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WARNING: POSTTREATMENT ACUTE EXACERBATION OF HEPATITIS B VIRUS (HBV)<\/strong><\/strong> FOR DELSTRIGO<\/em><\/strong><\/p>\n\n\n\nAll patients with HIV-1 should be tested for the presence of HBV<\/strong><\/strong><\/strong> before initiating ARV therapy. Severe acute exacerbations of HBV have been reported in people with concomitant HIV-1 and HBV who have discontinued products containing lamivudine or tenofovir disoproxil fumarate (TDF), which are components of DELSTRIGO. Patients coinfected with HIV-1<\/span> and HBV who discontinue DELSTRIGO should be monitored with both clinical and laboratory follow-up for at least several months after stopping DELSTRIGO. If appropriate, initiation of anti-HBV therapy may be warranted.<\/strong><\/p>\n<\/div><\/div><\/div><\/div>\n\n\n\n<\/div>\n\n\n\n
Contraindications<\/strong><\/p>\n\n\n\n<\/div>\n\n\n\n
PIFELTRO and DELSTRIGO are contraindicated when coadministered with drugs that are strong cytochrome P450 (CYP)3A enzyme inducers (including the anticonvulsants carbamazepine, oxcarbazepine, phenobarbital, and phenytoin; the androgen receptor inhibitor enzalutamide; the antimycobacterials rifampin and rifapentine; the cytotoxic agent mitotane; and the herbal product St. John\u2019s wort (Hypericum perforatum<\/em>)), as significant decreases in doravirine plasma concentrations may occur, which may decrease the effectiveness of DELSTRIGO and PIFELTRO.<\/p>\n\n\n\n<\/div>\n\n\n\n
DELSTRIGO is contraindicated in patients with a previous hypersensitivity reaction to lamivudine.<\/p>\n\n\n\n
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Warnings and Precautions<\/strong><\/p>\n\n\n\n<\/div>\n\n\n\n
Severe Skin Reactions<\/strong><\/em>
Severe skin reactions, including Stevens-Johnson syndrome (SJS)\/toxic epidermal necrolysis (TEN), have been reported during the postmarketing experience with doravirine-containing regimens. Discontinue PIFELTRO or DELSTRIGO, and other medications known to be associated with severe skin reactions, immediately if a painful rash with mucosal involvement or a progressive severe rash develops. Clinical status should be closely monitored, and appropriate therapy should be initiated.<\/p>\n\n\n\n<\/div>\n\n\n\n
![\"\"](\"https:\/\/www.merckconnect.com\/doravirine\/wp-content\/uploads\/sites\/129\/2025\/01\/CAT_DELSTRIGO_resistance_48week_chart_RGB_MC.svg\")
![\"Graphic](\"https:\/\/www.merckconnect.com\/doravirine\/wp-content\/uploads\/sites\/129\/2025\/05\/DEL_Resistance_144Wk_907d20.svg\")