NEVIRAPINE

COMMON BRAND NAME(S): Viramune

GENERIC NAME(S): NEVIRAPINE

Description: Nevirapine is a non-nucleoside reverse transcriptase inhibitor that acts against HIV-1. It binds directly to reverse transcriptase and thereby blocks the RNA-dependent and DNA-dependent DNA polymerase activities by disrupting the enzyme’s catalytic site.

Pharmacokinetics:

Absorption: Readily absorbed from the GI tract; peak plasma concentrations after 4 hr (oral).

Distribution: Crosses the placenta; enters breast milk. Protein-binding: Approx 60%.

Metabolism: Hepatic by microsomal enzymes.

Excretion: Via urine (as glucuronide conjugates of the hydroxylated metabolites).

Uses

Used for

HIV infection control in conjucntion with other HIV medications by decreasing the amount of HIV in your body thereby lowering your chance of getting HIV complications (such as new infections, cancer) and improves your quality of life.

Belongs to a class of drugs known as non-nucleoside reverse transcriptase inhibitors (NNRTIs).

To decrease your risk of spreading HIV disease to others, do all of the following:
- (1) continue to take all HIV medications exactly as prescribed by your doctor, (2) always use an effective barrier method (latex or polyurethane condoms/dental dams) during all sexual activity, and (3) do not share personal items (such as needles/syringes, toothbrushes, and razors) that may have contacted blood or other body fluids

Nevirapine should not be used to prevent HIV infection after accidental exposure (such as needle sticks, blood/bodily fluid contact). Different HIV medications are used to prevent infection after exposure.

How to use nevirapine

Always refer to your doctors instructions before taking this medication. Duration and dosage will be determined by your medical condition and its response to the medication. Make sure to take this mediciation in the prescribed amount and time period even after symptoms disappear. Discontinuing the medication before completion of treatment may cause incomplete treatment of condition. If Symptoms persist, consult your doctor

Taken by mouth; With or without food; usually once a day for the first 14 days of treatment then two times a day thereafter or as directed by your physician;

If medication comes in a liquid form, shake the bottle well before intake. Use a special measuring device/spoon for every dosage and not household spoon to avoid incorrect dose. If you are using a dosing cup, rinse the cup with water after taking the medication and drink all of the rinse water to make sure you take the full dose.

Do not stay on the once-daily dosing schedule for more than 28 days. Consult your doctor for more details.

Warnings

Rarely, nevirapine has caused severe (sometimes fatal) liver problems. Seek immediate medical attention if you develop symptoms of liver problems such as persistent nausea, loss of appetite, vomiting, stomach/abdominal pain, dark urine, pale stools, yellowing eyes/skin, unusual tiredness, rash.

Rarely, nevirapine has also caused serious (sometimes fatal) skin/allergic reactions. Seek immediate medical attention if you have any signs of skin/allergic reactions, including: rash, itching/swelling/redness (especially of the eyes/face), blisters, fever, persistent sore throat, unusual tiredness, mouth sores, severe dizziness, trouble breathing, unusual change in the amount of urine, muscle pain/tenderness/weakness, joint pain.Women are at increased risk for developing these severe reactions. To help decrease the risk of skin/allergic reactions in all patients, nevirapine is started at a lower dose for the first 14 days. Also, people with higher T-cell counts at the start of nevirapine treatment are at greater risk for liver problems. Therefore, nevirapine is usually only started if the T-cell count is fewer than 250 in women or fewer than 400 in men.Keep all medical and laboratory appointments so your doctor can monitor how you are responding to nevirapine. The risk of these serious side effects is high in the first 18 weeks and highest during the first 6 weeks of nevirapine treatment. However, these side effects may occur at any time while taking this medication.

If you have stopped taking nevirapine because of liver problems or skin/allergic reactions, you must never take any form of nevirapine again. Tell all of your doctors and pharmacists if you have ever stopped taking nevirapine because of these types of reactions.

Side effects

Minor side effects (if these symptoms persist or worsen, inform your doctor)

Tiredness, nausea, vomiting, drowsiness or diarrhea
Can commonly cause a rash that is usually not serious
Serious side effects (inform your doctor immediately)
- unexplained weight loss, persistent muscle aches/weakness, joint pain, numbness/tingling of the hands/feet/arms/legs, severe tiredness, vision changes, severe/persistent headaches, signs of infection (such as fever, chills, trouble breathing, cough, non-healing skin sores), signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter), signs of a certain nerve problem known as Guillain-Barre Syndrome (such as difficulty breathing/swallowing/moving your eyes, drooping face, paralysis, slurred speech).

- - Changes in body fat may occur while you are taking this medication (such as increased fat in the upper back and stomach areas, decreased fat in the arms and legs). Discuss the risks and benefits of use with your doctor
  - Severe allergic reactions are rare. Get immediate medical help if you notice the following:
  Rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing

Precautions

Precautions:

Inform your doctor
- Allergy to the medication or any allergies
- Medical History of liver problems (such as hepatitis B or C, cirrhosis), kidney dialysis, lactose or galactose intolerance.

Rarely, this drug may cause drowsiness

Should only be used when there is a clear need during pregnancy as it may harm an unborn baby. If you are planning to be pregnant or think you may be pregnant, discuss the risks and benefits of use with your doctor.

Nevirapine passes into breast milk. Because breast milk can transmit HIV, do not breast-feed.

Interactions:

Taking multiple drugs may affect how medications work and/or cause unwanted side effects. List down all the medications you are taking and inform your physician and pharmacist. Do not take, discontinue, or alter any dose of medications without prior approval of your physician.

Products that may interact with this medication include:
- rifabutin, warfarin, rifamycins (such as rifampin), St. John’s wort, among others, antiarrhythmics (such as amiodarone), boceprevir, some drugs used to treat seizures (such as carbamazepine, clonazepam), azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin), methadone, telaprevir, protease inhibitors such as atazanavir, ritonavir).
- Do not use prednisone to prevent a rash because it can actually increase the risk of a rash during the first 6 weeks of nevirapine treatment. Consult your physician for more details.

May decrease the effectiveness of hormonal birth control such as pills, patch, or ring

Overdose & Brands

Overdose:

If overdose is suspected, contact a poison control center or emergency room immediately.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and As soon as you remember, take a regular dose or if the time of the next dose is near, wait for it before taking another dose and resume your usual schedule. Do not increase the dose to compensate for the missed dose.

Storage

Room temperature between 59-86 degrees F (15-30 degrees C)
Do not expose to light and moisture
Do not store in the bathroom
Keep all medications away from pets and children

Brands:

Available Brands:

Viramune