title: Elvitegravir for the treatment of HIV.
abstract: Current antiretrovirals (ARVs) have demonstrated the ability to prolong the life of an HIV infected individual via suppression of the virus and subsequent restoration of immune function. Despite significant advancement, there remains an opportunity for improvement. One ARV that attempts to fill global HIV therapeutic needs by balancing convenience, safety, and efficacy is elvitegravir (EVG). Areas covered: Using MEDLINE/PubMed, a literature search was conducted for published articles on the safety and efficacy of EVG in the treatment of HIV infection. Expert opinion: EVG offers clinicians a convenient choice for HIV-positive patients that is safe and effective for both treatment-naïve and experienced patients, as well as an option for regimen simplification in virologically suppressed patients. EVG is conveniently co-formulated in fixed dose combination tablets to be taken once daily with food. EVG does not require dose adjustment for patients with severe renal impairment or mild to moderate liver disease. Importantly, EVG requires co-administration with a pharmacokinetic enhancer (i.e., ritonavir or cobicistat) in order to achieve therapeutic levels and facilitate once daily dosing. As a consequence, clinicians must carefully review concomitant medications and navigate potential drug-drug interactions mediated through potent inhibition of cytochrome P450 3A enzymes by ritonavir and cobicistat.
authors: a Department of Pharmacy Practice , Nova Southeastern University College of Pharmacy , Palm Beach Gardens , FL , USA.
authors: Nathan R
authors: NR
authors: Unger
authors: b Department of Pharmacy Practice , Nova Southeastern University College of Pharmacy , Davie , FL , USA.
authors: Marylee V
authors: MV
authors: Worley
authors: c Department of Pharmacy , Sarasota Memorial Health Care System , Sarasota , FL , USA.
authors: Jamie J
authors: JJ
authors: Kisgen
authors: b Department of Pharmacy Practice , Nova Southeastern University College of Pharmacy , Davie , FL , USA.
authors: Elizabeth M
authors: EM
authors: Sherman
authors: d Department of Pharmacotherapy and Translational Research , University of Florida College of Pharmacy , St. Petersburg , FL , USA.
authors: Lindsey M
authors: LM
authors: Childs-Kean
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D000069547:Cobicistat / Q000008:administration & dosage / Q000627:therapeutic use*; D065692:Cytochrome P-450 CYP3A Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D015363:Quinolones / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019438:Ritonavir / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents; D065692:Cytochrome P-450 CYP3A Inhibitors; D015363:Quinolones; C509700:elvitegravir; D000069547:Cobicistat; D019438:Ritonavir
keywords: AIDS; HIV; elvitegravir; integrase inhibitor; integrase strand transfer inhibitor