Symfi Lo)
TDF/3TC (Temixys)
TDF/FTC (Truvada)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., Lamivudine [Epivir, 3TC], Cobicistat [Tybost, COBI], Doravirine [Pifeltro, DOR], Efavirenz [Sustiva, EFV], Elvitegravir [EVG], Emtricitabine [Emtriva, FTC], Rilpivirine [Edurant, RPV]). Standard Adult Doses TDF (Viread)
TDF/EFV/FTC (Atripla)
TDF/3TC (Cimduo)
TDF/FTC/RPV (Complera)
TDF/DOR/3TC (Delstrigo)
TDF/EVG/c/FTC (Stribild)
TDF/EFV/3TC (Symfi or Symfi Lo)
TDF/3TC (Temixys)
TDF/FTC (Truvada)
|
High placental transfer to fetusb No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects) Human studies demonstrate no consistent link to low birth weight, but data are conflicting about potential effects on growth outcomes later in infancy. If patient has HBV/HIV coinfection, an HBV flare may occur if TDF is stopped; see Hepatitis B Virus/HIV Coinfection. Renal function should be monitored because of potential for renal toxicity. |
January 31, 2023 |
|
Zidovudine (ZDV) (ZDV/3TC) (ZDV/ABC/3TC) Note: Generic products are available for all formulations. |
ZDV (Retrovir) Capsule
Tablet
Oral Solution
IV Solution
ZDV/3TC (Combivir)
ZDV/ABC/3TC (Trizivir)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., ABC, 3TC). Standard Adult Doses ZDV (Retrovir)
ZDV/3TC (Combivir)
ZDV/ABC/3TC (Trizivir)
|
High placental transfer to fetusb No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects) |
January 31, 2023 |
| NNRTIs NNRTIs interfere with HIV reverse transcriptase by binding directly to the enzyme. |
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|
Doravirine (DOR) (DOR/3TC/TDF) |
DOR (Pifeltro)
DOR/3TC/TDF (Delstrigo)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination ARV drug products in pregnancy, please see the specific sections on other drug components (i.e., 3TC, TDF). Standard Adult Doses DOR (Pifeltro)
DOR/3TC/TDF (Delstrigo)
|
No human in vivo data are available on the placental transfer of DOR, but passage is noted in ex vivo models. Insufficient data are available to assess for teratogenicity in humans. No evidence exists of teratogenicity in rats or rabbits. |
January 31, 2023 |
|
Efavirenz (EFV) (EFV/FTC/TDF) (EFV/3TC/TDF) (EFV/3TC/TDF) Note: Generic products are available for some formulations. |
EFV (Sustiva)c Capsules
Tablet
EFV/FTC/TDF (Atripla) EFV 600-mg/FTC 200-mg/TDF 300mg tablet EFV/3TC/TDF (Symfi) EFV 600-mg/3TC 300-mg/TDF 300mg tablet EFV/3TC/TDF (Symfi Lo)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., 3TC, FTC, TDF). Standard Adult Doses EFV (Sustiva)
EFV/FTC/TDF (Atripla)
EFV/3TC/TDF (Symfi or Symfi Lo)
|
Moderate placental transfer to fetusb The FDA advises women to avoid becoming pregnant while taking EFV and advises health care providers to avoid administration during the first trimester of pregnancy because fetal harm may occur. However, the data on more than 7,900 periconception EFV exposures from Botswana rule out a threefold or greater increased risk of NTDs. As a result, the current Perinatal Guidelines do not restrict the use of EFV in pregnant women or in women who are planning to become pregnant. This is consistent with both the British HIV Association and WHO guidelines for use of ARV drugs in pregnancy. EFV should be continued in pregnant women who are on a virally suppressive, EFV-based regimen, because ARV drug changes during pregnancy may be associated with loss of viral control and an increased risk of perinatal transmission (see Pregnant People With HIV Who Are Currently Receiving Antiretroviral Therapy). |
January 31, 2023 |
|
Etravirine (ETR) |
Tablet
For patients who are unable to swallow tablets whole, the tablets may be dispersed in a glass of water. |
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
