Enfuvirtide
Indications
Enfuvirtide is used for:
HIV-1 infection
Adult Dose
Subcutaneous
HIV-1 infection
Adult: Combination therapy w/ other antiretroviral: 90 mg bid. Inject into the arm, thigh or abdomen as directed, at a different site from the preceding one.
Child Dose
Subcutaneous
HIV-1 infection
Child: 6-16 yr 2 mg/kg bid. Max: 90 mg bid;
>16 yr Same as adult dose.
Renal Dose
Administration
Reconstitute w/ 1.1 mL water for inj, gently tap the vial and allow to stand for up to 45 min to dissolve into soln. Do not shake or invert vial.
SC Administration
Inject SC into the upper arm, anterior thigh, or abdomen
Contra Indications
Hypersensitivity. Lactation.
Precautions
Patient w/ coagulation disorders, high initial viral load, low initial CD4 cell count, history of lung disease. Smokers and patients receiving IV drugs. Not intended in antiretroviral therapy-naive individual. Hepatic impairment and moderate to severe renal impairment. Childn. Pregnancy.
Pregnancy-Lactation
Pregnancy Category: B
Lactation: Unknown whether enfuvirtide is excreted in milk; avoid in breastfeeding women; the CDC advises HIV-infected women not to breast-feed to avoid postnatal transmission of HIV
Interactions
Increased serum concentration w/ protease inhibitors. Decreased serum concentration w/ orlistat. Increased risk of bleeding w/ anticoagulants.
Side Effects
Side effects of Enfuvirtide :
>10%
Difficult to separate from background regimen
Multiple inj site rxn (98%)
Pain & discomfort (96%)
Erythema (91%)
Induration (90%)
Nodules and cysts (80%)
Pruritis (65%)
Ecchymosis (52%)
Diarrhea (31%)
Nausea (22%)
Fatigue (20%)
Periph. neuropathy
Insomnia
1-10%
Difficult to separate from background regimen
Asthenia
Depression
Pruritis
Abdominal pain
Anorexia
Decreased appetite
Weight loss
Myalgia
Cough
Herpes simplex
Influenza-like illness
Pneumonia
Sinusitis
Lymphadenopathy
Pancreatitis
Mode of Action
Enfuvirtide, is an HIV fusion protein inhibitor which interferes w/ entry of HIV type 1 (HIV-1) into the host cell by binding to viral glycoprotein gp41 subunit, thereby inhibiting viral and cellular membrane fusion w/ the CD4 cell receptor.