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Nevirapine

Other Names: NVP, Viramune®
Manufacturer: Boehringer-Ingelheim Pharmaceuticals, Inc.

What is it?

Nevirapine is an antiretroviral medication, specifically a non-nucleoside reverse transcriptase inhibitor. It is used to treat HIV, a retrovirus. Retroviruses use the genetic material in the body’s cells to produce more virus which can infect other cells.

How does it work?

Nevirapine interferes with the life cycle of HIV to stop it from producing more virus. Specifically, it ties up the reverse transcriptase enzyme so it cannot build the genetic material needed to make more virus and infect more cells.

How do I take it?

  • Nevirapine is available as 200 mg tablets.
  • The usual starting dose is one tablet (200 mg) daily for 14 days, and then the dose is increased to one tablet twice daily.
  • Nevirapine may be taken with or without food.

It is extremely important that you take nevirapine and your other antiretroviral medications exactly as directed. You should set up a system that will help you remember to take your medicines so that you do not miss any doses. If you miss a dose, take it as soon as possible and space the remaining doses out over the rest of the day. However, if you skip a dose, do not take two doses at once. Do not stop taking the medication for any reason at any time unless you are directed to do so by your provider. If you are unable to continue taking your medication due to side effects, you should contact your provider immediately.

Special Considerations

  • Nevirapine should be stored at controlled room temperature in a dry place, out of the reach of children.
  • Please bring your medication bottles (empty and partially used) to each study visit.

Interactions

Some drugs taken together may have interactions that cause illness or impair the effectiveness of the drugs. Nevirapine has a number of serious drug interactions. You need to be familiar with the names of medications that you are taking and compare them to the medications listed below. Make sure that everyone who is prescribing or dispensing medications to you knows that you are taking nevirapine.

The following medications should not be given together with nevirapine:

  • Astemizole (Hismanal®)
  • Dihydroergotamine
  • Ergotamine
  • Midazolam (Versed®)
  • Triazolam (Halcion®)

Inform your provider if you are taking any of the following medications:

  • Amprenavir (Agenerase®)
  • Clarithromycin (Biaxin®)
  • Indinavir (Crixivan®)
  • Lopinavir/ritonavir (Kaletra®)
  • Rifabutin
  • Rifampin
  • Saquinavir (Fortovase®)
  • Warfarin (Coumadin®)

If you are taking oral contraceptives with nevirapine, an alternate form of birth control should be used.

Side Effects

Not everyone experiences side effects. When they do occur, they may be mild, moderate or severe. Some side effects cannot be felt by the patient but can be found through laboratory tests, so it is important to see your study clinician regularly for checkups so that side effects can be detected early and treated.

The most common side effect associated with nevirapine is skin rash. The majority of rashes associated with nevirapine occur during the first 6 weeks of taking the drug. Starting out at a lower dose for two weeks, and then increasing the dose can decrease the possibility of developing a rash. Rashes are usually mild and are seen on the upper body, the face, the hands, or feet.

Do not stop taking nevirapine if you experience a mild rash without any other symptoms. However, it is important to notify your study clinician that you have a rash.

If you experience a severe rash or a rash accompanied by a fever, blisters in your mouth, swelling, muscle or joint aches, you should call your provider immediately. A serious reaction known as Stevens-Johnson Syndrome can occur with nevirapine.

Other side effects of nevirapine that have been reported are nausea, headache, diarrhea, and fever.

 

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