Antiretroviral Treatments

ANTIRETROVIRAL TREATMENTS
Generic	Brand	Strength	Form	Usual Dose
CCR5 Co-Receptor Antagonists
maraviroc (MVC)	Selzentry	25mg, 75mg, 150mg, 300mg	tabs	Adults: ≥16yrs: Concomitant potent CYP3A inhibitors (eg, PIs [except tipranavir/ritonavir], delavirdine, elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, nefazodone, telithromycin, boceprevir) (with or without a potent CYP3A inducer): 150mg twice daily. Other concomitant drugs, including tipranavir/ritonavir, nevirapine, raltegravir, NRTIs, enfuvirtide: 300mg twice daily. Concomitant potent CYP3A inducers (eg, efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin) (without a potent CYP3A inhibitor): 600mg twice daily. Severe renal impairment (CrCl <30mL/min) or ESRD (without potent CYP3A inhibitors or inducers): reduce dose from 300mg twice daily to 150mg twice daily if postural hypotension occurs. Children: <2yrs: not established. If unable to swallow, use oral soln. ≥2yrs: Concomitant potent CYP3A inhibitors (eg, PIs [except tipranavir/ritonavir], delavirdine, elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, nefazodone, telithromycin, boceprevir) (with or without a potent CYP3A inducer): (10–<20kg): 50mg or 2.5mL twice daily; (20–<30kg): 75mg or 4mL twice daily; (30–<40kg): 100mg or 5mL twice daily; (≥40kg): 150mg or 7.5mL twice daily. Other concomitant drugs, including tipranavir/ritonavir, nevirapine, raltegravir, NRTIs, enfuvirtide: (10–<30kg): not recommended; (≥30kg): 300mg or 15mL twice daily. Concomitant potent CYP3A inducers (eg, efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin) (without a potent CYP3A inhibitor): not recommended.
maraviroc (MVC)	Selzentry	20mg/mL	oral soln
Fusion Inhibitors
enfuvirtide (ENF, T‑20)	Fuzeon	90mg/mL	pwd for SC inj after reconstitution	Adults: ≥16yrs: 90mg twice daily via SC inj into upper arm, anterior thigh, or abdomen Children: <6yrs: not established. ≥6−16yrs: Limited data available; recommended 2mg/kg (max 90mg) twice daily.
HIV-1 Integrase Strand Transfer Inhibitors
dolutegravir	Tivicay	10mg, 25mg, 50mg	tabs	Adults: Treatment-naïve or treatment-experienced INSTI-naïve or virologically suppressed switching to dolutegravir + rilpivirine: 50mg once daily. Treatment-naïve or treatment-experienced INSTI-naïve with concomitant certain UGT1A or CYP3A inducers: 50mg twice daily. INSTI-experienced with certain INSTI-associated resistance substitutions or clinically suspected INSTI resistance: 50mg twice daily. Children: <30kg or INSTI-experienced with documented or clinically suspected resistance to other INSTIs (raltegravir, elvitegravir): not established. Treatment-naïve or treatment-experienced INSTI-naïve: (30–<40kg): 35mg once daily; (≥40kg): 50mg once daily; when concomitant with certain UGT1A or CYP3A inducers: increase weight-based dose to twice daily.
raltegravir potassium (RAL)	Isentress	25mg, 100mg+	chew tabs	Adults: Treatment-naïve or virologically suppressed on Isentress 400mg twice daily: 1200mg (2 x 600mg) once daily or 400mg twice daily. Treatment-experienced: 400mg twice daily. Concomitant rifampin: 800mg (2 x 400mg) twice daily. Children: <4wks: use oral susp. ≥4wks (<25kg): use other forms; (≥25kg): 400mg twice daily; (≥40kg): treatment-naïve or virologically suppressed on Isentress 400mg twice daily: 1200mg (2 x 600mg) once daily or 400mg twice daily. If unable to swallow, can use chew tabs: (11–<14kg): 75mg twice daily; (14–<20kg): 100mg twice daily; (20–<25kg): 150mg twice daily; (25–<28kg): 150mg twice daily; (28–<40kg): 200mg twice daily; ≥40kg: 300mg twice daily. Chew tabs max dose: 300mg twice daily.
