QuickView for delavirdine (compound)

Summary
General Info

PubChem

PubChem Compound 441386

Name:	Delavirdine
PubChem Compound ID:	441386
Description:	A potent, non-nucleoside reverse transcriptase inhibitor with activity specific for HIV-1.
Molecular formula:	C₂₃H₃₂N₆O₆S₂
Molecular weight:	552.669 g/mol
Synonyms:	147221-93-0; D00895; Delavirdine mesilate (JAN); Delavirdine mesylate (USAN); C08087; U-90152S; Rescriptor; Delavirdine mesylate; Delavirdine mesilate; Rescriptor (TN)

DrugBank

Identification

Name:	Delavirdine
Name (isomeric):	DB00705
Drug Type:	small molecule
Description:	A potent, non-nucleoside reverse transcriptase inhibitor with activity specific for HIV-1.
Synonyms:	SPP; DLV
Brand:	Rescriptor, Bhap Der
Category:	Anti-HIV Agents, Nonnucleoside Reverse Transcriptase Inhibitors, Reverse Transcriptase Inhibitors
CAS number:	136817-59-9

Pharmacology

Indication:	For the treatment of HIV-1 infection in combination with appropriate antiretroviral agents when therapy is warranted
Pharmacology:	Delavirdine is a non-nucleoside reverse transcriptase inhibitor (nNRTI) with activity against Human Immunodeficiency Virus Type 1 (HIV-1). Delavirdine binds directly to reverse transcriptase (RT) and blocks the RNA-dependent and DNA-dependent DNA polymerase activities by causing a disruption of the enzyme's catalytic site. The activity of Delavirdi... show more » Delavirdine is a non-nucleoside reverse transcriptase inhibitor (nNRTI) with activity against Human Immunodeficiency Virus Type 1 (HIV-1). Delavirdine binds directly to reverse transcriptase (RT) and blocks the RNA-dependent and DNA-dependent DNA polymerase activities by causing a disruption of the enzyme's catalytic site. The activity of Delavirdine does not compete with template or nucleoside triphosphates. HIV-2 RT and eukaryotic DNA polymerases (such as human DNA polymerases alpha, beta, or sigma) are not inhibited by Delavirdine. show less «
Mechanism of Action:	Delavirdine binds directly to viral reverse transcriptase (RT) and blocks the RNA-dependent and DNA-dependent DNA polymerase activities by disrupting the enzyme's catalytic site.
Absorption:	Rapidly absorbed
Protein binding:	98%
Biotransformation:	Hepatic
Route of elimination:	Delavirdine is extensively converted to several inactive metabolites by cytochrome P450 3A (CYP3A). Delavirdine was excreted in the milk of lactating rats at a concentration three to five times that of rat plasma.
Half Life:	5.8 hours
Toxicity:	Major toxicity of delavirdine is rash and should be advised to promptly notify their physician should rash occur. The majority of rashes associated with delavirdine occur within 1 to 3 weeks after initiating treatment with delavirdine. The rash normally resolves in 3 to 14 days and may be treated symptomatically while therapy with delavirdine is continued. Any patient experiencing severe rash or rash accompanied by symptoms such as fever, blistering, oral lesions, conjunctivitis, swelling, muscle or joint aches should discontinue medication and consult a physician.
Affected organisms:	Human Immunodeficiency Virus

Interactions

Food interaction:

Take without regard to meals.

Drug interaction:

Calcium	The antiacid decreases the effect of delavirdine
Temsirolimus	Delavirdine may inhibit the metabolism and clearance of Temsirolimus. Concomitant therapy should be avoided.
Zonisamide	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of zonisamide by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zonisamide if delavirdine is initiated, discontinued or dose changed.
Alprazolam	The antiviral agent, delavirdine, may increase the effect and toxicity of the benzodiazepine, alprazolam.
Atorvastatin	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of atorvastatin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of atorvastatin if delavirdine is initiated, discontinued or dose changed.

