Nevira

Indications

Nevirapine is an antiretroviral medicine used, always together with other HIV medicines, to treat HIV-1 infection in adults and children. It has also been used to lower the risk of HIV passing from mother to baby around the time of birth, as part of a national programme.

How It Works

Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI). It blocks reverse transcriptase, an enzyme the HIV virus needs to copy itself. This lowers the amount of virus in the blood and helps the immune system recover. It does not cure HIV.

Dosage and Administration

Treatment is started and monitored by a doctor experienced in HIV care. In adults, treatment usually starts with 200 mg once daily for the first 14 days (a lead-in period that lowers the risk of rash and liver problems), then 200 mg twice daily if no rash appears. Children's doses depend on age and body size and are given as prescribed. Take with or without food, at the same times every day. Do not stop or miss doses, as this can make the virus resistant.

Interactions

Nevirapine speeds up the breakdown of many medicines and can make them less effective, including hormonal contraceptives, Methadone, Ketoconazole and some other HIV medicines. Rifampicin and St John's Wort lower Nevirapine levels. Tell your doctor about every medicine, herbal product and supplement you use.

Contraindications

• Allergy to Nevirapine.
• Moderate or severe liver disease.
• A previous severe rash or liver reaction caused by Nevirapine (it must never be restarted).

Side Effects

Common side effects include rash, nausea, headache, tiredness and raised liver enzymes. Serious skin reactions (Stevens-Johnson syndrome) and liver damage can occur, mostly in the first 18 weeks. The risk of liver problems is higher in women with higher CD4 counts.

Get urgent medical help for a severe or blistering rash, rash with fever, mouth sores or swelling, yellow skin or eyes, dark urine, pain in the right upper abdomen, or severe tiredness.

Pregnancy and Lactation

Nevirapine may be used in pregnancy when a doctor decides it is needed, with close liver monitoring. Breastfeeding advice for mothers with HIV depends on local guidance, so discuss this with your doctor.

Precautions and Warnings

Liver tests are needed regularly, especially in the first 18 weeks. If treatment is stopped for more than 7 days, the doctor may restart with the lead-in dose. Nevirapine does not prevent passing HIV to others through sex or blood. Hormonal contraceptives may not work well, so use a barrier method too.

Overdose

Overdose may cause rash, swelling, fever, tiredness, headache, nausea and sleep problems. Contact a doctor or hospital straight away.

Therapeutic Class

Antiretroviral, non-nucleoside reverse transcriptase inhibitor (NNRTI).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.