PIFELTRO

doravirine (DOR)

Recommended as a component of initial regimen in certain clinical situations

Non-Nucleoside “Non-Nuke”

Pifeltro tablet

STANDARD DOSE

One tablet once daily without regard to food. Tablet contains 100 mg of doravirine. Must be taken in combination with another antiretroviral(s) which does not contain the medication in this drug or medication from the same drug class.

Approved only for adults at this time. Take missed dose as soon as possible, unless it is closer to the time of your next dose. Do not double up on your next dose. No dosage adjustment necessary for mild, moderate, or severe kidney impairment or for mild or moderate liver impairment. Pifeltro has not been studied in patients with severe liver impairment.

MANUFACTURER

Merck and Co.
(800) 622–4477
pifeltro.com

PHARMACY

Drug Mart Pharmacy
shopdrugmart.com
(800) 877-0337

GET STARTED – Request To Fill Your Medication

•    See package insert for more complete information on potential side effects and interactions. 

Most common side effects (at least 5% of people taking it) observed with Pifeltro in studies were nausea (7%), dizziness (7%), headache (6%), fatigue (6%), diarrhea (5%), abdominal pain (5%), abnormal dreams (1%), and increased bilirubin (5%). Rash, which is a common side effect of the NNRTIs, was reported in up to 2% of the studied population. In one study (DRIVE-AHEAD), an in-depth analysis was conducted of the incidence of neuropsychiatric adverse events associated with a doravirine-containing regimen (Delstrigo) compared to Atripla. Neuropsychiatric events, such as depression, sleep disturbances, and dizziness, are another common side effect of the NNRTI class. Doravirine did not appear to negatively affect cholesterol in studied populations.

New interactions continue to be discovered after drug approval. When using with the antibiotic drug rifabutin (used for TB and MAC treatment), increase the Pifeltro dose to one tablet twice a day, approximately every 12 hours. The following are among the medications that may lower the blood levels of Pifeltro, and therefore may decrease its effectiveness, and should not be used with Pifeltro: the anticonvulsants carbamazepine, oxcarbazepine, phenobarbital, and phenytoin; the androgen receptor inhibitor enzalutamide; the antimycobacterials rifampin and rifapentine; the cytotoxic agent (cancer drug) mitotane; and the herbal St. John’s wort. Tell your provider or pharmacist about all medications, herbals, and supplements you are taking or thinking of taking, prescribed or not, as there are other drug interactions which are not listed here.

Received FDA approval in 2018. Doravirine may be an option for patients who have developed drug resistance to other NNRTIs. A single-tablet regimen (STR) containing doravirine was also approved last year; see Delstrigo page. Delstrigo, however, contains the older version of tenofovir, tenofovir DF. The stand-alone Pifeltro allows people to take it with the newer and less toxic tenofovir alafenamide, or TAF (found in Descovy). On the other hand, of course, the use of Pifeltro means the necessity for an extra pill of Descovy, or maybe more than one extra pill, depending on the regimen being used. Merck has applied to the FDA for a switch indication, so that people with undetectable viral load on their current treatment can switch to a Pifeltro-based regimen. Pifeltro was found to be non-inferior to boosted darunavir (Prezista) as well as efavirenz (Sustiva) at 48 weeks. Doravirine was superior to boosted darunavir at week 96 in terms of virologic suppression, but it should be noted there was a higher rate of study discontinuation in the boosted darunavir group. Doravirine is a non-nucleoside medication, and it should be noted that this class of drugs typically has a lower barrier to resistance as well as have extensive cross-resistance. Additionally, the emergence of resistance at the time of virologic failure has been reported with doravirine. Despite the side effects listed above, doravirine has tolerability advantages over efavirenz and has relatively favorable lipid effects when compared with both boosted darunavir and efavirenz. It also has fewer potential drug interactions than efavirenz or rilpivirine, and, unlike rilpivirine, virologic efficacy is not compromised in those with high baseline viral loads or low CD4 counts. Doravirine has not been directly compared to integrase inhibitor-based regimens in clinical trials yet. Because there were significantly fewer people who received doravirine + Epzicom compared to those who received Truvada, the guidelines consider Pifeltro plus Epzicom to be an option for initial therapy but the guidelines panel has less confidence in this regimen than in the other doravirine-containing regimens. There is no data on the safety of doravirine use in pregnancy. In the DRIVE-FORWARD study, comparing doravirine to darunavir, the treatment-naïve individuals in the study were 80% (darunavir group) and 84% (doravirine group) undetectable (less than 50 copies viral load). That’s a lower success rate than is expected in HIV treatment today, but was thought to be affected by the number of people who quickly dropped out of the study when they saw how many pills they had to take. Those drop-outs were counted as virologic failures. Only 1 of 364 doravirine-treated patients developed drug resistance, a low number for an NNRTI; there was no resistance noted in the boosted darunavir group. See more data online. Pifeltro now has a switch indication, so that people with undetectable viral load on a stable HIV treatment can switch to a regimen that includes Pifeltro if they have no drug resistance to it and no history of treatment failure.

