What is Rescriptor?

Rescriptor is an anti-HIV medication. It is in a category of HIV medicines called non-nucleoside reverse transcriptase inhibitors (NNRTIs). Rescriptor prevents HIV from entering the nucleus of healthy T-cells. This prevents the cells from producing new HIV and decreases the amount of virus in the body.

Rescriptor, manufactured by Pfizer, was approved by the U.S. Food and Drug Administration for the treatment of HIV in 1997.

Rescriptor must be used in combination with other drugs to treat HIV. It is usually combined with two nucleoside analogues.

Potential side effects and toxicity

The most common side effect of Rescriptor is skin rash. In clinical trials, approximately one of every four (25%) HIV-positive people who took the drug developed a rash. Most of these cases involved either mild or moderate rash—the rashes either improved on their own or were managed using a mild steroid cream or oral medication. If you experience rash while taking Rescriptor, be sure to report it to your doctor.

What are some drug interactions?

Rescriptor is broken down (metabolized) by the liver, like many medications used to treat HIV and AIDS. This means that Rescriptor can interact with other medications. Rescriptor can lower or raise the levels of other medications in the body. Similarly, other medications can lower or raise the levels of Rescriptor in the body. While many interactions are not a problem, some can cause your medications to be less effective or increase the risk of side effects.

Tell your doctors and pharmacists about all medicines you take. This includes those you buy over-the-counter and herbal or natural remedies, such as St. John’s Wort. Bring all your medicines when you see a doctor, or make a list of their names, how much you take, and how often you take them. Your doctor can then tell you if you need to change the dosages of any of your medications.

The following medications should not be taken while you are being treated with Rescriptor:

Antibiotics: Priftin (rifapentine), Mycobutin (rifabutin), Rifadin (rifampin)

Antihistamines: Hismanal (astemizole)

Acid reflux/heartburn medications: Propulsid (cisapride), Tagamet (cimetidine), Pepcid (famotidine), Zantac (ranitidine), Prevacid (lansoprazole), Nexium (esomeprazole), Prilosec (omeprazole), Protonix (pantoprazole), and other H2 antagonists and proton-pump inhibitors.

Sedatives: Versed (midazolam) and Halcion (triazolam)

Antimigraine medications: Wigraine and Cafergot (ergot medications)

Cholesterol-lowering medications (statins): Zocor (simvastatin) and Mevacor (lovastatin).

Nucleoside reverse transcriptase inhibitors (NRTIs) can be combined safely with Rescriptor.

Rescriptor can increase the blood levels of all of the available protease inhibitors. In turn, the dose of the protease inhibitor being used may need to be decreased.

If you take methadone, Rescriptor may increase the amount of it in your blood. It might be necessary to change your dose of methadone if you combine it with Rescriptor.

Cholesterol-lowering drugs, also known as "statins," can interact with Rescriptor. There are two statins that should not be used with Rescriptor: Zocor (simvastatin) and Mevacor (lovastatin). Levels of these two drugs can become significantly increased in the bloodstream if the are combined with Rescriptor, which increases the risk of side effects. The two statins that are considered to be the safest in combination with Rescriptor are Pravachol (pravastatin) and Lescol (fluvastatin). It is also possible to take Rescriptor with Lipitor (atorvastatin) or Crestor (rosuvastatin), although Rescriptor can increase Lipitor and Crestor levels in the bloodstream. If Lipitor or Crestor is prescribed, it's best to begin treatment with the lowest possible dose of the drug and then increase the dose if necessary.

Rescriptor can interact with some medications used to treat TB, MAC and other bacterial infections. Rifadin (rifampin) can decrease Rescriptor levels (these two drugs should not be used together). Rescriptor can increase Mycobutin (rifabutin) levels and Mycobutin can decreased Rescriptor levels (these two drugs should not be used together). Rescriptor can also increase Biaxin (clarithromycin) levels and Biaxin can decrease clarithromycin levels (if Biaxin must be used, your doctor should monitor your kidneys carefully).

It is not known if Rescriptor interacts with oral contraceptives/birth control pills (ethinyl estradiol).

Blood levels of Viagra (sildenafil) and Levitra (vardenafil), two drugs used for erectile dysfunction, likely increase if they are combined with Rescriptor. In turn, it is best to use a lower dose of these drugs in order to reduce the risk of side effects.

What is known about Rescriptor?

Rescriptor is available in 100mg tablets and 200mg capsules. The total daily dose is 400mg three times a day—either 4 tablets or 2 capsules in the morning, afternoon, and evening. The capsules are swallowed whole with a glass of water, juice, soda, or milk. The tablets can be dissolved in water or another liquid so that they are easier to swallow.

You may take Rescriptor either with or without food.

You should not take Rescriptor within an hour of taking an antacid medicine (e.g., Tums, Mylanta). This is because Rescriptor needs acid in the stomach in order to be absorbed properly.

Some people have a medical condition called achlorhydria. This is a minor problem resulting in low amounts of acid in the stomach. HIV-positive people who have achlorhydria should take Rescriptor with a liquid that contains some acid, such as orange or cranberry juice.

Rescriptor is not approved for use in HIV-positive children. To learn about treatment options available to children.

For HIV-positive adults beginning HIV drug therapy for the first time, Rescriptor is not listed as a recommended NNRTI option by the United States Department of Health and Human Services in its treatment guidelines. The NNRTI Sustiva (efavirenz) is listed as the "preferred" option and the NNRTI Viramune (nevirapine) is listed as an "alternative" option. To learn more about these recommendations and options.

If your viral load becomes detectable while taking a drug regimen that contains Rescriptor, your doctor can order a drug-resistance test to see which drugs your virus are becoming less sensitive to.