What are the HIV postexposure prophylaxis (PEP) regimens for patients older than 13 years with chronic kidney disease?

Updated: Jul 08, 2021
  • Author: Derek T Larson, DO; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Patients older than 13 years with chronic kidney disease (CrCl < 60 mL/min)

The preferred 3-drug regimen is as follows:

  • Renally dose-adjusted  zidovudine and  lamivudine daily  AND
  • Raltegravir 400 mg twice daily  OR dolutegravir 50 mg once daily

Caution: Coadministration of raltegravir or dolutegravir with antacids or cations (iron, calcium, or magnesium) can reduce drug absorption and therefore efficacy of PEP.

An alternative regimen is as follows:

  • Renally adjusted zidovudine and lamivudine daily  AND
  • Darunavir 800 mg daily  AND
  • Ritonavir 100 mg daily OR cobicistat 150 mg daily (as pharmacokinetic booster)

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