Brand Name: Viramune XR, Viramune
Other Name(s): NVP, extended-release nevirapine
Drug Class: Non-nucleoside Reverse Transcriptase Inhibitors
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 risk is greater 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
- Feeling unwell or like you have the flu
- Pain or tenderness on your right side below your ribs
- 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:
- Mouth sores
- Red or inflamed eyes, like "pink eye" (conjunctivitis)
- Swelling of your face
- Feeling unwell or like you have the flu
- Muscle or joint aches
- Any of the symptoms of liver problems listed above
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 in adults and children. Nevirapine is always used in combination with other HIV medicines.
Nevirapine comes in three different forms: immediate-release tablets and oral suspension (a liquid), and extended-release tablets. 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 in adults and in children 6 to less than 18 years of age.
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 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 or other liver problems.
- If you are on kidney dialysis.
- If you have skin problems, such as rash. Do not start nevirapine extended-release tablets if you have a rash.
- If you (or your child) have trouble swallowing pills.
- If you have any other medical conditions.
- 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 benefits outweigh the risks. 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 have HIV or are taking nevirapine.
- If you are using hormone-based birth control (such as pills, implants, or vaginal rings). 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. For more information about using birth control and HIV medicines at the same time, view the AIDSinfo HIV and Birth Control infographic.
- About other prescription and nonprescription medicines, vitamins, nutritional supplements, and herbal products, especially St. John's wort, 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, only 1 dose of nevirapine is given each day for the first 14 days of treatment. When starting nevirapine for the first time, only the immediate-release tablet and oral suspension forms of the drug are given. If you get a skin rash during the 14 day lead-in period, call your health care provider right away. Do not increase your nevirapine dose to 2 times a day or switch to taking nevirapine extended-release tablets.
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.
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.)
What Should I Do if I Forget a Dose?
If you miss a dose of nevirapine, take the missed dose as soon as you remember it. But if it is almost time for your next dose, skip the missed dose and just take your next dose at the regular time. Do not take two doses at the same time to make up for a missed dose.
If you stop taking nevirapine for more than 7 days, ask your health care provider how much to take before you start taking it again.
What Side Effects Can Nevirapine Cause?
Nevirapine may cause side effects. Many side effects from HIV medicines, such as nausea or occasional dizziness, are manageable. See the AIDSinfo fact sheet on HIV Medicines and Side Effects for more information.
Some side effects of nevirapine can be serious. Serious side effects of nevirapine include severe liver problems, skin rash, and skin reactions. The liver and skin problems can happen at any time during treatment, but the risk is greater during the first 18 weeks of treatment. (See the WARNING box above.)
Other possible side effects of nevirapine include:
- Changes in your immune system (called immune reconstitution inflammatory syndrome or IRIS). IRIS is a condition that sometimes occurs when the immune system begins to recover after treatment with an HIV medicine. As the immune system gets stronger, it may have an increased response to a previously hidden infection.
- Changes in body fat (including gain or loss of fat).
Tell your health care provider if you have any side effect that bothers you or that does not go away.
These are not all the possible side effects of nevirapine. To learn more about possible side effects of nevirapine, read the drug label or package insert or talk to your health care provider or pharmacist.
You can report side effects to FDA at 1-800-FDA-1088 (1-800-332-1088) or online at www.accessdata.fda.gov/scripts/medwatch/.
How Should Nevirapine Be Stored?
- Store nevirapine between 68°F to 77°F (20°C to 25°C).
- Do not use nevirapine if the original seal over the container opening is broken or missing.
- Throw away nevirapine that is no longer needed or expired (out of date). Follow FDA guidelines on how to safely dispose of unused medicine.
- Keep nevirapine and all medicines out of reach of children.
Where Can I Find More Information About Nevirapine?
More information about nevirapine is available:
- The 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. The Patient Counseling Information section of the labels includes information for people taking nevirapine.
- Nevirapine-related research studies, from the AIDS_info_ database of ClinicalTrials.gov study summaries.
- A list of FDA-approved HIV medicines, from AIDS_info_.
Main number: 800-243-0127
Patient assistance: 800-556-8317
[Note from TheBody: This article was created by AIDSinfo, who last updated it on March 1, 2018. We have cross-posted it with their permission.]