Pifeltro is the new Merck once-a-day stand-alone non-nucleoside reverse transcriptase inhibitor used to treat HIV in combination with other HIV medicines. Pifeltro is contained in the single-tablet regimen Delstrigo. This treatment is contraindicated with medications that are metabolized by the P450 enzyme inducer. This enzyme causes a significant decrease in doravirine plasma levels and low plasma levels decrease its effectiveness.

Karen T.
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"They truly care, I tell everyone to go here. I've been with them since 2008."
Yolanda P.
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"Always helpful to save money on medication and very kind."
Michael A.
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"Helpful and knowledgeable. Can't ask for better service, thank you!"
Patti E.
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"The staff at Drug Mart are exceptionally helpful. The quality of their products are top notch. I recommend Drug Mart to everyone. Am with them for life!!"
Darryl F.
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"This is the best pharmacy I have ever been to. They are caring, helpful and treat you with respect."
Anita H.
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"My daughter was able to get emergency medication after hours within half hour of making the phone call to the 800#. I can't recommend Drug Mart more highly."
Robert T.
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"I've been going here for years since my doctor recommended this pharmacy. They're busier now then when I first started but their service is still top notch. Thanks again for all your help!"
David D.
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"They are most accommodating, courteous, friendly and professional pharmacist I've ever dealt with. I'm so grateful to call this pharmacy my own."
Tonia B.
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"Always very caring when asking a question about your medication they know what they're talking about and they are very knowledgeable I've been going to them for oh my goodness since they opened up wow where did time go anyway my drug store for life thank you!"
Josh P.
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"This pharmacy is one of the best. Pharmacist has lots of knowledge and staff takes time to explain in detail. They do other half of what doctors should do. Also, no waiting like big name pharmacy. I highly recommend this pharmacy. They also deliver and ship to anywhere in USA."
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Drug Mart Pharmacy
5.0
Based on 163 reviews
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Chanice Dorsey
Chanice Dorsey
02:45 12 Mar 20
The staff at Drug Mart are truly an extension of my family. Vik offered me one of the greatest opportunities while in... nursing school, as a graduate, and as a working professional. He continues to encourage young adults to pursue their dreams and provides them with opportunities to be impactful within the community. You can’t get any better than this.read more
langston hannah
langston hannah
12:02 07 Mar 20
I am very pleased with the service that I receive from the pharmacy. The people who serve you are very helpful and... friendly and assist you in any way that they can. The pharmacist are well informed with your prescription needs, if there's a problem with anything you need they will do their best to resolve any issue you have. I recommend everyone to check them out and get their prescriptions filled at Drug Mart. I will always be a customer of Drug Mart because they are so good at what they do.read more
Yolanda Mesa
Yolanda Mesa
15:11 05 Mar 20
The best pharmacy I ever went. Staff is very polite and friendly. Very fast and they also deliver. One time I totally... forget about a medication and they went to my house.read more
tracey evans
tracey evans
16:32 03 Mar 20
Drug Mart is my family, I’ve been with them since day 1. I moved away for a few years to another state, I’ve been... back i NJ. a little over 5 years and I’m still a happy customer. They’re very friendly, knowledgeable and very helpful and understanding, prices are better then most..read more
Cassandra Hemby
Cassandra Hemby
21:33 28 Feb 20