raltegravir potassium (RAL)	Isentress	400mg	tabs
	Isentress HD	600mg	tabs
	Isentress Oral Suspension	100mg/pkt	pwd for oral susp	Adults: use tabs. Children: Pre-term neonates or <2kg: not recommended. Give first dose between 24–48hrs post birth if mother received raltegravir 2–24hrs before delivery. Birth to 1wk (2–<3kg): 4mg (0.4mL) once daily; (3–<4kg): 5mg (0.5mL) once daily; (4–<5kg): 7mg (0.7mL) once daily. 1 to 4wks (2–<3kg): 8mg (0.8mL) twice daily; (3–<4kg): 10mg (1mL) twice daily; (4–<5kg): 15mg (1.5mL) twice daily. ≥4wks (3–<4kg): 25mg (2.5mL) twice daily; (4–<6kg): 30mg (3mL) twice daily; (6–<8kg): 40mg (4mL) twice daily; (8–<11kg): 60mg (6mL) twice daily; (11–<14kg): 80mg (8mL) twice daily; (14–<20kg): 100mg (10mL) twice daily; (20–<25kg): use chew tabs. Oral susp max dose: 100mg (10mL) twice daily.
Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
delavirdine mesylate (DLV)	Rescriptor	100mg, 200mg	tabs	Adults: ≥16yrs: 400mg 3 times daily. Children: <16yrs: not established.
doravirine	Pifeltro	100mg	tabs	Adults: ≥18yrs: 100mg once daily. Concomitant rifabutin: 100mg twice daily (approx. 12hrs apart). Children: <18yrs: not established.
efavirenz (EFV)	Sustiva	50mg, 200mg	caps	Adults and Children: Once daily on an empty stomach, preferably at bedtime. Consider pretreating with antihistamine (for children) or steroid to minimize rash. <3mos or <3.5kg: not recommended. >3mos: (3.5−<5kg): 100mg; (5−<7.5kg): 150mg; (7.5−<15kg): 200mg; (15−<20kg): 250mg; (20−<25kg): 300mg; (25−<32.5kg): 350mg; (32.5−<40kg): 400mg; (>40kg) and adults: 600mg. Concomitant voriconazole: increase voriconazole maintenance dose to 400mg every 12hrs and decrease efavirenz dose to 300mg once daily using caps. Concomitant rifampin (≥50kg): increase efavirenz dose to 800mg once daily.
efavirenz (EFV)	Sustiva	600mg	tabs
etravirine (ETR)	Intelence	25mg+, 100mg, 200mg	tabs	Adults: Take after meals. ≥18yrs: 200mg twice daily. Children: <2yrs or <10kg: not recommended. Take after meals. ≥2yrs (≥10kg–<20kg): 100mg twice daily; (≥20kg–<25kg): 125mg twice daily; (≥25kg–<30kg): 150mg twice daily; (≥30kg): 200mg twice daily.
nevirapine (NVP)	Viramune	200mg+	tabs	Adults: ≥16yrs: Initially 200mg once daily for 14 days; then 200mg twice daily. Dialysis: Give additional 200mg after dialysis. Children: <15days: not recommended. ≥15days: Initially 150mg/m² once daily for 14 days, then increase to 150mg/m² twice daily. Both: If mild-to-moderate rash occurs during the 14‑day lead‑in period, do not give twice-daily regimen until rash has resolved. Max lead‑in period: 28 days, consider alternative regimen. If severe rash or hepatic event occurs, discontinue permanently. Max 400mg/day. Retitrate if stopped for >7 days.
	Viramune	50mg/ 5mL	oral susp
	Viramune XR	400mg	ext-rel tabs	Adults: Initially Viramune 200mg once daily for 14 days, then Viramune XR 400mg once daily. If mild-to-moderate rash develops during the 14‑day lead in period, do not start Viramune XR until rash has resolved. Lead‑in period not necessary if patient already on a regimen of immediate-release Viramune twice daily. Max once-daily lead in period: 28 days; consider alternative regimen. If severe rash or hepatic event occurs, discontinue permanently. Retitrate if stopped for >7 days. Children: <6yrs: not recommended. ≥6–<18yrs: Initially 150mg/m² Viramune oral susp or IR tabs once daily for 14 days (max 200mg/day); then Viramune XR dose based on BSA: 0.58–0.83m²: 200mg once daily; 0.84–1.16m²: 300mg once daily; ≥1.17m²: 400mg once daily. All: max 400mg/day.
rilpivirine	Edurant	25mg	tabs	Adults and Children: <12yrs: not recommended. ≥12yrs (≥35kg): 25mg once daily with a meal. Concomitant rifabutin: 50mg once daily; decrease to 25mg once daily when rifabutin is stopped.
Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs)
abacavir sulfate (ABC)	Ziagen	300mg	tabs	Adults: >16yrs: 300mg twice daily or 600mg once daily. Mild hepatic impairment: 200mg twice daily. Children: <3mos: not established. ≥3mos (oral soln): 8mg/kg twice daily or 16mg/kg once daily; max 600mg daily. If able to swallow tabs: 14−<20kg: 300mg once daily or 150mg twice daily; ≥20−<25kg: 450mg once daily or 150mg in the AM and 300mg in the PM; ≥25kg: use Adult dose.
abacavir sulfate (ABC)	Ziagen	20mg/mL	oral soln¹
abacavir sulfate (ABC)/ lamivudine (3TC)	Epzicom	600mg/ 300mg	tabs	Adults and Children: <25kg: use individual components. ≥25kg: 1 tab daily. Mild hepatic or renal impairment (CrCl< 50mL/min): not recommended; use individual components.
abacavir sulfate (ABC)/ lamivudine (3TC)/ zidovudine (ZDV)	Trizivir	300mg/ 150mg/ 300mg	tabs	Adults and Children: <40kg: not recommended. ≥40kg: 1 tab twice daily. Mild hepatic or renal impairment (CrCl <50mL/min): not recommended; use individual components.
didanosine (ddl)	Videx EC	125mg, 200mg, 250mg, 400mg	e‑c del‑rel caps	Adults and Children: Take once daily on an empty stomach. <20kg: use oral soln. 20–<25kg: 200mg. 25–<60kg: 250mg. ≥60kg: 400mg. Renal impairment (CrCl 30–59mL/min): <60kg: 125mg. ≥60kg: 200mg. CrCl 10–29mL/min: 125mg. CrCl <10mL/min or dialysis: <60kg: use oral soln; ≥60kg: 125mg. Concomitant tenofovir DF (CrCl ≥60mL/min): <60kg: 200mg; ≥60kg: 250mg.
didanosine (ddl)	Videx Pediatric Pwd for Oral Soln	2g, 4g	pwd for oral soln after reconstitution and dilution	Adults: Take on an empty stomach. <60kg: 125mg twice daily or 250mg once daily. ≥60kg: 200mg twice daily or 400mg once daily. Renal impairment (CrCl 30–59mL/min): <60kg: 150mg once daily or 75mg twice daily; ≥60kg: 200mg once daily or 100mg twice daily; CrCl 10–29mL/min: <60kg:100mg once daily; ≥60kg: 150mg once daily; CrCl <10mL/min or dialysis: <60kg: 75mg once daily; ≥60kg: 100mg once daily. Concomitant tenofovir DF (CrCl ≥60mL/min): <60kg: 200mg; ≥60kg: 250mg. Children: <2wks: not established. 2wks−8mos: 100mg/m² twice daily. ≥8mos: 120mg/m² twice daily. Max up to adult dose. Renal impairment: consider reducing dose.
emtricitabine (FTC)	Emtriva	200mg	caps	Adults: ≥18yrs: 200mg once daily. Renal impairment (CrCl 30−49mL/min): 200mg every 48hrs; (CrCl 15−29mL/min): 200mg every 72hrs; (CrCl <15mL/min or dialysis): 200mg every 96hrs. Children: <3mos: use oral soln. 3mos–17yrs (≤33kg): use oral soln; (>33kg): 200mg once daily. Renal impairment: Reduce dose or prolong dosing interval.
emtricitabine (FTC)	Emtriva	10mg/mL	oral soln	Adults: ≥18yrs: 240mg (24mL) once daily. Renal impairment: (CrCl 30–49mL/min): 120mg (12mL) once daily; (CrCl 15–29mL/min): 80mg (8mL) once daily; (CrCl <15mL/min or dialysis): 60mg (6mL) once daily. Children: <3mos: 3mg/kg once daily. 3mos–17yrs: 6mg/kg [max 240mg (24mL)] once daily. >33kg: may use cap form. Renal impairment: reduce dose or prolong dosing interval.
emtricitabine (FTC)/ tenofovir alafenamide (TAF)	Descovy	200mg/ 25mg	tabs	Adults and Children: HIV treatment <25kg or (concomitant PI plus ritonavir or cobicistat in children <35kg or adults with CrCl <15mL/min ± HD): not established. ≥25kg (and CrCl ≥30mL/min) or adults (with CrCl <15mL/min) receiving chronic HD: 1 tab once daily. PrEP: <35kg: not established. Confirm negative HIV-1 prior to initiation. ≥35kg (and CrCl ≥30mL/min) or adults (with CrCl <15mL/min) receiving chronic HD: 1 tab once daily. Both: severe renal impairment (CrCl 15-<30mL/min) or ESRD (CrCl <15mL/min) not receiving chronic HD: not recommended. Hemodialysis days: give dose after session.
