References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Etravirine (brand name Intelence) is a next-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) used to treat HIV. It was designed to work against HIV strains that have become resistant to older NNRTIs like efavirenz and nevirapine. This makes it a useful option for people with treatment experience who need a new combination.
Here’s how etravirine works, when it’s used, and what to expect.
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How Etravirine Works
Like other NNRTIs, etravirine blocks HIV’s reverse transcriptase enzyme, stopping the virus from converting its RNA into DNA. What sets etravirine apart is its flexibility — it can bind to reverse transcriptase even when the enzyme has changed shape due to drug resistance mutations. This gives it activity against many NNRTI-resistant strains.
When Is Etravirine Used?
- In treatment-experienced adults who have resistance to first-generation NNRTIs
- As part of an optimised background regimen, usually with a boosted protease inhibitor
- When other options are limited by resistance or side effects
Etravirine is not commonly used as a first-line treatment because newer drugs like dolutegravir and bictegravir are preferred.
How to Take Etravirine
| Detail | Guidance |
|---|---|
| Dose | 200mg twice daily |
| With food | Yes — always take after a meal |
| Tablet type | Tablet — can be dissolved in water if needed |
Side Effects
- Rash — the most common side effect, usually mild and self-limiting. Severe rash (Stevens-Johnson syndrome) is rare but requires immediate medical attention
- Nausea
- Diarrhoea
- Headache
- Peripheral neuropathy (tingling in hands or feet, uncommon)
Drug Interactions
Etravirine interacts with many medications because it both inhibits and induces liver enzymes. Important interactions include:
- Tipranavir, full-dose ritonavir — not recommended together
- Some statins — dose adjustments needed
- Clopidogrel — reduced effectiveness
- Some antifungals and antibiotics
- St John’s Wort — avoid
Always give your full medication list to your HIV team and pharmacist.
Read more: What is HIV? | Nevirapine | HIV and the immune system
Frequently Asked Questions
Can etravirine work if I’m resistant to efavirenz?
In many cases, yes. Etravirine was designed to overcome common NNRTI resistance mutations. Your HIV team will check your resistance profile to confirm it’s likely to work.
Why is etravirine taken twice daily?
The drug’s pharmacokinetics require twice-daily dosing to maintain effective levels. This is a downside compared to once-daily integrase inhibitors.
Is the rash dangerous?
Most etravirine rashes are mild and settle on their own. Severe skin reactions are very rare. Contact your HIV clinic promptly if a rash spreads or is accompanied by fever, blistering or mouth sores.
Related reading
- Efavirenz for HIV: An Older NNRTI Still in Use
- Eviplera: How This Anti-HIV Drug Works
- Dolutegravir: A Complete Guide to This HIV Medication
- Understanding Efavirenz in HIV Treatment
- Injectable HIV Treatment: Everything You Need to Know
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
