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An Overview of Viramune (Nevirapine)

May 6, 2015

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Nevirapine Nevirapine Oralviramune XR 400mgviramune XR 100mg

Brand Name: Viramune XR, Viramune
Other Name(s): extended-release nevirapine, NVP
Drug Class: Non-nucleoside Reverse Transcriptase Inhibitors
Approved Use: Treatment of HIV Infection


Chemical Image

nevirapine chemical image

nevirapine
Molecular Weight: 266.303


WARNING:

Nevirapine can cause serious, life-threatening side effects. These include severe liver problems, skin rash, and skin reactions. The liver and skin problems can happen at any time during treatment, but the time of greatest risk is during the first 18 weeks of treatment.

Stop taking nevirapine and contact your health care provider right away if you have any of the following symptoms that could be signs of liver problems:

  • Dark-colored urine.
  • Yellowing of your skin or the whites of your eyes (jaundice).
  • Light-colored bowel movements.
  • Fever.
  • Nausea.
  • Feeling unwell or like you have the flu.
  • Pain or tenderness on your right side below your ribs.
  • Tiredness.
  • Loss of appetite.

Stop taking nevirapine and contact your health care provider right away if you have a skin rash with any of the following symptoms:

  • Blisters.
  • Mouth sores.
  • Red or inflamed eyes, like "pink eye" (conjunctivitis).
  • Liver problems (see symptoms of liver problems above).
  • Swelling of your face.
  • Fever.
  • Feeling unwell or like you have the flu.
  • Tiredness.
  • Muscle or joint aches.

If your health care provider tells you to stop treatment with nevirapine because of serious liver or skin problems, you should never take nevirapine again.

While taking nevirapine, it is important to keep all of your appointments with your health care provider.


What Is Nevirapine?

Nevirapine is a prescription medicine approved by the U.S. Food and Drug Administration (FDA) for the treatment of HIV infection. Nevirapine comes in three different forms: immediate-release tablets, extended-release tablets, and a liquid (oral suspension). The immediate-release tablet and liquid forms of nevirapine are approved for use in adults and children 15 days and older. The extended-release tablets are approved for use only in those 6 years and older. Nevirapine is always used in combination with other HIV medicines.

Nevirapine belongs to a class (group) of HIV drugs called non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs attach to and block an HIV enzyme called reverse transcriptase. (An enzyme is a protein that starts or increases the speed of a chemical reaction.) By blocking reverse transcriptase, NNRTIs prevent HIV from multiplying and can reduce the amount of HIV in the body.

HIV medicines can't cure HIV/AIDS, but taking a combination of HIV medicines (called an HIV treatment regimen) every day helps people with HIV live longer, healthier lives. HIV medicines also reduce the risk of HIV transmission.


What Should I Tell My Health Care Provider Before Taking Nevirapine?

Before taking nevirapine, tell your health care provider:

  • If you are allergic to nevirapine or any other medicines.
  • If you have or have had hepatitis (inflammation of the liver) or problems with your liver.
  • If you are on kidney dialysis.
  • If you have skin problems, such as rash.
  • If you (or your child) have trouble swallowing pills.
  • About any other medical problems (including past medical problems).
  • If you are pregnant or plan to become pregnant. Whether nevirapine can harm an unborn baby is unknown. Nevirapine should be used during pregnancy only if the potential benefit justifies the potential risk to the unborn baby. Talk to your health care provider about possible risks with taking nevirapine when pregnant.
  • If you are breastfeeding or plan to breastfeed. Do not breastfeed if you are infected with HIV or are taking nevirapine.
  • If you are using hormone-based birth control (such as pills, injections, or implants). Nevirapine may make these forms of birth control less effective. Your health care provider can help you decide how to adjust your birth control while you are taking nevirapine.
  • About other prescription and nonprescription medicines, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Nevirapine may affect the way other medicines or products work, and other medicines or products may affect how nevirapine works. Taking nevirapine together with certain medicines or products may cause serious side effects.


How Should I Take Nevirapine?

Nevirapine comes in the following forms and strengths:

  • 200-mg immediate-release tablets (brand name: Viramune).
  • 100-mg extended-release tablets (brand name: Viramune XR).
  • 400-mg extended-release tablets (brand name: Viramune XR).
  • 50-mg/5 mL oral suspension (brand name: Viramune). An oral suspension is a mixture of a medicine and a liquid that can be taken by mouth.

Take nevirapine according to your health care provider's instructions.

To reduce the risk of skin rash, a low dose of nevirapine is given for the first 14 days of treatment. If you get a skin rash during the first 14 days of nevirapine treatment, call your health care provider right away. Do not increase your nevirapine dose to 2 times a day if you have a rash.

Take nevirapine with or without food. Never take more than one form of nevirapine at the same time.

Nevirapine extended-release tablets are not for use in children less than 6 years of age. The extended-release tablets should be swallowed whole and should not be chewed, crushed, or divided. Do not start taking nevirapine extended-release tablets if you have a rash.

Nevirapine oral suspension is a liquid. Shake it gently before each use, and use an oral dosing syringe or dosing cup to measure the right dose. If the dose is less than 1 teaspoon (5 mL), use a syringe to measure the dose. (Ask your pharmacist for a syringe or dosing cup if you do not have one.) After drinking the medicine, fill the dosing cup with water and drink it to make sure you get all the medicine.

Always take nevirapine in combination with other HIV medicines.

If you take too much nevirapine, contact your health care provider or local poison control center (1-800-222-1222) right away, or go to the nearest hospital emergency room.

For more information on how to take nevirapine, see the FDA drug labels for nevirapine immediate-release tablets (brand name: Viramune), nevirapine extended-release tablets (brand name: Viramune XR), and nevirapine oral suspension (brand name: Viramune), from DailyMed. (DailyMed is a federal website that includes the most recent drug labels submitted to FDA.)

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This article was provided by AIDSinfo. Visit the AIDSinfo website to find out more about their activities and publications.
 

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