Rilpivirine slows the progress of HIV infection. It is one of a number of medicines that you will need to take regularly.
Take your doses of rilpivirine with a meal. This is to help your body to absorb the full dose.Rilpivirine has been associated with some side-effects. Your doctor will discuss these with you before you start treatment.
|Type of medicine||A non-nucleoside reverse transcriptase inhibitor antiretroviral medicine|
|Used for||Human immunodeficiency virus (HIV) infection in adults|
There is also a combination tablet containing rilpivirine with tenofovir and emtricitabine, called Eviplera®
Rilpivirine is an antiretroviral medicine. It is used for human immunodeficiency virus (HIV) infection. It slows the progress of HIV infection, but it is not a cure. HIV destroys cells in the body, called CD4 T cells. These cells are a type of white blood cell and are important because they are involved in protecting your body from infection. If left untreated, the HIV infection weakens your immune system so that your body cannot defend itself against bacteria, viruses and other germs. Rilpivirine slows down the progress of HIV infection by reducing the amount of virus in your body. It does this by stopping the virus from copying (replicating) itself.
Rilpivirine will be prescribed for you by a doctor who is a specialist. It belongs to a group of antiretroviral medicines known as non-nucleoside reverse transcriptase inhibitors (NNRTIs). It is given alongside a number of other antiretroviral medicines, as part of a combination therapy. Taking three or more antiretroviral medicines at the same time is more effective than taking one alone. Taking a combination of different medicines also reduces the risk that the virus will become resistant to any individual medicine. It is vital to take them exactly as prescribed to maintain success and to help to prevent the virus from becoming resistant to the medicines. These medicines are usually taken for life.
Before taking rilpivirine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking rilpivirine it is important that your doctor knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work.
- If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take rilpivirine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about rilpivirine, and it will also provide you with a full list of the side-effects which you could experience from taking it.
- Take rilpivirine exactly as your doctor tells you to. The usual dose is one 25 mg tablet daily. It is important that you take the tablets with a meal, as this will help your body to absorb the full dose. Please note - it is not sufficient to take the tablet with a protein-rich nutritional drink instead of a meal.
- Swallow the tablets whole with a drink of water. Do not crush, break or chew the tablets.
- Try to take your doses at the same time of day each day, as this will help you to remember to take rilpivirine regularly.
- If you forget to take a tablet at your usual time, you should take it (with a meal) as soon as you remember, providing it is within 12 hours of the time you should have taken the dose. If when you remember, it is more than 12 hours late then do not take the missed tablet, but do remember to take your next tablet on time. Do not take two doses together to make up for a missed dose.
Getting the most from your treatment
- Keep your regular appointments with your doctor so that your progress can be monitored. You will need to have regular blood tests.
- It is important that you continue to take rilpivirine and your other antiretroviral treatment regularly. This will help to prevent the HIV from becoming resistant to the medicines you are taking. Even if you miss only a small number of doses, the virus can become resistant to treatment.
- If you develop an infection soon after you start the treatment, let your doctor know. As a result of taking rilpivirine, your immune system may start fighting an infection which was present before you started the treatment, but which you may not have been aware of.
- Follow carefully any advice your doctor gives to you about making lifestyle changes to reduce any risk of damage to your heart and blood vessels. These can include stopping smoking, eating healthily and taking regular exercise.
- Although treatment with antiretroviral medicines may reduce the risk of you passing HIV to others through sexual contact, it does not stop it. It is important that you use condoms.
- It is not uncommon for people with HIV to feel low or even depressed, especially soon after the diagnosis has been made and treatment has been started. If you have any feelings of depression, or any distressing thoughts about harming yourself, then you should speak with your doctor straightaway.
- Some people who have taken antiretroviral medicines (particularly over a long time) have developed a condition called osteonecrosis. This is a bone disease where bone tissue dies because there is a reduced blood supply to it. It leads to joint pains and stiffness, and can cause difficulties in movement. If you notice any of these symptoms, speak with your doctor.
- If you buy any medicines, supplements or herbal remedies 'over the counter', check with a pharmacist that they are suitable to take with rilpivirine and your other medicines. This is because some medicines interfere with antiretrovirals and can stop them from working properly. In particular, do not take St John's wort. Also, some antacids can reduce the amount of rilpivirine your body absorbs. Because of this, it is recommended that you do not take indigestion remedies during the two hours before or during the four hours after you take rilpivirine.
- Some people taking antiretroviral medicines develop changes to the way body fat is distributed in the body. This can result in changes to body image. Your doctor will discuss the possibility of this with you.
- If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
- Treatment for HIV is usually lifelong. Continue to take rilpivirine regularly, even if you feel well. This is to keep your immune system healthy.
Can rilpivirine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with rilpivirine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common rilpivirine side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Sleeping problems such as insomnia||If troublesome, let your doctor know|
|Feeling sick||Stick to simple meals - avoid rich or spicy food. If it continues or is severe, speak with your doctor straightaway|
|Headache||Ask your doctor to recommend a suitable painkiller|
|Feeling dizzy||Do not drive and do not use tools or machines while affected|
|Changes to some blood tests||Your doctor will check for this|
|Common rilpivirine side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Feeling sleepy or tired||Do not drive and do not use tools or machines while affected|
|Loss of appetite, feeling low or depressed, abnormal dreams, rash, dry mouth, tummy (abdominal) pain||If any of these become troublesome, let your doctor know|
If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.
How to store rilpivirine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Edurant® 25 mg tablets; Janssen-Cilag Ltd, The electronic Medicines Compendium. Dated January 2016.
- British National Formulary; 71st Edition (Mar-Sep 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox