rilpivirine hydrochloride at a glance
Medicine class
Non-nucleoside reverse transcriptase inhibitor (NNRTI)
Main role
Part of combination treatment for selected people with HIV-1
Food
Take with a meal; a nutritional drink alone is insufficient
Resistance
Resistance testing helps determine suitability
What is rilpivirine hydrochloride used for?
The selected product is licensed with other antiretroviral medicines for adults and children weighing at least 25 kg with HIV-1, no known NNRTI resistance-associated mutations, and a viral load not exceeding 100,000 HIV-1 RNA copies/mL.
Combination treatment of eligible people with HIV-1 infection
How does rilpivirine hydrochloride work?
Rilpivirine binds to HIV-1 reverse transcriptase and reduces viral replication. It does not cure HIV and is used with other antiretroviral medicines.
rilpivirine hydrochloride preparations and strengths
Tablet
Route: Oral
Strengths: 25 mg
How to take rilpivirine hydrochloride
Follow instructions from the specialist HIV team.
Take the film-coated tablet with a meal; a nutritional drink alone does not replace a meal.
Swallow the tablet whole with water. Do not chew or crush it.
Do not stop rilpivirine or other HIV medicines without discussing this with the HIV team.
Check with a pharmacist or HIV clinician before using indigestion or acid-reducing treatments.
rilpivirine hydrochloride side effects
Common or expected effects
- Headache or dizziness
- Nausea, vomiting, abdominal pain or discomfort
- Difficulty sleeping, abnormal dreams or sleepiness
- Depression or low mood
- Rash
- Tiredness
- Reduced appetite or dry mouth
- Changes in liver enzymes, cholesterol, triglycerides, bilirubin, pancreatic enzymes or blood-cell counts
Get urgent medical advice
- Fever, chills or sweats caused by immune reactivation of a previous infection
- New muscle weakness, palpitations, tremor or hyperactivity that may indicate an autoimmune reaction during immune recovery
rilpivirine hydrochloride in pregnancy
Available pregnancy data have not identified malformative or fetal toxicity, and rilpivirine may be considered when necessary. Blood levels can fall during pregnancy, so specialist review and close viral-load monitoring are needed. Do not stop antiretroviral treatment without specialist advice.
rilpivirine hydrochloride while breastfeeding
It is unknown how much rilpivirine enters human milk. Formula feeding is the safest option because it removes postnatal HIV transmission through breast milk. Discuss any wish to breastfeed early with the specialist perinatal HIV team.
rilpivirine hydrochloride interactions
Rilpivirine absorption depends on stomach acidity and it is mainly metabolised by CYP3A. Check all prescribed, non-prescription and herbal products with the HIV team.
Proton-pump inhibitors, including omeprazole, esomeprazole, lansoprazole, pantoprazole and rabeprazole
These substantially reduce rilpivirine absorption and must not be used together.
Antacids containing aluminium, magnesium or calcium
These can reduce absorption and need to be separated from rilpivirine.
H2-receptor antagonists, such as famotidine
These can reduce absorption and require strict separation from rilpivirine.
Common questions about rilpivirine hydrochloride
Answers are fully visible for fast scanning and source review.
What is rilpivirine hydrochloride used for?
It is used with other antiretroviral medicines to treat selected people with HIV-1 whose viral load and resistance results meet the licensing criteria.
Why must it be taken with a meal?
Food improves absorption. A nutritional or protein-rich drink alone does not count as the required meal.
Can tablets be crushed or chewed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.