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Details

Stereochemistry ACHIRAL
Molecular Formula C22H28N6O3S
Molecular Weight 456.561
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of DELAVIRDINE

SMILES

CC(C)NC1=CC=CN=C1N2CCN(CC2)C(=O)C3=CC4=C(N3)C=CC(NS(C)(=O)=O)=C4

InChI

InChIKey=WHBIGIKBNXZKFE-UHFFFAOYSA-N
InChI=1S/C22H28N6O3S/c1-15(2)24-19-5-4-8-23-21(19)27-9-11-28(12-10-27)22(29)20-14-16-13-17(26-32(3,30)31)6-7-18(16)25-20/h4-8,13-15,24-26H,9-12H2,1-3H3

HIDE SMILES / InChI
Delavirdine is a nonnucleoside reverse transcriptase inhibitor (NNRTI). Delavirdine binds directly to reverse transcriptase (RT) and blocks RNA-dependent and DNA-dependent DNA polymerase activities. Delavirdine does not compete with template:primer or deoxynucleoside triphosphates. HIV-2 RT and human cellular DNA polymerases alfa, gamma, or delta are not inhibited by delavirdine. In addition, HIV-1 group O, a group of highly divergent strains that are uncommon in North America, may not be inhibited by delavirdine. Delavirdine is marketed under the trade name Rescriptor, indicated for the treatment of HIV-1 infection in combination with at least 2 other active antiretroviral agents when therapy is warranted. .

Originator

Curator's Comment: # Pfizer

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
RESCRIPTOR

Approved Use

RESCRIPTOR Tablets are indicated for the treatment of HIV-1 infection in combination with at least 2 other active antiretroviral agents when therapy is warranted. The following should be considered before initiating therapy with RESCRIPTOR in treatment-naive patients. There are insufficient data directly comparing antiretroviral regimens containing RESCRIPTOR with currently preferred 3-drug regimens for initial treatment of HIV. In studies comparing regimens consisting of 2 nucleoside reverse transcriptase inhibitors (NRTIs) (currently considered suboptimal) to RESCRIPTOR plus 2 NRTIs, the proportion of patients receiving the regimen containing RESCRIPTOR who achieved and sustained an HIV-1 RNA level <400 copies/mL over 1 year of therapy was relatively low (see DESCRIPTION OF CLINICAL STUDIES). Resistant virus emerges rapidly when RESCRIPTOR is administered as monotherapy. Therefore, RESCRIPTOR should always be administered in combination with other antiretroviral agents.

Launch Date

1997
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
12.6 μM
200 mg 3 times / day steady-state, oral
dose: 200 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
18.8 μM
300 mg 3 times / day steady-state, oral
dose: 300 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
26.6 μM
400 mg 3 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
2.18 μM
200 mg 3 times / day steady-state, oral
dose: 200 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
N-DESISOPROPYL DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
2.88 μM
300 mg 3 times / day steady-state, oral
dose: 300 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
N-DESISOPROPYL DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
3.23 μM
400 mg 3 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
N-DESISOPROPYL DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
35 μM
400 mg 3 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
180 μM × h
400 mg 3 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
2.59 h
200 mg 3 times / day steady-state, oral
dose: 200 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
3.33 h
300 mg 3 times / day steady-state, oral
dose: 300 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
4.12 h
400 mg 3 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
4.71 h
200 mg 3 times / day steady-state, oral
dose: 200 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
N-DESISOPROPYL DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
6.18 h
300 mg 3 times / day steady-state, oral
dose: 300 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
N-DESISOPROPYL DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
7.5 h
400 mg 3 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
N-DESISOPROPYL DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
5.8 h
400 mg 3 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
2.3%
200 mg 3 times / day steady-state, oral
dose: 200 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
2.3%
300 mg 3 times / day steady-state, oral
dose: 300 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
2.3%
400 mg 3 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: MALE
food status: UNKNOWN
2%
400 mg 3 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
DELAVIRDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
400 mg 3 times / day steady, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: steady
Dose: 400 mg, 3 times / day
Sources:
unhealthy, >18 years
Health Status: unhealthy
Age Group: >18 years
Sex: M+F
Sources:
Disc. AE: Rash, Oral lesion...
Other AEs: Fever, Thrombocytopenia...
AEs leading to
discontinuation/dose reduction:
Rash (grade 3-4, 36%)
Oral lesion (1 patient)
Function liver abnormal (2 patients)
Headache (grade 4, 1 patient)
Other AEs:
Fever (grade 3, 1 patient)
Thrombocytopenia (1 patient)
Nausea (1 patient)
Fatigue (1 patient)
Sources:
400 mg 3 times / day multiple, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: multiple
Dose: 400 mg, 3 times / day
Sources:
unhealthy
Disc. AE: Rash...
AEs leading to
discontinuation/dose reduction:
Rash (3.2%)
Sources:
AEs