emtricitabine (FTC)/ tenofovir disoproxil fumarate (TDF)	Truvada	100mg/150mg, 133mg/200mg, 167mg/250mg, 200mg/300mg	tabs	Adults: HIV-1 infection: ≥35kg: 200mg/300mg once daily. CrCl 30–49mL/min: 200mg/300mg every 48hrs; CrCl <30mL/min, hemodialysis: not recommended. PrEP: confirm negative HIV-1 prior to initiation. ≥35kg: 200mg/300mg once daily. CrCl<60mL/min: not recommended. Children: HIV-1 infection: <17kg: not established. 17–<22kg: 100mg/150mg once daily. 22–<28kg: 133mg/200mg once daily. 28–<35kg: 167mg/250mg once daily. ≥35kg: 200mg/300mg once daily.
lamivudine (3TC)	Epivir	150mg+, 300mg	tabs	Adults: CrCl ≥50mL/min: 300mg once daily or 150mg twice daily; CrCl 30−49mL/min: 150mg once daily; CrCl 15−29mL/min: 150mg for 1st dose then 100mg once daily; CrCl 5−14mL/min: 150mg for 1st dose then 50mg once daily; CrCl <5mL/min: 50mg for 1st dose then 25mg once daily. Children: <3mos: not established. ≥3mos (oral soln): 5mg/kg twice daily or 10mg/kg once daily; max 300mg/day. Tabs: 14−<20kg: 150mg once daily or 75mg twice daily; ≥20−<25kg: 225mg once daily or 75mg in the AM and 150mg in the PM; ≥25kg: 300mg once daily or 150mg twice daily. Renal impairment: reduce dose or prolong dosing interval.
lamivudine (3TC)	Epivir	10mg/mL	oral soln
lamivudine/ tenofovir disoproxil fumarate (TDF)	Cimduo	300mg/ 300mg	tabs	Adults and Children: <35kg: not established. ≥35kg: 1 tab once daily.
lamivudine/ tenofovir disoproxil fumarate (TDF)	Temixys	300mg/ 300mg	tabs
lamivudine (3TC)/ zidovudine (ZDV)	Combivir	150mg/ 300mg	tabs	Adults and Children: <30kg: not recommended. ≥30kg: 1 tab twice daily. Hepatic or renal impairment (CrCl <50mL/min): not recommended; use individual components.
stavudine (d4T)	Zerit	15mg, 20mg, 30mg, 40mg	caps	Adults: ≥60kg: 40mg every 12hrs; <60kg: 30mg every 12hrs. Renal impairment: ≥60kg (CrCl 26−50mL/min): 20mg every 12hrs; (CrCl 10−25mL/min), dialysis: 20mg every 24hrs. <60kg (CrCl 26−50mL/min): 15mg every 12hrs; (CrCl 10−25mL/min), dialysis: 15mg every 24hrs. Children: ≤13 days: 0.5mg/kg every 12hrs. ≥14 days: (<30kg): 1mg/kg every 12hrs. ≥30kg: as adult. Renal impairment: Reduce dose or increase dosing interval.
stavudine (d4T)	Zerit	1mg/mL	pwd for oral soln after reconstitution
tenofovir disoproxil fumarate (TDF)	Viread	150mg, 200mg, 250mg, 300mg	tabs	Adults: ≥35kg: 300mg once daily. Renal impairment: CrCl 30–49mL/min: 300mg every 48hrs; CrCl 10–29mL/min: 300mg every 72–96hrs; hemodialysis: 300mg every 7 days or after a total of 12hrs of dialysis; CrCl <10mL/min: not recommended.
tenofovir disoproxil fumarate (TDF)	Viread	40mg/g	oral pwd	Children: <2yrs (<10kg): not established. Mix oral pwd with 2–4oz of soft food not requiring chewing (eg, applesauce, baby food, yogurt). Oral pwd (≥2yrs [≥10kg] or Tabs ≥2yrs [≥17kg]): 8mg/kg once daily; max 300mg/day. Tabs (if able to swallow): ≥2yrs (17–<22kg): 150mg once daily; (22–<28kg): 200mg once daily; (28–<35kg): 250mg once daily; (≥35kg): 300mg once daily.
zidovudine (ZDV)	—	300mg	tabs	Adults: ≥18yrs: 300mg twice daily. Renal impairment (CrCl <15mL/min) or on dialysis: 100mg every 6–8hrs. Prevention of maternal-fetal HIV or vertical transmission, severe anemia and/or neutropenia: see full labeling. Children: <6wks and/or for vertical transmission: see full labeling. 4wks to <18yrs: (4–<9kg): 24mg/kg/day (12mg/kg twice daily or 8mg/kg 3 times daily); (≥9–<30kg): 18mg/kg/day (9mg/kg twice daily or 6mg/kg 3 times daily); (≥30kg): 600mg/day (300mg twice daily or 200mg 3 times daily). Alternative dosing based on BSA: 480mg/m²/day (240mg/m² twice daily or 160mg/m² 3 times daily).
