Alternative drugs

The drugs below can sometimes be used for first-line ART.

This should only be if the preferred meds can’t be used. For example if there is drug resistance or difficult side effects.

Doravirine

Doravirine is a once-daily NNRTI that can be taken with or without food.

It was approved in 2019 and is also available as part of a single pill Delstrigo with TDF and lamivudine.

Raltgravir

Raltgravir is a once-daily integrase inhibitor given as two pills.

It can beonly be used if viral load is less than 100,000 copies/mL

Darunavir

Darunavir is the only protease inhibitor (PI) recommended in the UK.

It needs to be boosted by ritonavir or cobicistat.

It also needs to be taken with food.

Side effects from ritonavir and cobicistat include stomach upset, diarrhoea, nausea and increases in lipids. This is why PIs are nota preferred first choice.

The boosters interact with other meds including inhaled, injectable, nasal spray and topical steroids.

Ritonavir or cobicistat can be given as separate pills. There are also single pill version of darunavir/cobicistat (Rezolsta).

Last updated: 1 June 2022.