AEs

AESignificanceDosePopulation
Fatigue 1 patient
400 mg 3 times / day steady, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: steady
Dose: 400 mg, 3 times / day
Sources:
unhealthy, >18 years
Health Status: unhealthy
Age Group: >18 years
Sex: M+F
Sources:
Nausea 1 patient
400 mg 3 times / day steady, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: steady
Dose: 400 mg, 3 times / day
Sources:
unhealthy, >18 years
Health Status: unhealthy
Age Group: >18 years
Sex: M+F
Sources:
Thrombocytopenia 1 patient
400 mg 3 times / day steady, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: steady
Dose: 400 mg, 3 times / day
Sources:
unhealthy, >18 years
Health Status: unhealthy
Age Group: >18 years
Sex: M+F
Sources:
Oral lesion 1 patient
Disc. AE
400 mg 3 times / day steady, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: steady
Dose: 400 mg, 3 times / day
Sources:
unhealthy, >18 years
Health Status: unhealthy
Age Group: >18 years
Sex: M+F
Sources:
Function liver abnormal 2 patients
Disc. AE
400 mg 3 times / day steady, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: steady
Dose: 400 mg, 3 times / day
Sources:
unhealthy, >18 years
Health Status: unhealthy
Age Group: >18 years
Sex: M+F
Sources:
Fever grade 3, 1 patient
400 mg 3 times / day steady, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: steady
Dose: 400 mg, 3 times / day
Sources:
unhealthy, >18 years
Health Status: unhealthy
Age Group: >18 years
Sex: M+F
Sources:
Rash grade 3-4, 36%
Disc. AE
400 mg 3 times / day steady, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: steady
Dose: 400 mg, 3 times / day
Sources:
unhealthy, >18 years
Health Status: unhealthy
Age Group: >18 years
Sex: M+F
Sources:
Headache grade 4, 1 patient
Disc. AE
400 mg 3 times / day steady, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: steady
Dose: 400 mg, 3 times / day
Sources:
unhealthy, >18 years
Health Status: unhealthy
Age Group: >18 years
Sex: M+F
Sources:
Rash 3.2%
Disc. AE
400 mg 3 times / day multiple, oral
Highest studied dose
Dose: 400 mg, 3 times / day
Route: oral
Route: multiple
Dose: 400 mg, 3 times / day
Sources:
unhealthy
Overview

Overview

CYP3A4CYP2C9CYP2D6hERG



OverviewOther

Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
negligible
yes [Inhibition 16.7 uM]
yes [Inhibition 16.7 uM]
yes [Inhibition 16.7 uM]
yes [Ki 12.8 uM]
yes [Ki 2.6 uM]
yes [Ki 24 uM]
yes [Ki 9.5 uM]
yes (co-administration study)
Comment: coadministration of amprenavir with delavirdine resulted in an approximately 4-fold increase in amprenavir AUC to infinity (AUC∞) and a 6-fold increase in amprenavir Cmin
Page: 3.0
yes
yes
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
likely
no
yes
yes (co-administration study)
Comment: Coadministration of RESCRIPTOR and drugs that induce CYP3A, such as rifampin, may decrease delavirdine plasma concentrations and reduce its therapeutic effect. With rifampin: 97% decrease in AUC
Page: 3.0
PubMed

