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Rilpivirine (TMC278) is a next-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) developed for the treatment of HIV-1 infection. It acts by inhibiting the reverse transcriptase enzyme of HIV-1, thereby preventing viral replication. Omeprazole is a proton pump inhibitor used to reduce gastric acid secretion in conditions such as gastroesophageal reflux disease (GERD), peptic ulcer disease, and Zollinger-Ellison syndrome. When co-administered with rilpivirine (TMC278), omeprazole significantly reduces the plasma concentration of rilpivirine due to increased gastric pH affecting its absorption. This interaction can compromise the efficacy of rilpivirine in treating HIV-1 infection[3][7]. Rilpivirine is primarily developed by Janssen Pharmaceuticals; omeprazole was originally developed by AstraZeneca.
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