Detailed Drug Information:

DRUG CLASS AND MECHANISM: Nevirapine is an oral medication that is used for the treatment of infections with the human immunodeficiency virus (HIV). It is similar to efavirenz (Sustiva) and delavirdine (Rescriptor). Nevirapine is in a class of drugs called reverse transcriptase inhibitors which also includes zalcitabine (Hivid), zidovudine (Retrovir), didanosine (Videx), and lamivudine (Epivir). During infection with HIV, the HIV virus multiplies within the body's cells. The newly-formed viruses then are released from the cells and spread throughout the body where they infect other cells. In this manner, the infection spreads to new, uninfected cells that the body is continuallyproducing, and HIV infection is perpetuated. When producing new viruses, the HIV virus must manufacture new DNA for each virus. Reverse transcriptase is the enzyme that the virus uses to form this new DNA. Nevirapine directly inhibits the activity of reverse transcriptase and blocks the production of DNA and new viruses. Unlike zidovudine, nevirapine does not need to be converted to an active form and it does not compete with the compound (thymidine triphosphate) that is required by HIV virus to make new DNA. Nevirapine does not kill existing HIV virus and it is not a cure for HIV. The FDA approved nevirapine in September, 1996.

PREPARATIONS: Tablets: 200 mg Suspension: 10 mg/ml

STORAGE: Store at room temperature, 15-30°C (59-86°F).

PRESCRIBED FOR: Nevirapine is used together with other anti-HIV drugs for the treatment of HIV infection.

DOSING: The starting dose for adults is 200 mg daily. After 14 days the dose should be increased to 200 mg every 12 hours. Nevirapine must be administered in combination with other anti-HIV drugs because the HIV virus quickly becomes resistant to treatment when nevirapine is used alone.

Nevirapine may be administered without regard to meals since food does not reduce its absorption.

DRUG INTERACTIONS: Rifampin (Rifadin), rifabutin(Mycobutin), ketoconazole (Nizoral) and St. John's Wort decrease blood concentrations of nevirapine by increasing its breakdown. Decreased blood concentration may reduce the effect of nevirapine.

Nevirapine reduces the blood concentration of oral contraceptives and this could result in inadequate birth control. Nevirapine also decreases the concentration of methadone(Dolophine) and this could lead to narcotic withdrawal symptoms.

PREGNANCY: There are no adequate studies of nevirapine in pregnant women.

NURSING MOTHERS: Nevirapine is excreted in human breast milk. Nursing should be discontinued during nevirapine therapy. In addition, HIV infected mothers should not nurse because of the risk of transmitting HIV to an infant that is not infected.

SIDE EFFECTS: The most common side effects of nevirapine are rash, headaches, diarrhea, nausea, fever, abdominal pain and muscle pain (myalgia). The most serious side effects are liver failure and severe skin reactions.