PubMed

TitleDatePubMed
Expanded-spectrum nonnucleoside reverse transcriptase inhibitors inhibit clinically relevant mutant variants of human immunodeficiency virus type 1.
1999 Dec
Long-term exposure of HIV type 1-infected cell cultures to combinations of the novel quinoxaline GW420867X with lamivudine, abacavir, and a variety of nonnucleoside reverse transcriptase inhibitors.
2000 Apr 10
Prevalence and characteristics of multinucleoside-resistant human immunodeficiency virus type 1 among European patients receiving combinations of nucleoside analogues.
2000 Aug
Presence of 2',5'-Bis-O-(tert-butyldimethylsilyl)-3'-spiro-5"-(4"-amino-1",2"-oxath iole-2",2"-dioxide) (TSAO)-resistant virus strains in TSAO-inexperienced HIV patients.
2000 Jun 10
Mutational analysis of trp-229 of human immunodeficiency virus type 1 reverse transcriptase (RT) identifies this amino acid residue as a prime target for the rational design of new non-nucleoside RT inhibitors.
2000 May
Selection and characterization of human immunodeficiency virus type 1 variants resistant to the (+) and (-) enantiomers of 2'-deoxy-3'-oxa-4'-thio-5-fluorocytidine.
2000 May
Inhibition of clinically relevant mutant variants of HIV-1 by quinazolinone non-nucleoside reverse transcriptase inhibitors.
2000 May 18
Delavirdine: clinical pharmacokinetics and drug interactions.
2001
The emerging roles of non-nucleoside reverse transcriptase inhibitors in antiretroviral therapy.
2001
Use of HIV protease inhibitors as pharmacoenhancers.
2001 Feb
Site-directed mutagenesis of human immunodeficiency virus type 1 reverse transcriptase at amino acid position 138.
2001 Feb 1
Anti-HIV activity of aromatic and heterocyclic thiazolyl thiourea compounds.
2001 Feb 26
Interaction of delavirdine with human liver microsomal cytochrome P450: inhibition of CYP2C9, CYP2C19, and CYP2D6.
2001 Jan
Combination therapy with indinavir, ritonavir, and delavirdine and nucleoside reverse transcriptase inhibitors in patients with HIV/AIDS who have failed multiple antiretroviral combinations.
2001 May-Jun
Anti-human immunodeficiency virus drugs are ineffective against Pneumocystis carinii in vitro and in vivo.
2001 Nov 15
Drugs for HIV infection.
2001 Nov 26
The stereoselective targeting of a specific enzyme-substrate complex is the molecular mechanism for the synergic inhibition of HIV-1 reverse transcriptase by (R)-(-)-PPO464: a novel generation of nonnucleoside inhibitors.
2001 Nov 30
Can delavirdine substitute for ritonavir?
2001 Nov-Dec
Baseline antiretroviral drug susceptibility influences treatment response in patients receiving saquinavir-enhancing therapy.
2001 Nov-Dec
Non-nucleoside HIV-1 reverse transcriptase (RT) inhibitors: past, present, and future perspectives.
2002
Lack of hepatotoxicity associated with nonnucleoside reverse transcriptase inhibitors.
2002 Apr 1
Synthesis, biological evaluation, and binding mode of novel 1-[2-(diarylmethoxy)ethyl]-2-methyl-5-nitroimidazoles targeted at the HIV-1 reverse transcriptase.
2002 Apr 11
Rhabdomyolysis with acute renal failure probably related to the interaction of atorvastatin and delavirdine.
2002 Apr 15
Genotypic and phenotypic resistance patterns in early-stage HIV-1-infected patients failing initial therapy with stavudine, didanosine and nevirapine.
2002 Dec
Structural requirements for potent anti-human immunodeficiency virus (HIV) and sperm-immobilizing activities of cyclohexenyl thiourea and urea non-nucleoside inhibitors of HIV-1 reverse transcriptase.
2002 Dec
Synthesis of novel N-1 (allyloxymethyl) analogues of 6-benzyl-1-(ethoxymethyl)-5-isopropyluracil (MKC-442, emivirine) with improved activity against HIV-1 and its mutants.
2002 Dec 19
Nelfinavir urinary stones.
2002 Mar
Delavirdine increases drug exposure of ritonavir-boosted protease inhibitors.
2002 Mar 29
Pharmacia pilots patent share for HIV drug.
2003 Apr
Delavirdine malabsorption in HIV-infected subjects with spontaneous gastric hypoacidity.
2003 Feb
Simultaneous determination of nine antiretroviral compounds in human plasma using liquid chromatography.
2003 Feb 5
Pharmacokinetic interaction between amprenavir and delavirdine after multiple-dose administration in healthy volunteers.
2003 Jan
A V106M mutation in HIV-1 clade C viruses exposed to efavirenz confers cross-resistance to non-nucleoside reverse transcriptase inhibitors.
2003 Jan 3
Protease inhibitor-sparing regimens: new evidence strengthens position.
2003 Jun 1
Pfizer announces free drug program.
2003 Sep
Susceptibility of HIV-2, SIV and SHIV to various anti-HIV-1 compounds: implications for treatment and postexposure prophylaxis.
2004 Feb
Clinical efficacy of antiretroviral combination therapy based on protease inhibitors or non-nucleoside analogue reverse transcriptase inhibitors: indirect comparison of controlled trials.
2004 Jan 31
Roles of conformational and positional adaptability in structure-based design of TMC125-R165335 (etravirine) and related non-nucleoside reverse transcriptase inhibitors that are highly potent and effective against wild-type and drug-resistant HIV-1 variants.
2004 May 6
Patents

