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Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States

Non-Nucleoside Reverse Transcriptase Inhibitors

Rilpivirine (Edurant, RPV)

(Last updated: March 28, 2014; last reviewed: March 28, 2014)

Rilpivirine is classified as Food and Drug Administration Pregnancy Category B.

Animal Carcinogenicity Studies

Rilpivirine was neither mutagenic nor clastogenic in a series of in vitro and animal in vivo screening tests. Rilpivirine was not carcinogenic in rats when administered at doses 3 times higher than exposure in humans at the recommended dose of 25 mg once daily. Hepatocellular neoplasms were observed in both male and female mice at doses 21 times that of human therapeutic exposure; the observed hepatocellular findings in mice may be rodent-specific.

Reproduction/Fertility 

No effect on fertility was observed when rilpivirine was tested in rats at maternal doses up to 400 mg/kg/day, resulting in systemic drug exposure equivalent to 40 times the recommended human dose.

Teratogenicity/Developmental Toxicity

No evidence of embryonic or fetal toxicity or an effect on reproductive function was observed in rat and rabbit dams treated with rilpivirine during pregnancy and lactation at doses 15 and 70 times higher, respectively, than exposure in humans at the recommended dose of 25 mg once daily.

Placental and Breast Milk Passage 

No data exist on whether rilpivirine crosses the placenta or is excreted in breast milk in humans. Studies in lactating rats and their offspring indicate that rilpivirine is present in rat milk

Human Studies in Pregnancy

No adequate and well-controlled studies of rilpivirine use in pregnant women have been conducted.

Reference

  1. Rilpivirine [package insert]. Food and Drug Administration. Available at http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/202022s005lbl.pdf. Accessed on February 14, 2014. 

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