Nevirapine

Pronunciation: ne-VYE-ra-peen
Generic Name: Nevirapine
Brand Name: Viramune

Severe and sometimes fatal liver problems have occurred in patients taking Nevirapine. This may occur in men and women, but the risk may be greater in women and in patients with a high CD4 cell count at the start of treatment. Certain pregnant women and women with a CD4 cell count higher than 250 have the greatest risk. Liver function tests and CD4 cell counts may be performed while you take Nevirapine. Contact your doctor right away if you develop a rash, dark urine, yellowing of the eyes or skin, pale stools, stomach pain, nausea, loss of appetite, or unusual tiredness.

Nevirapine should only be used in patients who have been diagnosed with HIV. Do not use Nevirapine to prevent HIV infection if you have been exposed to the virus.

Nevirapine may cause serious and sometimes fatal skin reactions. Contact your doctor immediately if you develop a rash or red, swollen, blistered, or peeling skin.

The risk of liver and skin problems is greatest during the first 18 weeks of therapy, but these problems may occur at any time during treatment. Your doctor will check for side effects frequently during the first several months after you start taking Nevirapine. Be sure to keep all doctor and lab appointments. Take Nevirapine exactly as prescribed by your doctor. If you develop a liver or skin problem or if you have a severe allergic reaction to Nevirapine, you must not take it again.

Nevirapine is used for:

Treating HIV infection. It must be used along with other HIV medicines.

Nevirapine is a nonnucleoside reverse transcriptase inhibitor (NNRTI). It works by blocking the growth of HIV.

Do NOT use Nevirapine if:

• you are allergic to any ingredient in Nevirapine


• you have moderate to severe liver problems


• you have had a serious liver or skin reaction while taking Nevirapine


• you are taking another medicine that contains nevirapine


• you are taking efavirenz, certain HIV protease inhibitors (eg, atazanavir, fosamprenavir, lopinavir/ritonavir), itraconazole, ketoconazole, lurasidone, rifampin, or St. John's wort


• you have not been diagnosed with HIV

Contact your doctor or health care provider right away if any of these apply to you.

Before using Nevirapine:

Some medical conditions may interact with Nevirapine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have liver problems (eg, cirrhosis, hepatic fibrosis, hepatitis), abnormal liver function tests, or certain skin problems (eg, growths, rash)


• if you have kidney problems or are receiving dialysis


• if you have a fever, a high CD4 cell count, or an abnormally high level of white blood cells

Some MEDICINES MAY INTERACT with Nevirapine. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Prednisone because the risk of severe skin rash may be increased


• Fluconazole because it may increase the risk of Nevirapine's side effects


• Rifampin or St. John's wort because they may decrease Nevirapine's effectiveness


• Anticoagulants (eg, warfarin), HMG-CoA reductase inhibitors (eg, atorvastatin), or rifabutin because the risk of their side effects may be increased by Nevirapine


• Antiarrhythmics (eg, amiodarone, disopyramide), azole antifungals (eg, itraconazole, ketoconazole), calcium channel blockers (eg, diltiazem, nifedipine, verapamil), carbamazepine, cisapride, clarithromycin, clonazepam, cyclophosphamide, cyclosporine, efavirenz, ergot alkaloids (eg, ergotamine), ethosuximide, exemestane, fentanyl, HIV protease inhibitors (eg, atazanavir, fosamprenavir, lopinavir/ritonavir, indinavir, nelfinavir), hormonal contraceptives (eg, birth control pills), lurasidone, methadone, sirolimus, tacrolimus, tyrosine kinase receptor inhibitors (eg, dasatinib), or ulipristal because their effectiveness may be decreased by Nevirapine

This may not be a complete list of all interactions that may occur. Ask your health care provider if Nevirapine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Nevirapine:

Use Nevirapine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Nevirapine comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Nevirapine refilled.


• Take Nevirapine by mouth with or without food.


• Take Nevirapine with a full glass of liquid (8 oz/240 mL). You may take it with water, milk, or soda.


• Taking Nevirapine at the same time each day will help you remember to take it.


• Continue to take Nevirapine even if you feel well. Do not miss any doses.


• If you miss a dose of Nevirapine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you miss taking Nevirapine for more than 7 days, contact your doctor before you start to take it again.

Ask your health care provider any questions you may have about how to use Nevirapine.

Important safety information:

• Do NOT take more than the recommended dose or take for longer than prescribed without checking with your doctor.


• Nevirapine is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor.


• When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking Nevirapine, even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat.


• Nevirapine does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors.


• Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk, and loss of fat from the legs, arms, and face) may occur in some patients taking Nevirapine. The cause and long-term effects of these changes are unknown. Discuss any concerns with your doctor.


• Nevirapine may improve immune system function. This may reveal hidden infections in some patients. Tell your doctor right away if you notice symptoms of infection (eg, fever, sore throat, weakness, cough, shortness of breath) after you start Nevirapine.


• Hormonal birth control (eg, birth control pills) may not work as well while you are taking Nevirapine. To prevent pregnancy, use an extra form of birth control (eg, condoms).


• Lab tests, including liver function, heart function, complete blood cell counts, and CD4 cell counts, may be performed while you take Nevirapine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Nevirapine should be used with extreme caution in CHILDREN younger than 3 months; safety and effectiveness in these children have not been confirmed.


• Caution is advised when using Nevirapine in CHILDREN; they may be more sensitive to its effects, especially anemia.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking Nevirapine while you are pregnant. Nevirapine is found in breast milk. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or Nevirapine to the baby.

Possible side effects of Nevirapine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; headache; mild nausea or stomach pain; tiredness; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); change in the amount of urine produced; eye irritation, pain, redness, or swelling; fever, chills, or sore throat; general feeling of being unwell; mouth sores; muscle or joint aches or pain; red, swollen, peeling, or blistered skin (with or without fever); swollen lymph glands; symptoms of liver problems (eg, yellowing of the skin or eyes; dark urine; loss of appetite; pale stools; severe, persistent, or unusual nausea or stomach pain); unusual tiredness or weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Nevirapine side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include dizziness; fever; nausea; rash; severe or persistent headache; swelling; trouble breathing; trouble sleeping; unexplained weight loss; unusual tiredness; vomiting.

Proper storage of Nevirapine:

Store Nevirapine at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Nevirapine out of the reach of children and away from pets.

General information:

• If you have any questions about Nevirapine, please talk with your doctor, pharmacist, or other health care provider.


• Nevirapine is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Nevirapine. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Nevirapine resources

• Nevirapine Side Effects (in more detail)
• Nevirapine Dosage
• Nevirapine Use in Pregnancy & Breastfeeding
• Nevirapine Drug Interactions
• Nevirapine Support Group
• 1 Review for Nevirapine - Add your own review/rating

• Nevirapine Monograph (AHFS DI)


• Nevirapine Professional Patient Advice (Wolters Kluwer)


• nevirapine Concise Consumer Information (Cerner Multum)


• nevirapine Advanced Consumer (Micromedex) - Includes Dosage Information


• Viramune Prescribing Information (FDA)

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