Sample Use Guides

In Vivo Use Guide
HIV-1 infection (part of combination): Oral: 400 mg 3 times/day
Route of Administration: Oral
In vitro anti-HIV-1 activity of delavirdine was assessed by infecting cell lines of lymphoblastic and monocytic origin and peripheral blood lymphocytes with laboratory and clinical isolates of HIV-1. IC50 and IC90 values (50% and 90% inhibitory concentrations) for laboratory isolates (n = 5) ranged from 0.005 to 0.030 uM and 0.04 to 0.10 uM, respectively. Mean IC50 of clinical isolates (n = 74) was 0.038 uM (range: 0.001 to 40 0.69 uM); 73 of 74 clinical isolates had an IC50
Name Type Language
DELAVIRDINE
INN   MI   VANDF   WHO-DD  
INN  
Official Name English
DELAVIRDINE [MI]
Preferred Name English
DELAVIRDINE [VANDF]
Common Name English
Delavirdine [WHO-DD]
Common Name English
PIPERAZINE, 1-(3-((1-METHYLETHYL)AMINO)-2-PYRIDINYL)-4-((5-((METHYLSULFONYL)AMINO)-1H-INDOL-2-YL)CARBONYL)-
Systematic Name English
delavirdine [INN]
Common Name English
Classification Tree Code System Code
NDF-RT N0000009948
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
WHO-VATC QJ05AG02
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
LIVERTOX NBK547899
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
NDF-RT N0000175460
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
NCI_THESAURUS C97453
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
NDF-RT N0000175463
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
WHO-ATC J05AG02
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
Code System Code Type Description
SMS_ID
100000083479
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
CHEBI
119573
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
DRUG BANK
DB00705
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
NCI_THESAURUS
C65366
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
LACTMED
Delavirdine
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
INN
7234
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PRIMARY
ChEMBL
CHEMBL593
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PRIMARY
RXCUI
83816
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY RxNorm
DRUG CENTRAL
799
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
FDA UNII
DOL5F9JD3E
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
MERCK INDEX
m4152
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY Merck Index
MESH
D020008
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
EVMPD
SUB06949MIG
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
WIKIPEDIA
DELAVIRDINE
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
PUBCHEM
5625
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
CAS
136817-59-9
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY
EPA CompTox
DTXSID6022892
Created by admin on Mon Mar 31 18:09:12 GMT 2025 , Edited by admin on Mon Mar 31 18:09:12 GMT 2025
PRIMARY