Standard Adult Doses
|
Placental transfer varies; it is usually in the moderate-to-high categories, ranging from 0.19 to 4.25.b Insufficient data to assess for teratogenicity in humans. No evidence of teratogenicity in rats or rabbits. |
January 31, 2023 |
|
Nevirapine (NVP) Note: Generic products are available for some formulations. |
NVP (Viramune) Tablet
Oral Suspension
Viramune XR Tablets
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
Standard Adult Doses
|
High placental transfer to fetusb No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects and twofold increase in cardiovascular and genitourinary defects) An increased risk of symptomatic liver toxicity exists when first initiating therapy in women with CD4 counts ≥250/mm3. Liver toxicity is often associated with a rash and can be fatal. Pregnancy does not appear to increase this risk. NVP should be initiated in pregnant people with CD4 counts ≥250 cells/mm3 only if benefit clearly outweighs risk. A potential increased risk of life-threatening hepatotoxicity exists in pregnant people with high CD4 counts. Elevated transaminase levels at baseline may increase the risk of NVP toxicity. Patients who become pregnant while taking NVP-containing regimens and who are tolerating their regimens well can continue taking those regimens, regardless of their CD4 counts. |
January 31, 2023 |
|
Rilpivirine (RPV) (RPV/FTC/TDF) (RPV/DTG) (RPV/FTC/TAF) (CAB and RPV) CAB and RPV is a two-drug co-packaged product for IM injection. |
RPV (Edurant) Tablets
RPV/FTC/TDF (Complera)
RPV/DTG (Juluca)
RPV/FTC/TAF (Odefsey)
CAB and RPV (Cabenuva)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (CAB, DTG, FTC, TAF, TDF). Standard Adult Doses RPV (Edurant)
RPV/FTC/TDF (Complera)
RPV/DTG (Juluca)
RPV/FTC/TAF (Odefsey)
CAB and RPV (Cabenuva)
|
Moderate-to-high placental transfer to fetusb No evidence of human teratogenicity (can rule out twofold increase in overall birth defects) Two-drug regimens (e.g., the RPV/DTG FDC) are not recommended for use in pregnancy. |
January 31, 2023 |
| PIs PIs block the activity of the protease enzyme, which is required to assemble new HIV viral particles that are capable of infecting new cells. |
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Atazanavir (ATV) Note: Generic products are available for some formulations. Note: ATV must be combined with low-dose RTV boosting in pregnancy. (ATV/c) |
ATV (Reyataz) Capsules
Oral Powder
ATV/c (Evotaz)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., COBI). Standard Adult Doses In ARV-Naive Patients Without RTV Boosting
In ARV-Naive Patients With RTV Boosting
In ARV-Experienced Patients
In ARV-Experienced Patients Who Are Receiving an H2-Receptor Antagonist
In ARV-Experienced Patients Who Are Receiving an H2-Receptor Antagonist and TDF
Powder Formulation
ATV/c (Evotaz)
|
Low placental transfer to fetusb No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects) Must be given with RTV boosting in pregnancy Effect of in utero ATV exposure on infant indirect bilirubin levels is unclear. Nonpathologic elevations of neonatal bilirubin have been observed in some, but not all, clinical trials to date. Oral powder (but not capsules) contains phenylalanine, which can be harmful to patients with phenylketonuria. Use of ATV/c is not recommended during pregnancy. See Recommendations for Use of Antiretroviral Drugs During Pregnancy, Table 6, and Table 7 for discussions about avoiding the use of ATV/c during pregnancy. |
January 31, 2023 |
|
Darunavir (DRV) Note: Must be combined with low-dose RTV or COBI boosting. (DRV/c) (DRV/c/FTC/TAF) |
DRV (Prezista) Tablet
Oral Suspension
DRV/c (Prezcobix)