I so appreciate the dear people @Drug Mart! I am recovering from cancer and one day while in Chemotherapy I was told I... would need a certain cream right away, but I wouldn't be able to pick it up that day.however there is this very courteous and sweet young lady named Michele that assured me it would be delivered to me in at my daughter's home in Woodbridge, NJ, because that is where I go after having treatment.The kind of caring and compassion received there have made the staff endearing to me and has restored my faith in customer service again.read more
Denise Eady
Denise Eady
20:38 24 Feb 20
I love this place. Best pharmacy around!!!. I have been using this pharmacy since it opened. Whenever I walk in,... everyone is very cordial and always pleasant and with a smile, and they always greet me by nmy name. Vic and the other Pharmacists are very knowledgeable, and the staff takes the time to explain any new medications in detail. If you are not able to pick up your prescriptions, they do HOME delivery which is great. I transferred from Walgreens pharmacy and I am so glad I did!!!read more
Jay Bhatt
Jay Bhatt
21:05 22 Feb 20
The quality of service provided by the pharmacist and the staff is excellent! I wouldn't go to any other pharmacy. They... truly care.read more
Cindy Hall
Cindy Hall
15:21 20 Feb 20
I never have to wait. This is the best pharmacy I ever went to. I highly recommend them to everyone!
Maisha Bryant
Maisha Bryant
00:32 20 Feb 20
I have known Vik and his family since they opened. They have bright back what it means to have a home town family... operated pharmacy. He remembers you, that you have had a baby etc. He is compassionate and always goes above and beyond. He trains his staff to pursue their own dreams. Some have gone on to school. My prayer is that God gives him a long healthy life and that his business continues to prosper. Oh and BTW if you move he does mail order so he can continue to be your pharmacist no need to switch!read more
Sharel E. Gordon-Love
Sharel E. Gordon-Love
19:46 19 Feb 20
My family has been with Drug Mart since they first open and we’ve received top notch service every single time. Vic... and the staff are very friendly, and we are greeted with a smileread more
Tammy Nichols
Tammy Nichols
23:23 18 Feb 20
I used to get my prescriptions at Cvs. But when Drug Mart open close to my house i figured I give then a try and have... not looked back. The staff is always kind, helpful, and considerate. LOVE THIS PLACE.❤read more
Yolanda Parker
Yolanda Parker
20:50 17 Feb 20
I enjoyed the customer service I experience when I go into this store the friendly atmosphere the warm welcome you get... upon entering and exitingread more
Mike Webb
Mike Webb
16:48 06 Feb 20
Great being able to pick up my meds at this pharmacy. They are the best!
Janet Bynum
Janet Bynum
18:21 28 Jan 20
Leaving his experience I had with Drug Mart it's coming there getting my medication and then delivering it to me very... happy who had Drug Mart in my life far as my medications is concerned I don't have to call for refills they deliver them to me I've been the drug mart play my medications concern about 7 years or more appreciate the people they appreciate me I'm happy with Drug Mart this is my the best pharmacist that I know thank youread more
james hunter
james hunter
21:25 24 Jan 20
Always ready to help! Any way possible thank you for all your years of service!
Michelle Reyes
Michelle Reyes
21:03 24 Jan 20
Awesome staff always willing to help out 🙂
cindy ortega
cindy ortega
20:41 24 Jan 20
I love this pharmacy. Everyone makes you feel like your family. Any issues with prescription they try to resolve it... asap. I recommend this pharmacy to everyone.read more
jacqueline wells
jacqueline wells
19:33 31 Dec 19
Drug mart has the most pleasant employees and the service is swift I can't say enough good things about this pharmacy... Thanks for your years of dedication and service in our communityread more
Chris Hanington
Chris Hanington
13:47 18 Jul 19
These people take great care of THEIR people. Impressive!
R Turner
R Turner
21:57 01 Jun 19
I've been going here for years since my doctor recommended this pharmacy. They're busier now then when I first started... but their service is still top notch. Thanks again for all your help!read more
John Aleksandrowicz
John Aleksandrowicz
22:21 14 Apr 19
Great pharmacy with great customer service. Vik is great. He obviously cares about people and understands the needs of... each. Thank you!read more
Karen T
Karen T
18:54 06 Jan 19
This pharmacy is the best! I left Walgreens and very glad I did. They take the time to explain my medicines and know me... by name. I recommended them to all my family and friends.read more
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