List of Approved HIV Antiretroviral Drugs

More than 40 drugs are now available to treat HIV infection

Man hand taking medicine
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Antiretroviral drugs are used to treat HIV infection. They work by blocking a stage of the virus's life cycle and, by doing so, prevent the virus from replicating. The drugs are organized into six different classes based largely on the stage of the life cycle they inhibit.

As of 2021, the Food and Drug Administration has granted approval to 26 individual drug agents and 22 fixed-dosed combination (FDC) drugs comprised of two or more antiretrovirals. This includes the first antiretroviral drug regimen, called Cabenuva, that requires a once-monthly injection rather than having to take an oral dose every day.

Antiretroviral therapy is quickly changing, with newer drug agents offering fewer side effects, greater durability, and a decreased risk of drug resistance. In the past, antiretroviral therapy was described as a three-drug "cocktail." Today, with improved pharmacokinetics and a longer drug half-life, antiretroviral therapy may involve as few as two co-formulated drug agents.

While several new antiretroviral drugs have been added to the treatment arsenal since 2010, older ones like Crixivan (indinavir), Invirase (saquinavir), Rescriptor (delavirdine), Videx (didanosine), Viracept (nelfinavir), and Zerit (stavudine) have been discontinued and are no longer in use.

Entry/Attachment Inhibitors

As per their name, entry/attachment inhibitors work by blocking the virus's ability to attach to or enter healthy host cells. They do so by binding to different receptors on the surface of the host cell that HIV uses to lock onto and/or enter the cell. Without the means to enter a cell, HIV cannot replicate.

DRUG CLASS: Entry/Attachment Inhibitors
Brand Name  Generic Name Typical Adult Dosage Dietary Notes
Fuzeon  enfuvirtide 90mg injected 2x/day Not applicable
Rukubio fostemsavir One 600mg tablet 2x/day Taken with or without food
Selzentry maraviroc -One 150mg tablet 2x/day
-One 300mg tablet 2x/day
-Two 300mg tablets 2x/day
Taken with or without food
Trogarzo ibalizumab -2,000mg intravenous infusion as an induction dose
-800mg intravenous infusion every two week
Not applicable

Integrase Inhibitors

Integrase inhibitors work by blocking the incorporation of HIV's DNA into the host cell's DNA, a process known as integration. They do so by inhibiting a viral enzyme known as integrase.

DRUG CLASS: Integrase Inhibitors
Brand Name  Generic Name Typical Adult Dosage Dietary Notes
Isentress raltegravir One 400mg tablet 2x/day Taken with or without food
Isentress HD raltegravir One 600mg tablet 2x/day Taken with or without food
Tivicay dolutegravir -Untreated patients: One 50mg tablet 1x/day -Patients with resistance to Isentress: One 50mg tablet 2x/day Taken with or without food
Vocabria cabotegravir One 30mg tablet 1x/day (specifially taken with oral Edurant for one month as the induction dose for Cabenuva extended-release injection - see "FDC Drugs" below) Taken with food

Nucleoside Reverse Transcriptase Inhibitors

In order for HIV to replicate, it uses an enzyme called reverse transcriptase to translate its viral RNA into double-stranded DNA, which is then integrated into the nucleus of the host cell to "hijack" its genetic machinery. By doing so, HIV can begin to churn out multiple copies of itself.

Nucleoside reverse transcriptase inhibitors (NRTIs) block the action of reverse transcriptase and so prevent the replication of the virus.

DRUG CLASS: Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
Brand Name  Generic Name Typical Adult Dosage Dietary Notes 
Emtriva emtricitabine -One 100mg tablet 1x/day
-One 150mg tablet 2x/day
Taken with or without food
Epivir lamivudine -One 300mg tablet 1x/day
-One 150mg tablet 2x/day
Taken with or without food
Retrovir AZT, zidovudine One 300mg tablet 2x/day Food may ease stomach discomfort
Viread tenofovir One 300mg tablet 1x/day Taken with or without food
Ziagen abacavir -Two 300mg tablets 1x/day
-One 300mg tablet 2x/day
Taken with or without food

Non-Nucleoside Reverse Transcriptase Inhibitors

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) also block reverse transcriptase but in a different way. Rather than attaching to viral DNA like NRTIs do, NNRTIs bind directly to the enzyme, blocking its action.

DRUG CLASS: Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
 Brand Name Generic Name Typical Adult Dosage Dietary Notes
Edurant rilpivirine One 25mg tablet 1x/daily Taken with a meal
Intelence etravirine One 200mg tablet 2x/day Taken with a meal
Pifeltro doravirine One 100mg tablet 1x/day  Taken with or without food
Sustiva efavirenz One 600mg tablet 1x/day Taken on an empty stomach, preferably at bedtime
Viramune IR (immediate-release) nevirapine -First 14 days: 200mg tablet 2x/day -Maintenance dose: 200mg tablet 2x/day Taken with or without food
Viramune XR (extended- release) nevirapine -First 14 days: One 200mg IR tablet 1x/day -Maintenance dose: One 400mg XR tablet 1x/day Taken with or without food

Protease Inhibitors

Protease inhibitors (PIs) work by blocking an enzyme known as protease. Once HIV takes over the genetic machinery of the host cell, it produces long-chain proteins that must be cut into smaller pieces (by protease) in order to be assembled into a new viral particle. By binding to protease, the long-chain proteins cannot be cut and new viral particles cannot be produced.

