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# Doravirine

A newer NNRTI: taken with or without food, independent of stomach acid, with fewer nervous system and lipid effects than efavirenz.

Updated 2026-11-01

- Class: [Non-nucleoside reverse transcriptase inhibitors (NNRTIs)](https://durgical.com/en/pharmacology/classes/non-nucleoside-reverse-transcriptase-inhibitors/)
- Enzyme: HIV-1 reverse transcriptase (NNRTI pocket)
- ATC code: J05AG06

Also called: DOR

✂**HIV-1 reverse transcriptase (NNRTI pocket)**Doravirine

ⓘ The figure shows doravirine in the allosteric pocket of HIV-1 reverse transcriptase.

**Target in 3D:** HIV-1 reverse transcriptase (NNRTI pocket). PDB structure 4NCG (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/4NCG) · Drag to rotate · pinch to zoom

## Mechanism of action

It binds the allosteric pocket of HIV-1 reverse transcriptase and blocks viral DNA synthesis. It keeps activity against some of the commonest resistance mutations to older NNRTIs.

- It binds the allosteric pocket of reverse transcriptase
- It locks the enzyme
- Viral DNA synthesis stops

## Pharmacokinetics

**Absorption**
Absorbed with or without food; proton pump inhibitors do not affect it much

**Metabolism**
Liver, mainly by CYP3A4

## Indications

- HIV-1 infection, combined with other antiretrovirals [HIV infection and AIDS →](https://durgical.com/en/conditions/hiv-infection-and-aids/)

## Adverse effects

### Common

- Nausea, diarrhoea, abdominal pain
- Headache, dizziness, tiredness
- Abnormal dreams

### Serious (rare, important)

- Severe skin reactions (blistering rash, mouth sores)

## Contraindications

- Strong CYP3A inducers: rifampicin, carbamazepine, phenobarbital, phenytoin, St John's wort

## Key interactions

**Rifampicin and inducing anticonvulsants**
Greatly lower doravirine: not combined

**Rifabutin**
Can be used with a doravirine adjustment ordered by the team

## What is monitored

- Viral load and CD4
- Skin

## Administration and safety

- By mouth, with or without food
- Also available combined with lamivudine and tenofovir disoproxil in one tablet

## Nursing care

- Check for inducing drugs (TB drugs, anticonvulsants)
- Teach to report rash with fever or mouth sores
- Keep a full list of medicines and herbal products and review it with pharmacy before any new drug

## Pregnancy and breastfeeding

Antiretroviral treatment in pregnancy protects the mother and lowers HIV transmission to the baby; the treating team chooses the regimen.

## Memory aid

'DORavirine: sleep better than with efavirenz'.

## Test yourself

Think of the answer, then tap the question to see it.

## What practical absorption difference does doravirine have from rilpivirine?

Doravirine needs neither food nor stomach acid; rilpivirine does.

## Why is doravirine not combined with rifampicin?

Rifampicin induces CYP3A4 and greatly lowers doravirine levels, risking failure and resistance.

## Which class is doravirine in and where does it bind?

It is an NNRTI: it binds the allosteric pocket of HIV-1 reverse transcriptase.

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## Related drugs

- [Efavirenz](https://durgical.com/en/pharmacology/efavirenz/)
- [Rilpivirine](https://durgical.com/en/pharmacology/rilpivirine/)

## Related conditions

- [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/)

[← Back to the class: Non-nucleoside reverse transcriptase inhibitors (NNRTIs)](https://durgical.com/en/pharmacology/classes/non-nucleoside-reverse-transcriptase-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Doravirine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a618048.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=J05AG06) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 64 (McGraw Hill, 2023).

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Representative model, for educational purposes only.

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