	Retrovir	100mg	caps
		10mg/ mL	syrup
		10mg/mL	soln for IV inj after dilution	Adults: Give by IV infusion over 1hr; use only until oral therapy can be given. 1mg/kg every 4hrs. Renal impairment (CrCl <15mL/min) or on dialysis: 1mg/kg every 6–8hrs. Prevention of maternal-fetal HIV or vertical transmission, severe anemia and/or neutropenia: see full labeling. Children: Vertical transmission: See full labeling.
Pharmacokinetic Enhancer
cobicistat	Tybost	150mg	tabs	Adults and Children: <12yrs (<35kg): not established (with atazanavir) or (<40kg): not established (with darunavir). Take with food. Must be co-administered at same time as atazanavir or darunavir. ≥12yrs (≥35kg): 150mg once daily with atazanavir 300mg once daily (if treatment-naïve or experienced); or (≥40kg): 150mg once daily with darunavir 800mg once daily (if treatment-naïve or experienced with no darunavir resistance associated substitutions).
Protease Inhibitors (PIs)
atazanavir sulfate (ATV)	Reyataz	150mg, 200mg, 300mg	caps	Adults: Take with food. Treatment-naive: atazanavir 300mg + ritonavir 100mg, both once daily; or atazanavir 400mg once daily if unable to tolerate ritonavir. Concomitant efavirenz: atazanavir 400mg + ritonavir 100mg (both once daily) + efavirenz 600mg (on an empty stomach at bedtime). ESRD with hemodialysis: atazanavir 300mg + ritonavir 100mg. Hepatic impairment (mild): 400mg once daily; (moderate): 300mg once daily; (severe): not recommended. Treatment-experienced: atazanavir 300mg + ritonavir 100mg; both once daily. Pregnancy (2nd or 3rd trimester) plus concomitant H2-blocker or tenofovir: atazanavir 400mg + ritonavir 100mg, both once daily. Concomitant tenofovir: consider giving atazanavir 300mg + tenofovir 300mg + ritonavir 100mg, all once daily; see full labeling. Concomitant H2-blockers or PPIs: see full labeling. All other pregnant patients: no dose adjustments needed. Children: <6yrs: not recommended. Take with food. Take once daily. 6–18yrs (15–<35kg): atazanavir 200mg + ritonavir 100mg; ≥35kg: atazanavir 300mg + ritonavir 100mg. Treatment-naive: ≥13yrs and ≥40kg who are unable to tolerate ritonavir: atazanavir 400mg once daily. Patients ≥13yrs and ≥40kg receiving concomitant tenofovir, H2-blockers, or PPIs: give atazanavir with ritonavir. See full labeling.
atazanavir sulfate (ATV)	Reyataz	50mg	oral pwd³	Adults: Use caps form. Children: <3mos (<5kg): not recommended. ≥3mos (5–<15kg): atazanavir 200mg (4 pkts) + ritonavir oral soln 80mg; (15–<25kg): atazanavir 250mg (5 pkts) + ritonavir oral soln 80mg; (≥25kg who are unable to swallow caps): atazanavir 300mg (6 pkts) + ritonavir oral soln 100mg; all: single daily dose.
