Page 240 - HIV/AIDS Guidelines

Appendix B, Table 7. Antiretroviral Dosing Recommendations in Patients with Renal or Hepatic
Insufficiency (Last updated March 27, 2012; last reviewed March 27, 2012) (page 3 of 4)

Antiretrovirals Usual Daily Dose
Generic Name (Refer to Appendix B, Dosing in Renal Insufficiency
(abbreviation)/ Tables 1–6 for additional (Including with chronic ambulatory Dosing in Hepatic Impairment
Trade Name peritoneal dialysis and hemodialysis)
dosing information.)
Rilpivirine 25 mg PO once daily No dosage adjustment necessary Child-Pugh Class A or B: no dosage
(RPV)/ adjustment
Edurant
Child-Pugh Class C: no dosage
recommendation

Rilpivirine (RPV) + 1 tablet PO once daily Not recommended for use in patients with CrCl Child-Pugh Class A or B: no dosage
Tenofovir (TDF) + <50 mL/min. Instead use individual drug adjustment
Emtricitabine (FTC)/ components of the fixed-dose combination and
Complera adjust TDF and FTC doses levels according to Child-Pugh Class C: no dosage
CrCl level. recommendation

Protease Inhibitors
Atazanavir 400 mg PO once daily or No dosage adjustment for patients with renal Child-Pugh
(ATV)/ (ATV 300 mg + RTV 100 mg) dysfunction not requiring HD Class Dose
Reyataz PO once daily
ARV-naive patients on HD: B 300 mg once
(ATV 300 mg + RTV 100 mg) once daily daily
C not
ARV-experienced patients on HD: ATV or RTV- recommended
boosted ATV not recommended
RTV boosting is not recommended in
patients with hepatic impairment (Child-
Pugh Class B or C).
Darunavir (DRV 800 mg + RTV 100 mg) PO No dosage adjustment necessary Mild-to-moderate hepatic impairment:
(DRV)/ once daily (ARV-naive patients no dosage adjustment
Prezista only) or
(DRV 600 mg + RTV 100 mg) PO Severe hepatic impairment: not
BID recommended
Fosamprenavir 1400 mg PO BID or No dosage adjustment necessary Child-Pugh
(FPV)/ (FPV 1400 mg + Score Dose
Lexiva RTV 100–200 mg) PO once PI-naive patients only:
daily or 5–9 700 mg BID
(FPV 700 mg + RTV 100 mg) 10–15 350 mg BID
PO BID
PI-naive or PI-experienced patients:
5–6 700 mg BID + RTV 100 mg
once daily
7–9 450 mg BID + RTV 100 mg
once daily
10–15 300 mg BID + RTV 100 mg
once daily

Indinavir 800 mg PO q8h No dosage adjustment necessary Mild-to-moderate hepatic insufficiency
(IDV)/ because of cirrhosis: 600 mg q8h
Crixivan

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents O-15

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