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INTEGRASE STRAND TRANSFER INHIBITOR (INSTI)
Isentress and Isentress HD (raltegravir) are prescription medications approved by the U.S. Food and Drug Administration (FDA) to treat human immunodeficiency virus type 1 (HIV-1) infection in adults and children at least 2 kilograms.
These insights are based on 150 comments about Isentress from myHIVteam members. These are the experiences of a small number of people and are not meant to be medical advice.
Benefits:
Considerations:
Isentress/Isentress HD is an antiviral medicine called an integrase inhibitor. It blocks HIV integrase, an enzyme HIV-1 needs to make more copies of itself.
Doctors prescribe Isentress and Isentress HD with other HIV medicines to treat HIV-1 infection in adults and children who meet the age and weight requirements.
HIV-1 is the virus that causes acquired immune deficiency syndrome (AIDS).
Isentress comes as film-coated tablets, chewable tablets, and an oral suspension. Isentress HD comes as film-coated tablets. The medicine may be taken with or without food.
Isentress and Isentress HD film-coated tablets should be swallowed whole. Isentress chewable tablets may be chewed or swallowed whole. For children who cannot chew the 25-milligram chewable tablet, it may be crushed as directed in the prescribing information and by the healthcare provider.
For adults who have not taken HIV treatment before or who are virologically suppressed on an initial Isentress 400-milligram twice-daily regimen, the recommended dose may be:
For treatment-experienced adults, the recommended Isentress dose is generally 400 milligrams by mouth twice daily.
When Isentress is taken with rifampin in adults, the recommended dose is 800 milligrams by mouth twice daily.
Doses for babies, children, and adolescents depend on age, body weight, treatment history, and the Isentress formulation being used. Pediatric doses may be given once daily or twice daily depending on these factors.
Do not switch between Isentress film-coated tablets, chewable tablets, oral suspension, or Isentress HD without first talking with your healthcare provider.
This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 150 comments about Isentress from myHIVteam members.
Members who use Isentress often say it helps to stay alert to side effects, keep up with lab work, and talk openly with a doctor about any changes. Many also mention that having a routine for taking doses and asking about treatment options or interactions can make day-to-day treatment feel more manageable.
Ask your doctor about reactions that do not go away.
“I have suffered from continuous itchy skin that at times can become unbearable. Later I realized I was allergic to Isentress, caused extreme rashes, and had to be hospitalized.”
Stick to a dosing routine and try not to miss doses.
“Pretty much after 22 years I’ve adapted to a schedule. In the a.m. right after breakfast, usually around 7 a.m. Then immediately after lunch around 1 p.m. meds are taken. Night time right before bedtime around 9 p.m.”
Keep track of side effects and tell your doctor.
“Recently, I have developed a pain in my left knee and have spasms in the same leg at night, so I have a call into my ID to talk to him about it.”
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In clinical studies of Isentress and Isentress HD, the most common side effects occurred in about 2 percent to 6 percent of people. These include:
Isentress can cause serious side effects that may require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Merck & Co., Inc, the manufacturer of Isentress and Isentress HD, offers a savings coupon. Eligible people with private insurance may pay as little as $0 in out-of-pocket costs, up to a maximum program benefit of $6,800.
The program is not available to people who are uninsured or enrolled in Medicare or other government insurance programs.
To learn more, visit the savings coupon website.
Before you take Isentress or Isentress HD, tell your doctor if you:
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements. Some medicines may interact with Isentress or Isentress HD.
Do not stop taking Isentress or Isentress HD or let your supply run out without speaking with your healthcare provider. The amount of virus in your blood may increase, and the virus may become harder to treat.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Isentress, talk with your doctor about the risks and benefits.
A pregnancy exposure registry monitors pregnancy outcomes in people exposed to Isentress or Isentress HD. Healthcare providers can register pregnancies by visiting the Antiretroviral Pregnancy Registry or calling 800-258-4263.
Do not breastfeed if you have HIV-1 because HIV-1 can pass to your baby through breast milk.
These answers are fact-checked by our editorial staff.
How effective are Isentress and Isentress HD for HIV?
Clinical studies found that Isentress and Isentress HD, when taken with other HIV medicines, can lower the amount of HIV-1 in the blood.
In adults starting HIV treatment for the first time, 66 percent of people taking Isentress 400 milligrams twice daily had HIV-1 RNA levels below 50 copies per milliliter at week 240.
In another study of adults starting HIV treatment for the first time, 82 percent of people taking Isentress HD 1,200 milligrams once daily and 80 percent of people taking Isentress 400 milligrams twice daily had HIV-1 RNA levels below 40 copies per milliliter at week 96.
In adults who had taken HIV treatment before, 55 percent of people taking Isentress 400 milligrams twice daily with optimized background therapy had HIV-1 RNA levels below 50 copies per milliliter at week 96, compared with 27 percent of people taking placebo with optimized background therapy.
How long do Isentress and Isentress HD take to work for HIV?
In a short study in which raltegravir was given alone, HIV-1 RNA levels dropped by an average of about 1.66 log10 copies per milliliter by day 10.
Isentress and Isentress HD should always be taken with other HIV medicines as prescribed. Clinical studies measured treatment response over longer periods, including several weeks and months.
Can Isentress cause rash or allergic reactions in people taking it for HIV?
Yes. Severe and sometimes life-threatening or fatal skin reactions have been reported with Isentress and Isentress HD. These include Stevens-Johnson syndrome and toxic epidermal necrolysis.
Serious allergic reactions have also been reported. Symptoms may include a rash with fever, feeling generally ill, extreme tiredness, muscle or joint aches, blisters, mouth sores, eye inflammation, swelling of the face, trouble breathing, or signs of liver problems.
If these symptoms happen, stop Isentress or Isentress HD and any other suspected medicines right away and get medical help immediately.
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