Brand name : Virem
Active substances : Darunavir
Strength : 600 mg
Manufactured by : Emcure
Pack : 60 Tablets
Virem 600mg tablets are consist of an active substance known as Darunavir which evacuate anti-retroviral activity, the main ingredient which is used as darunavir. Because appearance of anti-viral medicine resistance which occurred during single use of Virem, the drug administered by combining with other anti-retroviral drugs. Virem 600mg is belongs to HIV protease inhibitor, includes in the treatment of AIDS & HIV infections.
In usual dose 600mg (2 dose of 300mg) taken twice daily (BD) with food in oral administration. While in adult patients the Treatment for no Viremresistance associate substitutions is 800mg ViremOD with Ritonavir OD (once daily) with food. Virem 600mg combination with Ritonavir 100mg BD with food provide treatment for at least one Viremresistance associated substitution is.
Darunavir is drive out an anti-retroviral effect by prohibiting the protease enzyme which is needed for HIV viral multiplication, Dimerization and catalytic effect of HIV-1 protease also forbidden. In virus infected cells, darunavir includes in inhibits the separation of HIV encoded Gag-pol polyproteins, thus the prevention which blocks the production of mature infectious virus particle. Darunavir has molecular affability, so it can easily adapts for changing shape of protease enzymes.
while administration with Ritonavir will produce Tmax( peak plasma concentration)of approx 2.5-4 hrs and bioavailabilty is 37% and 82% of Virem 600mg and ritonavir 100mg.
The human plasma protein bound is 95%.
basically Virem 600mg undergo oxidative metabolism by CYP3A.
After single dose or co administration with Ritonavir will excreted approx 79.5% in feces and 13.9% in urine
Pediatric age of 3 to less than 18 years :
In pediatric patients, Viremshould not be used as single dosing for daily. Dose recommendation should be based on weighing at least 10kg but less than 15 kg; Greater or equal to 10kg to less tan 11kg: The prescribed dose is 200mg of Viremwith 32mg of ritonavir Greater or equal to 11kg to less than 12 kg: The prescribed dose is 220mg of Viremwith 32mg of ritonavir Greater or equal to 12kg to less than 13kg: The prescribed dose is 240mg of Viremwith 40mg of ritonavir Greater or equal to 13kg to less than 14kg: The prescribed dose is 260mg of Viremwith 40mg of ritonavir Greater or equal to 14kg to less than 15kg: The prescribed dose is 280mg of Viremwith 48mg of ritonavir. Dose recommendation for weighing at least 15kg; ≥ 15kg to <30kg: 375mg of Viremwith 50mg ritonavir ≥30kg to <40kg: 450mg of Viremwith 60mg of ritonavir ≥40kg: 600mg of Viremwith 100mg of ritonavir For liver impairment: In mild to moderate hepatic impairment patients, dosage adjustment should not be suggested. In severe hepatic impairment patients, the use of Viremshould not be allowed.
Virem is a sulfonamide moiety, use with cautiously if patients are allergy to sulfonamide. Due to Drug interactions: Some drug – drug interaction may causes severe life threatening conditions. Avoid the combinational therapy. Hemophilia: In protease inhibitor therapies, there is a chance of getting increased bleeding condition leads to skin hematomas & hemarthrosis in patients suffered with hemophilia type A or B Diabetes mellitus: Increasing blood glucose level during the Virem 600mg therapy is a major adverse effect. Monitor the patient’s glucose level during the treatment periodically. Redistribution of fat: The major adverse risk of this condition is obesity. This may generally occurs in anti-retroviral treatments. Immune reconstitution syndrome: This may occurs in Virem 600mg therapy; to overcome the problem therapy should be discontinued.
Interaction of Virem with ritonavir are mostly based on CYP3A for clearance and increased plasma concentration causes life threatening reactions similarily with Interaction with Alfuzosin cause hypotension Interaction with Dihydroergotamine causes peripheral vasospasm sand ischemia. Interaction with Cisapride and pimozide causes cardiac arrhythmias Conicomitant use of Midazolam and triazolam causes respiratory depression.
Category C: In animal studies revealed that in reproduction has an adverse reaction on fetus and there has been no acceptable and well illustrate studies in human but the drug usage in pregnant women assign potential risk for fetus.
Virem 600mg is probably unsafe to use during breastfeeding. Please consult with doctor
The dose is missed by patient, administer the missed dose before the next dose timing reaches or leave the missed dose and follow the regular schedule Please consult the doctor.
Common side effects: Mild nausea,stomach ache, insomnia, itching and rashes,Change in body shape (fat).
Serious side effects :
Signs of allergic reaction like Hives, Dyspnea, Swelling of (face,lips,throat,tongue); Severe hepatomegaly with steatosis; Chest discomfort; Wheezing; Cold sore; increased heart rate; Lumbar pain