The human immunodeficiency virus (HIV) requires a complicated treatment regimen to keep in check. Rilpivirine is one of the drugs that can be used as part of a treatment program. It works by inhibiting one of the enzymes that the virus uses to replicate itself.
As of 2011, HIV was not curable, but it could be controlled through drugs. The virus can replicate itself enough, in the absence of antiviral drugs, to cause acquired immunodeficiency syndrome (AIDS). Each viral particle in the body uses enzymes and a host cell's own machinery to make more copies of itself. Rilpivirine targets one of the enzymes that the virus produces for this process. It is suitable as a primary treatment for new HIV diagnoses.
Reverse transcriptase is the enzyme of interest to the drug, and it is essential to replication. Rilpivirine blocks this enzyme from working correctly and therefore prevents the creation of new copies of the virus. HIV mutates easily and gains resistance to the antiviral drugs, so rilpivirine is never used alone. Instead, it forms part of a treatment regimen that includes other drugs. This combination of drugs might be able to prevent the amount of viral particles in the body from increasing and therefore halt the progression of the disease.
People who are HIV-positive and take this drug should not skip any doses or run out of the drug, in case the viral particles begin to replicate again. Each dose is tailored to individual patients, but a typical dose is 25 milligrams once per day in tablet form. Some medicines, such as antacids, can interfere with the action of rilpivirine, so these should be taken at different times to the drug.
Several medicines, such as the antibiotic rifampin, the steroid dexamethasone or the herbal product St. John's wort are not safe to take with this drug. Patients who have also suffered from depression or mental illness should inform their doctors prior to taking the drug. Kidney, liver or heart trouble are also important for a doctor to know before he or she can prescribe the drug.
Side effects such as gastrointestinal issues are possible, and these can be severe. Alterations in mental state, such as suicidal thoughts, decrease in the ability to feel pleasure or difficulty concentrating, can also occur. Sleeplessness, abnormal tiredness and jaundice can also result. These symptoms might be only temporary and can resolve themselves over time.