darunavir ethanolate (DRV)	Prezista	75mg, 150mg, 600mg, 800mg	tabs	Adults: ≥18yrs: Treatment-naive or treatment-experienced with no darunavir resistance associated substitutions: darunavir 800mg + ritonavir 100mg once daily. Treatment-experienced with at least one darunavir resistance associated substitution or with no baseline resistance information: darunavir 600mg + ritonavir 100mg twice daily. Pregnancy: darunavir 600mg + ritonavir 100mg twice daily; may consider darunavir 800mg + ritonavir 100mg once daily only if stable on dose prior to pregnancy and virologically suppressed (HIV-1 RNA <50copies/mL). Children: <3yrs: not recommended. Treatment-naive or treatment-experienced with no darunavir resistance associated substitutions: ≥3yrs to <18yrs: ≥10kg–<11kg: darunavir 350mg + ritonavir 64mg once daily; ≥11kg–<12kg: darunavir 385mg + ritonavir 64mg once daily; ≥12kg–<13kg: darunavir 420mg + ritonavir 80mg once daily; ≥13kg–<14kg: darunavir 455mg + ritonavir 80mg once daily; ≥14kg–<15kg: darunavir 490mg + ritonavir 96mg once daily; ≥15–<30kg: darunavir 600mg + ritonavir 100mg once daily; ≥30kg–<40kg: darunavir 675mg + ritonavir 100mg once daily; ≥40kg: darunavir 800mg + ritonavir 100mg once daily. Treatment-experienced with at least one darunavir resistance associated substitution: ≥3yrs to <18yrs: ≥10kg–<11kg: darunavir 200mg + ritonavir 32mg twice daily; ≥11kg–<12kg: darunavir 220mg + ritonavir 32mg twice daily; ≥12kg–<13kg: darunavir 240mg + ritonavir 40mg twice daily; ≥13kg–<14kg: darunavir 260mg + ritonavir 40mg twice daily; ≥14kg–<15kg: darunavir 280mg + ritonavir 48mg twice daily; ≥15–<30kg: darunavir 375mg + ritonavir 48 mg twice daily; ≥30kg–<40kg: darunavir 450mg + ritonavir 60mg twice daily; ≥40kg: darunavir 600mg + ritonavir 100mg twice daily. See full labeling for complete weight based dosing. Both: Take with food. Severe hepatic impairment: not recommended.
darunavir ethanolate (DRV)	Prezista	100mg/ mL	oral susp
fosampre– navir calcium (FOS‑APV)	Lexiva	700mg	tabs	Adults: Oral susp: take without food. Therapy-naive: 1.4g twice daily; or fosamprenavir 1.4g + ritonavir 200mg once daily; or fosamprenavir 1.4g + ritonavir 100mg once daily; or fosamprenavir 700mg + ritonavir 100mg twice daily. PI‑experienced: fosamprenavir 700mg + ritonavir 100mg twice daily. Hepatic dysfunction: See full labeling. Children: PI‑naive (<4wks) or PI‑experienced (<6mos): not recommended. Oral susp: Take twice daily with food. PI‑naive (≥4wks−18yrs) or PI‑experienced (≥6mos): <11kg: fosamprenavir 45mg/kg + ritonavir 7mg/kg; 11−<15kg: fosamprenavir 30mg/kg + ritonavir 3mg/kg; 15−<20kg: fosamprenavir 23mg/kg + ritonavir 3mg/kg; ≥20kg: fosamprenavir 18mg/kg + ritonavir 3mg/kg. PI‑naive (≥2yrs): fosamprenavir 30mg/kg. Both: If emesis occurs within 30min after dosing, re‑dose. Do not exceed adult dose. See full labeling.
fosampre– navir calcium (FOS‑APV)	Lexiva	50mg/mL	oral susp
indinavir sulfate (IDV)	Crixivan	200mg, 400mg	caps	Adults: Take with water on an empty stomach or with a light meal. 800mg every 8hrs. Concomitant rifabutin: 1g every 8hrs and reduce rifabutin dose by ½. Concomitant ketoconazole, itraconazole, delavirdine, or hepatic insufficiency: 600mg every 8hrs. Children: Not established. 3−18yrs: 500mg/m² every 8hrs has been used; see full labeling.
lopinavir (LPV)/ ritonavir (RTV)	Kaletra	100mg/ 25mg, 200mg/ 50mg	tabs	Adults: Oral soln: take with food. ≥18yrs: <3 lopinavir resistance-associated substitutions: 400/100mg twice daily or 800/200mg once daily. ≥3 lopinavir resistance-associated substitutions or concomitant carbamazepine, phenobarbital, phenytoin, efavirenz, nevirapine, nelfinavir, or if pregnant (avoid oral soln): once-daily dosing not recommended. Concomitant efavirenz, nevirapine, or nelfinavir: 500/125mg (two 200/50mg tabs + one 100/25mg tab) or 520/130mg (6.5mL) twice daily. Children: <42wks postmenstrual age or <14 days postnatal: not recommended. 14days–6mos: 16/4mg/kg or 300/75mg/m² twice daily. Do not administer with efavirenz, nevirapine, or nelfinavir. >6mos–<18yrs: 230/57.5mg/m² twice daily or, if <15kg: 12/3mg/kg twice daily; ≥15–40kg: 10/2.5mg/kg twice daily; >40kg: max 400/100mg twice daily. Concomitant efavirenz, nevirapine, or nelfinavir: >6mos–<18yrs: 300/75mg/m² twice daily, or if <15kg: 13/3.25mg/kg twice daily; ≥15–45kg: 11/2.75mg/kg twice daily; >45kg: max oral soln: 520/130mg (6.5mL) twice daily; or max tabs: 500/125mg twice daily. See full labeling.