DRV/c/FTC/TAF (Symtuza)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about use of combination products in pregnancy, please see the specific sections on other components (i.e., COBI, FTC, TAF). Standard Adult Doses ARV-Naive Patients
ARV-Experienced Patients if Patient Has No DRV Resistance Mutations
ARV-Experienced Patients if Any DRV Resistance Mutations Are Present
DRV/c (Prezcobix)
DRV/c/FTC/TAF (Symtuza)
|
Low placental transfer to fetusb No evidence of teratogenicity in mice, rats, or rabbits. No evidence of human teratogenicity. Must be boosted with low-dose RTV The Panel does not recommend once-daily dosing with DRV/r during pregnancy or the use of DRV/c during pregnancy. If a DRV/c regimen is continued during pregnancy, viral load should be monitored frequently. |
January 31, 2023 |
|
Lopinavir/Ritonavir (LPV/r) |
LPV/r (Kaletra) Tablets
Oral Solution
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
Standard Adult Doses
Tablets
Oral Solution
With EFV or NVP in PI-Naive or PI-Experienced Patients
|
Low placental transfer to fetusb No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects) Oral solution contains 42% alcohol and 15% propylene glycol and is not recommended for use in pregnancy. Once-daily LPV/r dosing is not recommended during pregnancy. |
January 31, 2023 |
| Entry Inhibitors Entry and attachment inhibitors block viral binding or fusion of HIV to host cells. |
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|
Fostemsavir (FTR) |
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
Standard Adult Doses (FTR) Rukobia
|
No human data are available regarding placental passage. A study in rats demonstrates placental passage of temsavir or other metabolites. Insufficient data to assess for teratogenicity in humans. No evidence of teratogenicity in rats or rabbits. |
January 31, 2023 |
|
Ibalizumab-uiyk (IBA) |
IV Solution
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
Standard Adult Doses
|
No human data are available, but placental transfer of IBA, a monoclonal antibody, is possible and documented in monkeys. Based on data in cynomolgus monkeys with in utero exposure, potential exists for reversible immunosuppression (CD4 T cell and B cell lymphocytopenia) in infants born to mothers exposed to IBA during pregnancy. The FDA requires collection of prospective data in individuals exposed to IBA during pregnancy to monitor maternal and pregnancy outcomes, including adverse effects on the developing fetus, neonate, and infant. Insufficient data to assess for teratogenicity in humans |
January 31, 2023 |
|
Maraviroc (MVC) |
Tablets
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
Standard Adult Doses
Dose Adjustments
|
Moderate placental transfer to fetusb No evidence of teratogenicity in rats or rabbits; insufficient data to assess teratogenicity in humans |
January 31, 2023 |
| INSTIs INSTIs are the viral enzyme that catalyzes the two-step process that inserts HIV DNA into the genome of the host cell. |
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Bictegravir/Emtricitabine/ Tenofovir Alafenamide (BIC/FTC/TAF) Note: BIC is available only as part of an FDC tablet. |
BIC/FTC/TAF (Biktarvy)
|
Pregnancy PK in Pregnancy
Dosing in Pregnancy
For guidance about use of combination products in pregnancy, please see the specific sections on other components (i.e., FTC, TAF). Standard Adult Doses
|
More data are needed to characterize the placental passage of BIC. Insufficient data exist to assess for teratogenicity in humans. No evidence of teratogenicity in rats or rabbits exists. BIC can be taken with food at the same time as any preparation containing iron or calcium—including prenatal vitamins—but should not be administered within 2 hours of these preparations when taken on an empty stomach. BIC can be taken at least 2 hours before or 6 hours after antacids containing aluminum or magnesium. |
