Nevirapine

Indications

Nevirapine is used for: HIV infection

Adult Dose

Oral HIV infection Adult: Combined with other antiretrovirals: 200 mg once daily for the first 14 days; increase to 200 mg bid if rash does not develop. Interrupting the treatment for >7 days necessitate reintroduction at a lower dose for the first 14 days.

Child Dose

Oral HIV infection Child: Combined with other antiretrovirals: 2 mth to 8 yr: 4 mg/kg once daily for the first 14 days; increase to 7 mg/kg bid if no rash is present. 8-16 yr: 4 mg/kg once daily for 14 days followed by 4 mg/kg bid. Max: 400 mg daily. Interrupting the treatment for >7 days necessitate reintroduction at a lower dose for the first 14 days.

Renal Dose

Renal impairment: Haemodialysis: A further 200-mg dose is recommended after dialysis.

Administration

May be taken with or without food.

Contra Indications

Hypersensitivity. Lactation. Severe hepatic impairment.

Precautions

Pregnancy. Interrupt treatment if severe hepatotoxicity or life-threatening skin reactions develop. Renal or hepatic insufficiency. Monitor liver function periodically.

Pregnancy-Lactation

Interactions

Mutually increased levels effects when used with drugs extensively metabolised by CYP3A. Reduced levels/effects of methadone.

Adverse Effects

Side effects of Nevirapine : Skin rash, nausea, vomiting, headache, abnormal LFT, fatigue, diarrhoea, abdominal pain. Potentially Fatal: Severe and life-threatening hepatotoxic and skin reactions

Mechanism of Action

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.