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This safety and warning information is essential for the safe use of Pifeltro (doravirine). Please read carefully and discuss with your healthcare provider if you have any concerns or questions.

• Serious Drug Interactions: It is crucial to provide your healthcare team with a comprehensive list of all medications you are currently taking, including over-the-counter drugs and supplements. Avoid starting any new medication without consulting your healthcare provider or pharmacist, as Pifeltro (doravirine) can interact with various drugs. Notably, interactions with carbamazepine (Tegretol), rifampin (Rifadin), and nevirapine (Viramune) can reduce the effectiveness of Pifeltro by lowering its levels in your body. Be cautious if you are on multiple medications.

• Immune Reconstitution Syndrome: As Pifeltro (doravirine) begins to work, it can trigger an immune response leading to inflammation. This occurs because the medication helps your immune system recover and become more active in combating infections. While this is beneficial, it can also cause significant inflammation. Your healthcare provider may conduct tests to detect infections before you start Pifeltro, especially if this is your first HIV antiretroviral treatment. If other infections are present, they might need treatment before commencing Pifeltro. Contact your provider if you experience symptoms such as fever, breathing difficulties, or sudden health changes after beginning the medication.

• Contraindications: Pifeltro (doravirine) should not be used alongside medications that significantly affect its metabolism, such as the herbal supplement St. John's wort, certain antiseizure drugs, and some tuberculosis treatments. If any of these apply to you, consult your healthcare provider before using this medication.

By adhering to these guidelines and consulting with your healthcare provider, you can minimize risks and ensure the effective use of Pifeltro (doravirine).

When taking this medication, some individuals may experience common side effects, which are generally mild. These may include dizziness, nausea, headache, extreme tiredness, diarrhea, stomach pain, and unusual dreams. While these effects often resolve on their own, it's advisable to consult your healthcare provider if they persist or worsen.

Occasionally, other side effects such as rash, trouble sleeping, sleepiness, and confusion may occur. If these happen, especially in a severe form, it's important to reach out to your healthcare provider for guidance.

There are also rare but serious side effects that necessitate immediate medical attention. These include signs of an allergic reaction, such as skin rash, itching, or swelling of the face, lips, tongue, or throat. Additionally, symptoms of an infection like fever, chills, or a persistent cough, and severe skin reactions such as redness, blistering, or peeling, should be promptly addressed by a medical professional.

Furthermore, as your immune system strengthens, it might become overactive or begin to fight off existing infections, leading to symptoms like unexplained weight loss, persistent severe tiredness, muscle aches, vision changes, or signs of an overactive thyroid. It's crucial to seek medical help if you encounter any of these serious symptoms. Changes in body fat distribution might also occur, and while their long-term effects are unknown, discussing potential exercises to mitigate this with your doctor could be beneficial. Always stay vigilant for any other effects not listed, and consult your healthcare provider if you notice anything unusual.