lopinavir (LPV)/ ritonavir (RTV)	Kaletra	80mg/ 20mg per mL	oral soln^2,5
nelfinavir mesylate (NFV)	Viracept	250mg, 625mg	tabs	Adults and Children: Take with food. <2yrs: not recommended. 2−13yrs: 45−55mg/kg twice daily or 25−35mg/kg 3 times daily; max 2.5g/day. >13yrs: 1.25g twice daily or 750mg 3 times daily. Reduce concomitant rifabutin dose by ½ and give nelfinavir 1.25g twice daily.
ritonavir (RTV)	Norvir	100mg	tabs, soft gel caps^2,5	Adults: Take with meals. Initially at least 300mg twice daily, increase every 2−3 days by 100mg twice daily to 600mg twice daily. Concomitant other Pls (eg, atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir): Reduce ritonavir dose. See full labeling.
		80mg/mL	oral soln²	Children: <1mo or before postmenstrual age <44wks: not recommended. >1mo: Initially 250mg/m² twice daily; increase every 2−3 days by 50mg/m² twice daily to 350−400mg/m² twice daily; max 600mg twice daily.
		100mg	oral pwd	Adults: not applicable. Children: <1mo: not recommended. Use only for dosing increments of 100mg; if less than or between 100mg intervals, use oral soln. >1mo: initially 250mg/m² twice daily, increase every 2‒3 days by 50mg/m² twice daily to 350‒400mg/m² twice daily; max 600mg twice daily. Concomitant other PIs (eg, atazanavir, darunavir, fosamprenavir, saquinavir, tipranavir); reduce ritonavir dose.
saquinavir mesylate (SQV)	Invirase	500mg	tabs	Adults: Take within 2hrs after a meal. >16yrs: saquinavir 1g twice daily + ritonavir 100mg twice daily (taken at same time). Treatment-naive or switching from a delavirdine- or rilpivirine-containing regimen: initially saquinavir 500mg twice daily + ritonavir 100mg twice daily for 7 days, then increase to saquinavir 1g twice daily + ritonavir 100mg twice daily. Children: ≤16yrs: not recommended.
saquinavir mesylate (SQV)	Invirase	200mg	hard gel caps
tipranavir (TPV)	Aptivus	250mg	soft gel caps²	Adults: Tipranavir 500mg + ritonavir 200mg twice daily. Children: <2yrs: not recommended. Use oral soln if unable to swallow caps. 2−18yrs: tipranavir 14mg/kg + ritonavir 6mg/kg or (375mg/m² + ritonavir 150mg/m²) twice daily; max tipranavir 500mg + ritonavir 200mg twice daily. Intolerance or toxicity (if virus not resistant to multiple PIs): may reduce dose to tipranavir 12mg/kg + ritonavir 5mg/kg or (290mg/m² + ritonavir 115mg/m²) twice daily.
tipranavir (TPV)	Aptivus	100mg/ mL	oral soln⁴
Multiclass Fixed-Dose Combination
abacavir/ dolutegravir/ lamivudine	Triumeq	600mg/ 50mg/ 300mg	tabs	Adults and Children: <40kg: not recommended. ≥40kg: 1 tab daily. Concomitant efavirenz, fosamprenavir/ritonavir, tipranavir/ritonavir, carbamazepine, rifampin: give additional dolutegravir 50mg separated by 12hrs from Triumeq.
atazanavir/ cobicistat	Evotaz	300mg/ 150mg	tabs	Adults: 1 tab daily. Children: <18yrs: not established.
bictegravir/ emtricitabine (FTC)/tenofovir alafenamide (TAF)	Biktarvy	50mg/ 200mg/ 25mg	tabs	Adults and Children: <25kg: not established. ≥25kg: 1 tab once daily.
darunavir/ cobicistat	Prezcobix	800mg/ 150mg	tabs	Adults: 1 tab daily. Children: <18yrs: not established.
darunavir/ cobicistat/ emtricitabine/ tenofovir alafenamide	Symtuza	800mg/ 150mg/ 200mg/ 10mg	tabs	Adults: ≥18yrs: 1 tab once daily with food. Severe renal (CrCl <30mL/min) or severe hepatic impairment: not recommended. Children: <18yrs: not established.
dolutegravir/ lamivudine	Dovato	50mg/ 300mg	tabs	Adults: 1 tab once daily. Concomitant carbamazepine, rifampin: give additional dolutegravir 50mg separated by 12hrs from Dovato. Renal impairment (CrCl <50mL/min) or severe hepatic impairment: not recommended. Children: not established.
