HIV Treatments: List of Prescription Medications

Medically reviewed by Daniel Murrell, MD on January 2, 2018Written by the Dr.China Editorial Team

Introduction

HIV infection starts when the virus is transmitted through with infected body fluids, such as blood, semen, or breast milk. HIV targets the immune system and invades white blood cells called T-cells. These are cells that fight infection. By entering the body’s cells, the virus hides from the immune system.

After the virus invades these cells, it replicates (makes copies of itself). Then, the cells explode. They release many viral cells that go on to invade other cells in the body. This process destroys the immune system’s ability to fight infections, and generally keeps the body from working well.

Currently, there is no known cure for HIV. However, medications can help people living with HIV manage the condition and live healthy lives. These drugs work by stopping HIV from replicating. Here is a list of drugs that are currently approved by the U.S. Food and Drug Administration (FDA) to treat HIV.

To keep in mind

  • Medications can help treat HIV, but they do not prevent the spread of HIV to others.

Classes of drugs for HIV

There are many different classes of drugs used to treat HIV. Each person’s doctor will decide on the best medications for them individually. This decision will depend on their viral load and strain, as well as on how severe their case is and how far it has spread.

All people with HIV need to take more than one drug. This is because attacking HIV from multiple directions reduces the viral load more quickly. It also helps prevent resistance to the drugs being used. This means a person’s medications may work better to treat their HIV.

Multiclass combination drugs

Combination drugs combine medications from different classes into one drug form. The drugs are combined to make a complete HIV regimen. This type of regimen is usually used to treat people who have never taken HIV medications before.

Examples of these drugs include:

  • abacavir/dolutegravir/lamivudine (Triumeq)
  • dolutegravir/rilpivirine (Juluca)
  • elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate (Stribild)
  • elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (Genvoya)
  • efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla)
  • emtricitabine/rilpivirine/tenofovir disoproxil fumarate (Complera)
  • emtricitabine/rilpivirine/tenofovir alafenamide (Odefsey)
  • bictegravir, emtricitabine, and tenofovir alafenamide (approval from the FDA expected in )

Integrase inhibitors

Integrase inhibitors are a class of medication that stops the action of integrase enzyme. This is a viral enzyme that HIV uses to infect T-cells. Integrase inhibitors are usually among the first HIV drugs used in people who have recently contracted HIV because they work well and have minimal side effects. Examples of these drugs include:

  • dolutegravir (Tivicay)
  • elvitegravir (Vitekta)
  • raltegravir (Isentress)
  • raltegravir extended-release (Isentress HD)

Several combinations of these drugs are also available. See “Multiclass combination drugs” above.

Nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs)

You may hear NRTIs referred to as “nukes.” They work by interrupting the life cycle of HIV as it tries to copy itself. These drugs also have other actions that prevent HIV from replicating in the body. Examples of NRTIs include:

  • abacavir (Ziagen)
  • abacavir/lamivudine (Epzicom)
  • abacavir/lamivudine/zidovudine (Trizivir)
  • lamivudine/zidovudine (Combivir)
  • lamivudine (Epivir)
  • zidovudine (Retrovir)
  • emtricitabine/tenofovir disoproxil fumarate (Truvada)
  • emtricitabine (Emtriva)
  • tenofovir disoproxil fumarate (Viread)
  • emtricitabine/tenofovir alafenamide (Descovy)

Some NRTIs are rarely used and will be discontinued by the manufacturer by 2020. These drugs include:

  • didanosine (Videx)
  • didanosine extended-release (Videx EC)
  • stavudine (Zerit)

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)

These drugs work in a similar way to NRTIs. They stop the virus from replicating itself in your body. Examples of these drugs include:

  • efavirenz (Sustiva)
  • etravirine (Intelence)
  • nevirapine (Viramune)
  • nevirapine extended-release (Viramune XR)
  • rilpivirine (Edurant)
  • delavirdine mesylate (Rescriptor): rarely used

Several combinations of these drugs are also available. See “Multiclass combination drugs” above.

Protease inhibitors

Protease inhibitors work by binding to protease. This is a protein that HIV needs to replicate in the body. When protease can’t do its job, the virus can’t complete the process that makes new copies. This reduces the number of viruses that can infect more cells. Some protease inhibitors are only approved by the FDA to treat hepatitis C, but these are not the same as those used to treat HIV infection.

Examples of protease inhibitors used to treat HIV include:

  • atazanavir/cobicistat (Evotaz)
  • darunavir/cobicistat (Prezcobix)
  • lopinavir/ritonavir (Kaletra)
  • ritonavir (Norvir): always used to boost other medications, such as atazanavir, lopinavir, darunavir, or elvitegravir
  • atazanavir (Reyataz): often given together with ritonavir
  • darunavir (Prezista): must be given together with ritonavir
  • fosamprenavir (Lexiva): often given together with ritonavir
  • tipranavir (Aptivus): must be given together with ritonavir

HIV protease inhibitors that are rarely used because they have more side effects include:

  • nelfinavir (Viracept)
  • indinavir (Crixivan): often given together with ritonavir
  • saquinavir (Invirase): must be given together with ritonavir

Entry inhibitors (including fusion inhibitors)

Entry inhibitors are another class of HIV medication. HIV needs a host T-cell in order to make copies of itself. These drugs block the virus from entering a host T-cell. This prevents the virus from replicating itself.

Entry inhibitors are rarely used in the United States because other available drugs are more effective and better tolerated. An example of an entry inhibitor is:

  • enfuvirtide (Fuzeon)

Chemokine co-receptor antagonists (CCR5 antagonists)

CCR5 antagonists block HIV from entering cells. CCR5 antagonists are rarely used in the United States because other available drugs are more effective. An example of this type of drug includes:

  • maraviroc (Selzentry)

Cytochrome P4503A (CYP3A) inhibitors

CYP3A are enzymes that protect liver and gastrointestinal health. CYP3A inhibitors increase the levels of certain HIV drugs in the body. These HIV drugs include protease inhibitors and certain integrase inhibitors. Examples of CYP3A inhibitors include:

  • cobicistat (Tybost)
  • ritonavir (Norvir)

Immune-based therapies

Because HIV affects the immune system, researchers are studying ways that biological drugs can prevent viral replication. Certain immune-based treatments have been successful in some people in clinical trials and are currently being researched. They would be used along with other HIV medications.

An example of an immune-based therapy is . This drug is an entry inhibitor. It prevents HIV from entering certain immune cells.

HIV drug side effects

Many HIV drugs can cause temporary side effects when first used. These effects can include:

  • diarrhea
  • dizziness
  • headaches
  • fatigue
  • fever
  • muscle aches
  • nausea
  • vomiting

You may have side effects for several weeks after starting a new medication. If these side effects get worse or last longer than a few weeks, talk to your doctor. Your doctor may suggest ways to ease your side effects, or they may prescribe you a different drug.

Less often, HIV drugs can cause serious or long-term side effects. These effects depend on the type of drugs you’re taking. Your doctor can tell you more.

Talk to your doctor

There’s no cure for HIV yet, but prescription medications can help slow the progression of the virus. Drugs can also improve your symptoms and make living with HIV more comfortable. This medication list is a brief overview of the types of drugs that are available to treat HIV. Talk to your doctor about all of these options. With your help, your doctor can determine the best treatment plan for you.

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