January 31, 2023 |
|
Cabotegravir (CAB) (CAB) CAB and RPV is a two-drug co-packaged product for IM injection. |
CAB
CAB and RPV
RPV 300-mg/mL suspension for IM injection |
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., RPV). Standard Adult Doses Oral Lead-In Therapy (Optional)
Changing Dosing Frequency and Managing Missed Doses |
No human data are available regarding placental passage. Insufficient data to assess for teratogenicity in humans. No evidence of teratogenicity in rats or rabbits. |
January 31, 2023 |
|
Dolutegravir (DTG) (DTG/3TC) (DTG/RPV) (DTG/ABC/3TC) |
DTG (Tivicay)
DTG (Tivicay PD)
DTG film-coated tablets and DTG dispersible tablets are not bioequivalent and are not interchangeable. DTG/3TC (Dovato)
DTG/RPV (Juluca)
DTG/ABC/3TC (Triumeq)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., ABC, 3TC, RPV). Standard Adult Doses In ARV-Naive or ARV‑Experienced (but INSTI-Naive) Patients
|
High placental transfer to fetusb No evidence of teratogenicity in rats or rabbits. The most recent data from Botswana indicates the prevalence of NTDs in infants born to pregnant women with HIV receiving DTG at conception is no longer statistically different than in those receiving other antiretrovirals. DTG is a Preferred antiretroviral drug for use during pregnancy, irrespective of trimester, and for people who are trying to conceive (see Recommendations for Use of Antiretroviral Drugs During Pregnancy and Table 7). To maximize DTG absorption, doses should not be administered within 2 hours of ingesting any preparation that contains such minerals as iron or calcium, including prenatal vitamins. |
January 31, 2023 |
|
Elvitegravir (EVG) Note: As of October 2017, the single-drug formulation of EVG (Vitekta) is no longer available. (EVG/c/FTC/TAF) (EVG/c/FTC/TDF) |
EVG/c/FTC/TAF (Genvoya)
EVG/c/FTC/TDF (Stribild)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about use of combination products in pregnancy, please see the specific sections on other components (i.e., COBI, FTC, TAF). Standard Adult Doses Genvoya and Stribild
|
Evidence of high placental transfer of EVG and low transfer of COBIb Insufficient data to assess for teratogenicity in humans. No evidence of teratogenicity in rats or rabbits. EVG/c is not recommended for use in pregnancy. For persons who become pregnant while taking EVG/c, consider frequent viral load monitoring or switching to a more effective, recommended regimen. If a woman continues taking a regimen that contains EVG/c, doses should be administered with a meal and should not be administered within 2 hours of ingesting any preparation that contains minerals, such as iron or calcium, including prenatal vitamins. |
January 31, 2023 |
|
Raltegravir (RAL) |
RAL (Isentress) Film-Coated Tablets
Chewable Tablets
RAL (Isentress HD) Film-Coated Tablets
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
Standard Adult Doses In Patients Who Are Not Receiving Rifampin
In Patients Who Are Receiving Rifampin
|
High placental transfer to fetusb No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects) There is a case report of markedly elevated liver transaminases with RAL use in late pregnancy. Severe, potentially life-threatening, and fatal skin reactions and HSRs have been reported in nonpregnant adults. RAL chewable tablets contain phenylalanine. To maximize RAL absorption, doses should not be administered within 2 hours of ingestion of any preparation containing minerals—such as iron or calcium—including prenatal vitamins. |
January 31, 2023 |
