Generic Name: nevirapine (ne VYE ra peen)
Brand Names: Viramune, Viramune XR
What is nevirapine?
Nevirapine is an antiviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in your body.
Nevirapine is used to treat HIV, which causes the acquired immunodeficiency syndrome (AIDS). Nevirapine will not prevent or cure HIV or AIDS.
Nevirapine may also be used for purposes not listed in this medication guide.
What is the most important information I should know about nevirapine?
Nevirapine can cause severe or life-threatening effects on the liver. Call your doctor at once if you have any of these liver symptoms while taking nevirapine: skin rash, nausea, stomach pain, loss of appetite, low fever, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). Nevirapine may also cause severe or life-threatening skin reactions. Contact your doctor at once if you have fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. This type of reaction is a medical emergency.
There are many other medicines that can interact with nevirapine, or make it less effective. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.
Use all medications as directed by your doctor. Do not change your doses or medication schedule without your doctor's advice.
Taking this medication will not prevent you from passing HIV to other people.
What should I discuss with my healthcare provider before taking nevirapine?
Nevirapine can cause life-threatening effects on the liver. Call your doctor at once if you have any of these liver symptoms while taking nevirapine: skin rash, nausea, stomach pain, loss of appetite, low fever, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). Nevirapine may also cause severe or life-threatening skin reactions. Contact your doctor at once if you have fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. This type of reaction is a medical emergency. Do not use this medication if you are allergic to nevirapine, or if you have moderate to severe liver disease.
The following drugs should not be used while you are taking nevirapine:
atazanavir (Reyataz);
efavirenz (Sustiva, Atripla);
itraconazole (Sporanox);
ketoconazole (Nizoral);
rifampin (Rifater, Rifamate, Rifater); or
St. John's wort.
To make sure you can safely take nevirapine, tell your doctor if you have any of these other conditions:
skin problems;
- liver disease (or a history of hepatitis);
- kidney disease (or if you are on dialysis); or
if you have ever taken delavirdine (Rescriptor) or efavirenz (Sustiva, Atripla) and they were not effective in treating your condition.
FDA pregnancy category B. Nevirapine is not expected to be harmful to an unborn baby. However, nevirapine may be more likely to cause liver damage in a pregnant woman. Tell your doctor if you are pregnant or plan to become pregnant during treatment. HIV can be passed to your baby if you are not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection. Nevirapine can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking nevirapine.
If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of nevirapine on the baby.
Women with HIV or AIDS should not breast-feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.
How should I take nevirapine?
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Nevirapine is usually taken only once daily for the first 2 weeks, and then increased to twice daily. Starting with a low dose can reduce your risk of skin reactions. Follow your doctor's instructions about how often to take the medication.
If you stop taking nevirapine for longer than 7 days, call your doctor before you start taking the medicine again. You may have to start with a lower dose.
Nevirapine can be taken with or without food. You may also take the medicine with milk or a soft drink.
Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time. Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
To be sure this medication is helping your condition, your blood cells and liver function will need to be tested often, especially during the first 6 to 18 weeks of treatment. Visit your doctor regularly.
Use nevirapine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
Do not take nevirapine as your only HIV medication. HIV/AIDS is usually treated with a combination of different drugs. Your disease may become resistant to nevirapine if you do not take it in combination with other HIV medicines your doctor has prescribed.
Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.
Store at room temperature away from moisture and heat.
See also: Nevirapine dosage (in more detail)
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
If you have not taken nevirapine for 7 days in a row, call your doctor before you start taking the medicine again.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include swelling in your hands or feet, sleep problems, weight loss, fever, joint pain or swelling, red or tender bumps on your shins, wheezing, cough, or trouble breathing.
What should I avoid while taking nevirapine?
Avoid drinking alcohol. It may increase your risk of liver damage. Taking this medication will not prevent you from passing HIV to other people. Avoid having unprotected sex or sharing razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.