DRUG CLASS: Protease Inhibitors
Brand Name  Generic Name Typical Adult Dosage Dietary Notes
Aptivus tipranavir Two 250mg capsules + 200mg Norvir 2x/day Best taken with a meal
Lexiva fosamprenavir -Two 700mg tablets 2x/day
-Two 700mg tablets + 100mg Norvir 1x/day
-Patients with previous PI failure:
One 700mg tablet + 100mg Norvir 2x/day
Taken with or without food
Prezista darunavir -800mg + 100mg Norvir 1x/day
-Patients with known levels of Prezista-associated resistance:
One 600mg tablet + 100mg Norvir 2x/day
Taken with food
Reyataz atazanavir -Two 200mg capsules 1x/day
-300mg + 100mg Norvir 1x/day
Taken with light meal

Pharmacokinetic Enhancers

Also called HIV boosters, these drugs are used to "boost" the concentration of protease inhibitors in the bloodstream. Without them, the concentration of the accompanying PI would quickly fall beneath the therapeutic level, providing the virus an opportunity to replicate.

DRUG CLASS: Pharmacokinetic Enhancers
 Brand Name Generic Name Typical Adult Dosing Dietary Notes
 Norvir ritonavir Dosage varies depending on which PI it is taken with Taken with or without food
 Tybost cobicistat 150mg 1x/day Taken with food

Fixed-Dose Combination Drugs

Fixed-dose combination (FDC) drugs reduce the daily pill burden a person with HIV may otherwise be faced with when undergoing antiretroviral therapy. Some FDC drugs are used with other antiretroviral agents. Others are entirely used on their own.

Of the 22 FDC drugs approved for use in the United States, 14 are all-in-one treatments taken once daily.

Fixed-Dose Combination (FDC) Drugs
Brand Name Contents Typical Adult Dosage Dietary Notes
Atripla 600mg Sustiva + 200mg Emtriva + 300mg Viread One tablet 1x/dailly Taken on an empty stomach, preferably at bedtime
Biktarvy 50mg bictegravir + 200mg Emtriva + 25mg tenofovir alafenamide One tablet 1x/daily Taken with or without food
Cabenuva 400-600mg cabotegravir + 600-900mg Edurant (in separate prefilled syringes) -Initiation injections: One 600mg cabotegravir injection and one 900mg injection of Edurant for Month One (only after an induction dose of Vocabria - see "Intergrase Inhibitors" above) -Maintentance injections: One 400mg cabotegravir injection and one 600mg Edurant injection 1x/month thereafter Not applicable
Cimduo 300mg Emtriva + 300mg Viread  One tablet 1x/day Taken with or without food
Combivir 300mg Retrovir + 150mg Epivir One tablet 2x/day Food may ease stomach discomfort
Complera 25mg Edurant + 200mg Emtriva + 300mg Viread -One tablet 1x/day -For people on rifabutin: One tablet plus an additional 25mg Edurant 1x/day  Taken with food
Descovy 200mg Emtriva + 25mg tenofovir alafenamide One tablet daily Taken with or without food
Delstrigo 100mg Pifeltro + 300mg Epivir + 300mg Viread -One tablet 1x/day -For people on rifabutin: One tablet 1x/day followed by 100mg of Pifeltro 12 hours later Taken with or without food
Dovato 50mg Tivicay + 300mg Epivir -One tablet 1x/day -For people on rifabutin or carbemazepine: One tablet 1x/day followed by 50mg of Tivicay 12 hours later Taken with or without food
Epzicom 600mg Ziagen + 300mg Epivir One tablet 1x/day Taken with or without food
Evotaz 300mg Reyataz + 150mg Tybost One tablet 1x/day Taken with food
Genvoya 150mg elvitegravir +150mg Tybost + 200mg Emtriva + 10mg tenofovir alafenamide One tablet 1x/day Taken with food
Juluca 50mg Tivicay + 25mg Edurant -One tablet 1x/day -For people on rifabutin: One tablet plus an additional 25mg Edurant 1x/day  Taken with food
Kaletra 200mg lopinavir + 50mg Norvir -Two tablets 2x/day -People with less than 3 mutations associated with lopinavir resistance: Four tablets 1x/day Taken with or without food
Odefsey 25mg Edurant + 200mg Emtriva + 25mg tenofovir alafenamide One tablet 1x/day Taken with food
Prezcobix 800mg Prezista + 150mg Tybost One tablet 1x/day Taken with food
Symtuza 800mg Prezista + 150mg Tybost + 200mg Emtriva + 10mg tenofovir alafenamide One tablet 1x/day Taken with food
Symfi 600mg Sustiva + 300mg Epivir + 300mg Viread One tablet 1x/day Taken on an empty stomach, preferably at bedtime
Symfi Lo 400mg Sustiva + 300mg Epivir + 300mg Viread One tablet 1x/day Taken on an empty stomach, preferably at bedtime
Stribild 150mg elvitegravir +150mg Tybost + 200mg Emtriva + 300mg Viread One tablet 1x/day Taken with food
Triumeq 600mg Ziagen + 50mg Tivicay + 300 mg Epivir One tablet 1x/day Taken with or without food
Truvada 300mg Viread + 200mg Emtriva One tablet 1x/day Taken with or without food
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