Products
Nevirapine is commercially available in tablet and sustained-release tablet form (Viramune, generics). It has been approved in many countries since 1997.
Structure and properties
Nevirapine (C15H14N4O, Mr = 266.3 g/mol) exists as a white crystalline powder that is practically insoluble in water. It has a non-nucleoside structure.
Effects
Nevirapine (ATC J05AG01) has antiviral properties against HIV. The effects are due to noncompetitive inhibition of the enzyme reverse transcriptase, which plays a critical role in viral replication.
Indications
As part of combination antiretroviral therapy for the treatment of HIV-1 infection.
Dosage
According to the SmPC. Tablets may be taken independently of meals.
Contraindications
- Hypersensitivity or intolerance
- Severe impairment of liver or kidney function
- Combination with St. John’s wort and rifampicin (enzyme inducers).
For complete precautions, see the drug label.
Interactions
Nevirapine has a potential for drug-drug interactions. It is metabolized by CYP3A4 and is a CYP inducer. Appropriate drug-drug interactions must be considered.
Adverse effects
The most common possible adverse effects include rash, allergic reactions, liver inflammation, abnormal liver function test, nausea, vomiting, diarrhea, abdominal pain, fatigue, fever, headache, and muscle pain. Nevirapine can cause severe skin reactions such as Stevens-Johnson syndrome and severe liver inflammation. Therefore, close monitoring is necessary, especially during the first 18 weeks of treatment.