Calcium	The antiacid decreases the effect of delavirdine
Temsirolimus	Delavirdine may inhibit the metabolism and clearance of Temsirolimus. Concomitant therapy should be avoided.
Zonisamide	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of zonisamide by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zonisamide if delavirdine is initiated, discontinued or dose changed.
Alprazolam	The antiviral agent, delavirdine, may increase the effect and toxicity of the benzodiazepine, alprazolam.
Atorvastatin	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of atorvastatin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of atorvastatin if delavirdine is initiated, discontinued or dose changed.
Saquinavir	Increases the effect of saquinavir and hepatic toxicity
Methylphenobarbital	The anticonvulsant, methylphenobarbital, decreases the effect of delavirdine.
Cisapride	Delavirdine, a strong CYP3A4 inhibitor, may increase the metabolism of cisapride. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of cisapride if delavirdine is initiated, discontinued or dose changed.
Tamoxifen	Delavirdine may decrease the therapeutic effect of Tamoxifen by decreasing the production of active metabolites. Concomitant therapy should be avoided.
Zolpidem	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of zolpidem by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zolpidem if delavirdine is initiated, discontinued or dose changed.
Vinblastine	Delavirdine, a strong CYP3A4 inhibitor, may decrease the metabolism of Vinblastine. Consider alternate therapy to avoid Vinblastine toxicity. Monitor for changes in the therapeutic/adverse effects of Vinblastine if Delavirdine is initiated, discontinued or dose changed.
Midazolam	The antiviral agent, delavirdine, may increase the effect and toxicity of the benzodiazepine, midazolam.
Magnesium oxide	The antiacid decreases the effect of delavirdine
Zuclopenthixol	Delavirdine, a strong CYP2D6 inhibitor, may increase the serum concentration of zuclopenthixol by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zuclopenthixol if delavirdine is initiated, discontinued or dose changed.
Dihydroergotoxine	The antiretroviral agent may increase the ergot derivative toxicity
St. John's Wort	St. John's Wort decreases the antiretroviral effect
Trimipramine	The strong CYP3A4/CYP2D6 inhibitor, Delavirdine, may decrease the metabolism and clearance of Trimipramine, a CYP3A4/CYP2D6 substrate. Consider alternate therapy or monitor for changes in therapeutic and adverse effects of Trimipramine if Delavirdine is initiated, discontinued or dose changed.
Fosamprenavir	Decreased levels of delavirdine with increased levels of amprenavir
Vinorelbine	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of Vinorelbine by decreasing its metabolism. Consider alternate therapy to avoid Vinorelbine toxicity. Monitor for changes in the therapeutic and adverse effects of Vinorelbine if Delavirdine is initiated, discontinued or dose changed.
Methylergonovine	The antiretroviral agent may increase the ergot derivative toxicity
Carisoprodol	Strong CYP2C19 inhibitors such as delavirdine may decrease the metabolism of CYP2C19 substrates such as carisoprodol. Consider an alternative for one of the interacting drugs in order to avoid toxicity of the substrate. Some combinations are specifically contraindicated by manufacturers. Suggested dosage adjustments are also offered by some manufacturers. Please review applicable package inserts. Monitor for increased effects of the CYP substrate if a CYP inhibitor is initiated/dose increased, and decreased effects if a CYP inhibitor is discontinued/dose decreased.
Verapamil	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of Veramapil, a CYP3A4 substrate, by decreasing its metabolism and clearance. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Verapamil if Delavirdine is initiated, discontinued or dose changed.
Astemizole	Increased risk of cardiotoxicity and arrhythmias
Methysergide	The antiretroviral agent may increase the ergot derivative toxicity
Tolbutamide	Delavirdine, a strong CYP2C9 inhibitor, may decrease the metabolism and clearance of Tolbutamide, a CYP2C9 substrate. Consider alternate therapy or monitor for changes in Tolbutamide therapeutic and adverse effects if Delavirdine is initiated, discontinued or dose changed.
Quinupristin	This combination presents an increased risk of toxicity
Tramadol	Delavirdine may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance. Delavirdine may decrease the effect of Tramadol by decreasing active metabolite production.
Venlafaxine	Delaviridine, a CYP2D6 and CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP2D6 and CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Delavirdine is initiated, discontinued, or dose changed.
Aluminium	The antiacid decreases the effect of delavirdine
Amprenavir	Decreased levels of delavirdine with increased levels of amprenavir
Vincristine	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of Vincristine by decreasing its metabolism. Consider alternate therapy to avoid Vincristine toxicity. Monitor for changes in the therapeutic and adverse effects of Vincristine if Delavirdine is initiated, discontinued or dose changed.
Ergonovine	The antiretroviral agent may increase the ergot derivative toxicity
Indinavir	Delavirdine may increase the effect of indinavir.