Nevirapine side effects
Get emergency medical help if you have any of these signs of an allergic reaction: tired feeling, joint or muscle pain, muscle weakness, skin rash, bruising, severe tingling, numbness, mouth sores, trouble breathing, or swelling of your face, lips, tongue, or throat. Stop taking nevirapine and call your doctor at once if you have a serious side effect such as:
nausea, pain in your upper stomach, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
fever, chills, body aches, flu symptoms;
any other signs of new infection; or
the first sign of any skin rash, no matter how mild.
Less serious side effects may include:
mild nausea, vomiting, diarrhea, or stomach pain;
muscle pain;
headache, tired feeling; or
changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Nevirapine Dosing Information
Usual Adult Dose for HIV Infection:
Initial dose (lead-in dosing period):
Immediate-release formulation: 200 mg orally once a day for 14 days
Maintenance dose (following the lead-in dosing period):
Immediate-release formulation: 200 mg orally twice a day
Extended-release formulation: 400 mg orally once a day
Patients must never take more than one form of nevirapine at the same time.
Usual Adult Dose for Reduction of Perinatal Transmission of HIV:
Women without antepartum antiretroviral therapy:
Immediate-release formulation: 200 mg orally once as a single dose at the onset of labor
According to the Perinatal HIV Guidelines Working Group, single dose nevirapine may be given to the mother in addition to IV intrapartum zidovudine.
Usual Pediatric Dose for HIV Infection:
Immediate-release formulation:
15 days or older:
Initial dose (lead-in dosing period): 150 mg/m2 orally once a day for 14 days
Maintenance dose (following the lead-in dosing period): 150 mg/m2 orally twice a day
Maximum dose: 200 mg/dose
According to the Working Group on Antiretroviral Therapy and Medical Management of HIV-Infected Children, younger children (e.g., 8 years or less) may require 200 mg/m2 orally twice a day. The total daily dose should not exceed 400 mg.
Usual Pediatric Dose for Reduction of Perinatal Transmission of HIV:
Infant of mother without antepartum antiretroviral therapy:
Immediate-release formulation: 2 mg/kg orally once as a single dose given between birth and 72 hours of age
If the mother did not receive nevirapine or received nevirapine 2 hours or less before delivery, the neonatal dose should be administered as soon as possible after birth.
According to the Perinatal HIV Guidelines Working Group, single dose nevirapine may be given to the neonate in addition to 6 weeks of zidovudine therapy.
What other drugs will affect nevirapine?
There are many other medicines that can interact with nevirapine, or make it less effective. Before taking nevirapine, tell your doctor if you are using any of the following drugs:
maraviroc (Selzentry);
fentanyl (Actiq, Duragesic, Fentora, Onsolis), methadone (Diskets, Dolophine, Methadose);
a blood thinner such as warfarin (Coumadin, Jantoven);
an antibiotic such as clarithromycin (Biaxin) or rifabutin (Mycobutin);
antifungal medicine such as fluconazole (Diflucan) or voriconazole (Vfend);
ergot medicine such as ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal), ergonovine (Ergotrate), or methylergonovine (Methergine);
heart or blood pressure medications such as amiodarone (Cordarone, Pacerone), diltiazem (Cartia, Cardizem), disopyramide (Norpace), felodipine (Plendil), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others;
medication to prevent organ transplant rejection;
other HIV medicines such as darunavir (Prezista), fosamprenavir (Lexiva), nelfinavir (Viracept), indinavir (Crixivan), ritonavir (Norvir, Kaletra), or saquinavir (Invirase); or
seizure medication such as carbamazepine (Tegretol), clonazepam (Klonopin), or ethosuximide (Zarontin).
This list is not complete and there are many other drugs that can interact with nevirapine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.
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 Advanced Consumer (Micromedex) - Includes Dosage Information
- Nevirapine Professional Patient Advice (Wolters Kluwer)
- Nevirapine Monograph (AHFS DI)
- Nevirapine MedFacts Consumer Leaflet (Wolters Kluwer)
- Viramune Prescribing Information (FDA)
- Viramune XR Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)
Compare nevirapine with other medications
- HIV Infection
- Reduction of Perinatal Transmission of HIV
Where can I get more information?
- Your pharmacist can provide more information about nevirapine.
See also: nevirapine side effects (in more detail)
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