dolutegravir/ rilpivirine	Juluca	50mg/ 25mg	tabs	Adults: 1 tab once daily with a meal. Concomitant rifabutin: take additional rilpivirine 25mg tab once daily during coadministration. Children: not established.
doravirine/ lamivudine/ tenofovir disoproxil fumarate	Delstrigo	100mg/ 300mg/ 300mg	tabs	Adults: ≥18yrs: 1 tab once daily. Concomitant rifabutin: give additional doravirine 100mg approx. 12hrs after Delstrigo dose. Children: <18yrs: not established.
efavirenz (EVF)/ emtricitabine (FTC)/ tenofovir disoproxil fumarate (TDF)	Atripla	600mg/ 200mg/ 300mg	tabs	Adults and Children: <40kg: not established. Take on empty stomach. ≥40kg: 1 tab once daily (preferably at bedtime). Concomitant rifampin (≥50kg): give additional 200mg/day of efavirenz.
efavirenz/ lamivudine/ tenofovir disoproxil fumarate	Symfi	600mg/ 300mg/ 300mg	tabs	Adults and Children: <40kg: not established. ≥40kg: 1 tab once daily on an empty stomach (preferably at bedtime). Concomitant rifampin (≥50kg): give additional 200mg/day of efavirenz.
efavirenz/ lamivudine/ tenofovir disoproxil fumarate	Symfi Lo	400mg/ 300mg/ 300mg	tabs	Adults and Children: <35kg: not established. ≥35kg: 1 tab once daily on an empty stomach (preferably at bedtime). Concomitant rifampin (≥50kg): give additional 400mg/day of efavirenz.
emtricitabine (FTC)/ rilpivirine/ tenofovir alafenamide (TAF)	Odefsey	200mg/ 25mg/ 25mg	tabs	Adults and Children: <12yrs (<35kg): not established. ≥12yrs (≥35kg and CrCl ≥30mL/min): 1 tab once daily with food. Pregnancy (already on prior stable dose and with HIV-1 RNA <50 copies/mL): continue with 1 tab once daily; monitor viral load. Severe renal impairment (CrCl 15-<30mL/min) or ESRD (CrCl <15mL/min) not receiving chronic HD: not recommended.
emtricitabine (FTC)/ rilpivirine/ tenofovir disoproxil fumarate (TDF)	Complera	200mg/ 25mg/ 300mg	tabs	Adults and Children: <12yrs (<35kg): not established. ≥12yrs (≥35kg): 1 tab once daily with food. Pregnancy (already on prior stable dose and with HIV-1 RNA <50 copies/mL): continue with 1 tab once daily; monitor viral load. Renal impairment (CrCl<50mL/min): not recommended. Concomitant rifabutin: take additional rilpivirine 25mg once daily.
elvitegravir/cobicistat/ emtricitabine (FTC)/ tenofovir alafenamide (TAF)	Genvoya	150mg/ 150mg/ 200mg/10mg	tabs	Adults and Children: <25kg: not established. ≥25kg and CrCl ≥30mL/min; or adults with CrCl <15mL/min on chronic hemodialysis (give dose after session): 1 tab once daily with food. Severe hepatic or renal impairment (CrCl 15–<30mL/min), or ESRD (CrCl <15mL/min) not on hemodialysis: not recommended.
elvitegravir/ cobicistat/ emtricitabine (FTC)/ tenofovir disoproxil fumarate (TDF)	Stribild	150mg/ 150mg/ 200mg/ 300mg	tabs	Adults and Children: <12yrs or <35kg: not established. ≥12yrs (≥35kg): 1 tab once daily with food. Renal impairment (CrCl <70mL/min): not recommended; discontinue if CrCl declines to <50mL/min during therapy; also in children: no data available. Severe hepatic impairment: not recommended.
CD4-DIRECTED POST-ATTACHMENT HIV-1 INHIBITOR
ibalizumab-uiyk	Trogarzo⁶	200mg/1.33mL	soln for IV inj after dilution	Adults: Infuse over ≥30mins for 1st infusion; may reduce to ≥15mins for subsequent infusions if tolerated. 2000mg as single loading dose followed by 800mg maintenance dose every 2wks. Children: not established.
NOTES
Key: + = scored; HD = hemodialysis; PI = protease inhibitor ¹Contains parabens, propylene glycol; ²Contains alcohol; ³Contains phenylalanine; ⁴Contains Vit. E 116 IU/mL; ⁵Keep in refrigerator; ⁶For heavily treatment-experienced adults with multidrug resistant HIV-1 infection failing their current antiretroviral regimen (Rev. 3/2020)

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