Warfarin	Delavirdine, a strong CYP2C9 inhibitor, may decrease the metabolism of warfarin. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of warfarin if delavirdine is initiated, discontinued or dose changed.
Rifampin	Rifampin decreases the effect of delavirdine
Ritonavir	Increases the effect of ritonavir
Zopiclone	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of zopiclone by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zopiclone if delavirdine is initiated, discontinued or dose changed.
Dihydroergotamine	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of dihydroergotamine by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of dihydroergotamine if delavirdine is initiated, discontinued or dose changed.
Triazolam	The antiviral agent, delavirdine, may increase the effect and toxicity of the benzodiazepine, triazolam.
Tiagabine	The strong CYP3A4 inhibitor, Delavirdine, may decrease the metabolism and clearance of Tiagabine, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Tiagabine if Delavirdine is initiated, discontinued or dose changed.
Trimethoprim	The strong CYP2C9 inhibitor, Delavirdine, may decrease the metabolism and clearance of Trimethoprim, a CYP2C9 substrate. Consider alternate therapy or monitor for changes in therapeutic and adverse effects of Trimethoprim if Delavirdine is initiated, discontinued or dose changed.
Ergotamine	The antiretroviral agent may increase the ergot derivative toxicity
Trazodone	The CYP3A4 inhibitor, Delavirdine, may increase Trazodone efficacy/toxicity by decreasing Trazodone metabolism and clearance. Consider alternate therapy or monitor for changes in Trazodone efficacy/toxicity if Delavirdine is initiated, discontinued or dose changed.
Rifabutin	Rifabutin decreases the effect of delavirdine
Tamsulosin	Delavirdine, a CYP3A4/2D6 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP3A4/2D6 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Delavirdine is initiated, discontinued, or dose changed.
Tipranavir	Concomitant use may result in increased Tipranavir and decreased Delavirdine concentrations. Monitor for altered therapeutic and adverse effects of both agents if either agent is initiated, discontinued or dose changed.
Bromazepam	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of bromazepam by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of bromazepam if delavirdine is initiated, discontinued or dose changed. Dosage adjustments may be required.
Torasemide	Delavirdine, a strong CYP2C9 inhibitor, may increase the serum concentration of Torasemide, a CYP2C9 substrate, by decreasing Torasemide metabolism and clearance. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of Torasemide if Delavirdine is initiated, discontinued or dose changed.
Tacrolimus	The strong CYP3A4 inhibitor, Delavirdine, may decrease the metabolism and clearance of Tacrolimus, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in therapeutic and adverse effects of Tacrolimus if Delavirdine is initiated, discontinued or dose changed.
Telithromycin	Delavirdine may increase the plasma concentration of Telithromycin. Consider alternate therapy or monitor therapeutic/adverse effects.
Tolterodine	Delavirdine may decrease the metabolism and clearance of Tolterodine. Adjust Tolterodine dose and monitor for efficacy and toxicity.
Dantrolene	Delavirdine may increase the serum concentration of dantrolene by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of dantrolene if delavirdine is initiated, discontinued or dose changed.
Terfenadine	Increased risk of cardiotoxicity and arrhythmias
Zafirlukast	Delavirdine, a strong CYP2C9 inhibitor, may decrease the metabolism and clearance of zafirlukast. Consider alternate therapy or monitor for changes in zafirlukast therapeutic and adverse effects if delavirdine is initiated, discontinued or dose changed.
Voriconazole	Delavirdine, a strong CYP2C9 inhibitor, may increase the serum concentration of voriconazole by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of voriconazole if delavirdine is initiated, discontinued or dose changed.
Lovastatin	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of lovastatin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of lovastatin if delavirdine is initiated, discontinued or dose changed.
Simvastatin	Delavirdine, a strong CYP3A4 inhibitor, may increase the serum concentration of simvastatin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of simvastatin if delavirdine is initiated, discontinued or dose changed.
Vardenafil	Delavirdine, a strong CYP3A4 inhibitor, may reduce the metabolism and clearance of Vardenafil. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of Vardenafil.
Teniposide	The strong CYP3A4 inhibitor, Delavirdine, may decrease the metabolism and clearance of Teniposide, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Teniposide if Delavirdine is initiated, discontinued or dose changed.
Magnesium	Magnesium antacids may decrease the absorption of delavirdine.
Fosphenytoin	The anticonvulsant, fosphenytoin, decreases the effect of delavirdine.
Carbamazepine	The anticonvulsant, carbamazepine, decreases the effect of delavirdine.
Phenobarbital	The anticonvulsant, phenobarbital, decreases the effect of delavirdine.
Phenytoin	The anticonvulsant, phenytoin, decreases the effect of delavirdine.
Tadalafil	Delavirdine may reduce the metabolism of Tadalafil. Concomitant therapy should be avoided if possible due to high risk of Tadalafil toxicity.

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Targets

Reverse transcriptase

Enzymes