| Pharmacoenhancers Pharmacoenhancers reduce the metabolism of antiretroviral drugs and prolong their presence in plasma, allowing for more convenient dosing regimens. |
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Cobicistat (COBI) (ATV/c) (EVG/c/FTC/TAF) (DRV/c) (EVG/c/FTC/TDF) (DRV/c/FTC/TAF) |
COBI (Tybost) Tablet
ATV/c (Evotaz)
EVG/c/FTC/TAF (Genvoya)
DRV/c (Prezcobix)
EVG/c/FTC/TDF (Stribild)
DRV/c/FTC/TAF (Symtuza)
|
Pregnancy PKs in Pregnancy
Dosing in Pregnancy
For guidance about the use of combination products in pregnancy, please see the specific sections on other components (i.e., FTC, TAF, TDF, ATV, DRV, EVG). Standard Adult Doses COBI (Tybost)
ATV/c (Evotaz)
EVG/c/FTC/TAF (Genvoya)
DRV/c (Prezcobix)
EVG/c/FTC/TDF (Stribild)
DRV/c/FTC/TAF (Symtuza)
|
Low placental transfer to fetusb No evidence of human teratogenicity (can rule out twofold increase in overall birth defects) Use of COBI-boosted ATV, DRV, or EVG is not recommended in pregnancy. |
January 31, 2023 |
|
Ritonavir (RTV) (LPV/r) |
RTV (Norvir) Capsule
Tablet
Oral Solution
Powder
LPV/r (Kaletra) Tablets
Oral Solution
|
Pregnancy PKs in Pregnancy
RTV Dosing in Pregnancy
LPV/r Dosing in Pregnancy
For guidance about use of combination products in pregnancy, please see the specific sections on other components (i.e., LPV/r). Standard Adult Dose of RTV (Norvir) When Used as PK Booster for Other PIs
Tablet
Capsule or Oral Solution
Standard Adult Doses of LPV/r (Kaletra)
Tablet
Oral Solution
With EFV or NVP in PI-Naive or PI-Experienced Patients
|
Low placental transfer to fetusb No evidence of increased risk of human teratogenicity (can rule out 1.5-fold increase in overall birth defects) RTV should only be used as low-dose booster for other PIs. RTV oral solution contains 43% alcohol and, therefore, is not recommended for use during pregnancy because no safe level of alcohol exposure during pregnancy is known. LPV/r oral solution contains 42% alcohol and 15% propylene glycol and is not recommended for use in pregnancy. Once-daily LPV/r dosing is not recommended during pregnancy. |
January 31, 2023 |
| a Individual ARV drug doses may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Antiretroviral Guidelines, Appendix B, Table 11). b Placental transfer categories are determined by mean or median cord blood/maternal delivery plasma drug ratio: High: >0.6 Moderate: 0.3–0.6 Low: <0.3 c Generic product available Key: 3TC = lamivudine; ABC = abacavir; ART = antiretroviral therapy; ARV = antiretroviral; ATV = atazanavir; ATV/c = atazanavir/cobicistat; ATV/r = atazanavir/ritonavir; AUC = area under the curve; BIC = bictegravir; BMI = body mass index; CAB = cabotegravir; CD4 = CD4 T lymphocyte; COBI = cobicistat; CYP = cytochrome P; DOR = doravirine; DRV = darunavir; DRV/c = darunavir/cobicistat; DRV/r = darunavir/ritonavir; DTG = dolutegravir; EFV = efavirenz; ETR = etravirine; EVG = elvitegravir; EVG/c = elvitegravir/cobicistat; FDA = U.S. Food and Drug Administration; FDC = fixed-dose combination; FPV/r = fosamprenavir/ritonavir; FTC = emtricitabine; FTR = fostemsavir; HBV = hepatitis b virus; HSR = hypersensitivity reaction; IBA = ibalizumab; IM = intramuscular; INSTI = integrase strand transfer inhibitor; IV = intravenous; LPV = lopinavir; LPV/r = lopinavir/ritonavir; MVC = maraviroc; NNRTI = non-nucleoside reverse transcriptase inhibitor; NRTI = nucleoside reverse transcriptase inhibitor; NTD = neural tube defect; NVP = nevirapine; PI = protease inhibitor; PK = pharmacokinetic; PPI = proton pump inhibitor; RAL = raltegravir; RPV = rilpivirine; RTV = ritonavir; TAF = tenofovir alafenamide; TDF = tenofovir disoproxil fumarate; TPV = tipranavir; TPV/r = tipranavir/ritonavir; WHO = World Health Organization; ZDV = zidovudine |
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