Zepdon
Zepdon (Raltegravir 400 mg) — Cipla first-in-class integrase strand transfer inhibitor for HIV-1. 400 mg twice daily with NRTI backbone. Preferred in pregnancy.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
Quick Answer
Zepdon — Raltegravir 400 mg (Cipla Inc). First-in-class integrase strand transfer inhibitor. 400 mg BID. Combined with two NRTIs for complete regimen. Preferred in pregnancy and where CYP interactions are problematic.
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INSTIs have a higher genetic barrier than NNRTIs but resistance does occur with poor adherence. >95% adherence remains the goal. Always monitor viral load every 3-6 months.
How integrase inhibitors work
Integrase strand transfer inhibitors (INSTIs) block the HIV integrase enzyme that splices viral DNA into the host genome. Without integration, viral replication cannot proceed. Modern INSTIs (raltegravir, dolutegravir, bictegravir, elvitegravir, cabotegravir) are highly potent, well-tolerated, and have a higher genetic barrier to resistance than NNRTIs.
INSTI-based regimens are the WHO and US/EU guideline first-line for adult HIV — typically combined with two NRTIs (TDF/FTC, TAF/FTC, or ABC/3TC) for a complete regimen.
Side effects
- Generally well tolerated — much better than older NNRTIs and PIs
- Insomnia, vivid dreams, headache (especially raltegravir, dolutegravir)
- Weight gain (more with dolutegravir, bictegravir than raltegravir) — monitor BMI long-term
- Modest creatinine rise (cobicistat, dolutegravir) — pseudo-rise from inhibition of tubular creatinine secretion, not true renal injury
- Hepatic transaminase rises (rare) — monitor LFTs first 6 months
- Cabotegravir injection-site reactions (long-acting form)
INSTIs chelate with calcium, magnesium, aluminium, and iron. Separate the dose from antacids, iron supplements, multivitamins, and calcium-containing supplements by 2 hours before or 6 hours after.
Frequently Asked Questions
Why are INSTIs first-line?
High potency, fast viral suppression, high genetic barrier to resistance, generally well-tolerated, fewer drug interactions, broad activity across HIV-1 subtypes. WHO 2018-onward and US DHHS/EACS guidelines all prefer INSTI-based first-line regimens.
Drug interactions?
INSTIs chelate with polyvalent cations (Mg2+, Al3+, Fe2+, Ca2+) — separate from antacids, iron, calcium, multivitamins by 2 hours before / 6 hours after. Otherwise relatively few interactions; cobicistat-boosted versions (elvitegravir/c) have CYP3A4 issues, raltegravir has fewest interactions.
What about resistance?
Higher genetic barrier than NNRTIs but resistance does emerge with poor adherence — monitor viral load and intervene early.
Pregnancy?
Dolutegravir is safe in pregnancy (initial Tsepamo signal of neural tube defects has been refuted by larger cohorts; risk is no different from other ART). Raltegravir is also safe with extensive pregnancy data.
Side effects?
Insomnia, vivid dreams, headache, weight gain, modest serum creatinine rise (mostly cosmetic — does not reflect true renal damage).
Long-acting injectables?
Cabotegravir + rilpivirine long-acting IM (every 1-2 months) is approved for stable, virologically suppressed adults — alternative to daily oral therapy. Lenacapavir is a newer option.
What if I miss a dose?
Take it when you remember if <6 hours late. If >6 hours late, skip and resume — do not double up. Repeated missed doses risk resistance.
HBV co-infection?
INSTIs do not treat HBV. Use a TDF- or TAF-containing NRTI backbone for HBV/HIV co-infection — never abruptly stop these drugs without hepatology supervision.
Will I need lifelong therapy?
Yes — current treatment requires lifelong ART. Long-acting injectables reduce daily pill burden but still represent ongoing therapy. Cure research (CRISPR, broadly neutralising antibodies, latency reversal) is active but not yet clinical.
What about cardiometabolic effects?
Some INSTIs (dolutegravir, bictegravir) and TAF have been associated with weight gain and metabolic shifts. Monitor weight, BP, lipids, glucose annually. Manage CV risk independently.
Other HIV & Antiviral Medications
- Trioday — TDF + 3TC + EFV — single-tablet regimen by Cipla
- Triomune — d4T + 3TC + NVP — older 3-in-1 (stavudine-based)
- Zepdon — raltegravir 400 mg — integrase inhibitor
- Abamune L — abacavir + lamivudine — alternative NRTI backbone
- Tenvir L — tenofovir + lamivudine — alternative NRTI backbone
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| Strength | 400 mg |
|---|---|
| Quantity | 60 Tablet/s, 120 Tablet/s, 180 Tablet/s |
| Pharma Form | Tablet/s |
| Manufacturer | Cipla Inc |
| Treatment | HIV Infection |
| Generic Brand | Raltegravir |
Zepdon
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