Capravirine

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Capravirine

Chemical structure of Capravirine

Capravirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that was investigated for the treatment of HIV/AIDS. It belongs to a class of antiretroviral drugs that target the reverse transcriptase enzyme, which is crucial for the replication of the HIV virus.

Mechanism of Action

Capravirine works by binding to the reverse transcriptase enzyme of the HIV virus. This binding inhibits the enzyme's activity, preventing the conversion of viral RNA into DNA, a critical step in the viral replication cycle. By blocking this process, capravirine helps to reduce the viral load in patients infected with HIV.

Development and Clinical Trials

Capravirine was developed as part of efforts to expand the arsenal of drugs available to treat HIV/AIDS, particularly in cases where the virus has developed resistance to other NNRTIs. During clinical trials, capravirine showed promise in reducing viral loads in patients. However, its development was eventually discontinued due to concerns about its efficacy and safety profile compared to other available treatments.

Pharmacokinetics

Capravirine is administered orally and undergoes extensive metabolism in the liver. It is primarily metabolized by the cytochrome P450 enzyme system, which can lead to significant drug-drug interactions. The pharmacokinetic profile of capravirine necessitated careful consideration of dosing regimens to optimize its therapeutic effects while minimizing adverse reactions.

Adverse Effects

Like many antiretroviral drugs, capravirine was associated with a range of potential side effects. Common adverse effects included gastrointestinal disturbances, such as nausea and diarrhea, as well as skin rashes. More serious side effects, although less common, included hepatotoxicity and hypersensitivity reactions.

Discontinuation

The development of capravirine was halted after phase II clinical trials. The decision was based on the emergence of more effective NNRTIs with better safety profiles and fewer drug-drug interactions. As a result, capravirine did not proceed to phase III trials and was never approved for clinical use.

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Contributors: Prab R. Tumpati, MD