Darunavir

It is the most recently approved protease inhibitor and is preferred by DHHS guidelines. Darunavir is approved for both initial therapy in naïve HIV-infected patients as well as the treatment of experienced patients with HIV that is resistant to other protease inhibitors. Darunavir must be taken with food to increase absorption. Its terminal elimination half-life is 15 hours when combined with ritonavir. Darunavir is extensively metabolized by the CYP3A enzymes and is also an inhibitor. The side effects are similar to those of the other protease inhibitors with the addition of possible rash. Early reports demonstrate a decreased risk of hyperlipidemia, but it is not known if darunavir is less likely to cause insulin resistance and lipodystrophy, as seen with other protease inhibitors.GI adverse effects and rash occur, and liver toxicity has been reported.Darunavir contains a sulfonamide moiety and should be used with caution in sulfonamide allergy.