Intelence

Intelence is the brand name for etravirine, a non-nucleoside reverse transcriptase inhibitor (NNRTI) used in the treatment of HIV-1 infection. It is prescribed as part of combination antiretroviral therapy for treatment-experienced adults and certain pediatric patients, particularly those with resistance or intolerance to other NNRTIs. Intelence was approved by the U.S. FDA in 2008 and is marketed by Janssen.

Mechanism of action: Etravirine binds to an allosteric site on the HIV-1 reverse transcriptase enzyme, inhibiting viral replication through non-competitive inhibition. Its molecular flexibility allows activity against many NNRTI-resistant strains, contributing to its role in regimens for patients with resistance to first-generation NNRTIs.

Medical uses: Intelence is indicated for treatment-experienced individuals with HIV-1 infection, in combination with other antiretroviral agents. It is often employed in people who have developed resistance to other NNRTIs, or in treatment histories where alternative NNRTIs are unsuitable. It is not typically used as first-line therapy in antiretroviral-naive patients.

Administration and dosage: The usual dose is 200 mg taken orally twice daily with meals to optimize absorption. Patients with hepatic impairment may require dose adjustments, and severe hepatic impairment is generally avoided. Because of drug interactions, concurrent use with certain other medicines must be reviewed with a clinician.

Safety and precautions: Common adverse effects include rash, nausea, diarrhea, fatigue, and headache. Serious rash, hypersensitivity reactions, and hepatotoxicity have been reported, necessitating monitoring of clinical status and liver function tests. Etravirine can interact with other drugs via effects on liver enzymes, so clinicians review concomitant medications for potential interactions. Pregnancy category and pediatric use are considered separately by regulatory guidance.