13
Table 6. Renal and Hepatic Dosing (continued)
ARVs
Generic Name
(Abbreviation)
Trade Name
Usual Daily
Dose
a
Dosing in Renal
Insufficiency
b
Dosing in Hepatic
Impairment
Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
Efavirenz
(EFV)
Sustiva
®
600 mg PO once
daily, at or before
bedtime
No dosage
adjustment
necessary
No dosage
recommendation; use with
caution in patients with
hepatic impairment.
Etravirine
(ETR)
Intelence
®
200 mg PO bid No dosage
adjustment
necessary
Child-Pugh Class A or B:
• No dosage adjustment
Child-Pugh Class C:
• No dosage rec.
Rilpivirine
(RPV)
Edurant
®
25 mg PO once
daily
No dosage
adjustment
necessary
Child-Pugh Class A or B:
• No dosage adjustment
Child-Pugh Class C:
• No dosage rec.
Protease Inhibitors (PIs)
Atazanavir
(ATV)
Reyataz
®
400 mg PO once
daily or ATV 300
mg + RTV 100 mg
PO once daily
No dosage
adjustment for
patients with renal
dysfunction who
do not require HD
ARV-Naive
Patients on HD:
• ATV 300 mg +
RTV 100 mg
once daily
ARV-Experienced
Patients on HD:
• ATV or
ATV/r NOT
recommended
Child-Pugh Class B:
• 300 mg once daily
Child-Pugh Class C:
• NOT recommended
• RTV boosting is NOT
recommended in
patients with hepatic
impairment (Child-
Pugh Class B or C).
Darunavir
(DRV)
Prezista
®
DRV 800 mg +
RTV 100 mg PO
once daily (ARV-
naive patients only)
otherwise DRV
600 mg + RTV
100 mg PO bid
No dosage
adjustment
necessary
Mild-to-Moderate
Hepatic Impairment:
• No dosage adjustment
Severe Hepatic
Impairment:
• NOT recommended
Ritonavir-
Boosted
Lopinavir
(LPV/r)
Kaletra
®
LPV/r 400/100 mg
PO bid or LPV/r
800/200 mg PO
once daily
Avoid once-daily
dosing in patients
on HD.
Mild-to-Moderate
Hepatic Insufficiency:
• No dosage adjustment
necessary
Severe Hepatic
Insufficiency:
• No recommendation
