Common uses

Nevirapine is used in combination with other medications to treat human immunodeficiency virus (HIV) infection in patients with or without acquired immunodeficiency syndrome (AIDS). Nevirapine is in a class of medications called non-nucleoside reverse transcriptase inhibitors (NNRTIs). It works by decreasing the amount of HIV in the blood. Nevirapine does not cure HIV and may not prevent you from developing HIV-related illnesses. Nevirapine does not prevent the spread of HIV to other people.

Before using

Before taking nevirapine,
• tell your doctor and pharmacist if you are allergic to nevirapine or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin);certain antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral) and voriconazole (Vfend); calcium channel blockers such as diltiazem (Cardizem, Dilacor, Tiazac), nifedipine (Adalat, Procardia), and verapamil (Calan, Covera, Isoptin, Verelan); clarithromycin (Biaxin);certain cancer chemotherapy medications such as cyclophosphamide (Cytoxan); cisapride (Propulsid); cyclosporine (Neoral, Sandimmune); ergot alkaloids such as ergotamine (Cafergot, Ercaf, others); fentanyl (Duragesic, Actiq); medications for irregular heartbeat such as amiodarone (Cordarone) and disopyramide (Norpace); medications for seizures such as carbamazepine (Tegretol), clonazepam (Klonopin), and ethosuximide (Zarontin); methadone (Dolophine), other medications for HIV or AIDS such as amprenavir (Agenerase), atazanavir (Reyataz), efavirenz (Sustiva), indinavir (Crixivan); lopinavir and ritonavir combination (Kaletra), nelfinavir (Viracept) and saquinavir (Fortovase, Invirase); prednisone (Deltasone); rifabutin (Mycobutin), rifampin (Rifadin, Rimactane), sirolimus (Rapamune),and tacrolimus (Prograf).Many other medications may interact with nevirapine, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
• tell your doctor and pharmacist what herbal products you are taking, especially St. John's wort .
• tell your doctor if you have or have ever had kidney disease, especially if you are being treated with dialysis (treatment to clean the blood outside the body when the kidneys are not working well).
• tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking nevirapine, call your doctor. You should not breastfeed if you are infected with HIV or are taking nevirapine.
• tell your doctor if you are taking oral contraceptives ('birth control pills') to prevent pregnancy. Nevirapine may interfere with the action of oral contraceptives. Talk to your doctor about other methods of birth control that will work for you.
• you should know that your body fat may increase or move to other areas of your body such as your breasts, waist, or upper back.

Directions

May be taken with or without food but taking with food may help reduce nausea. Doses should be taken as close to 12 hours apart as possible. If a dose is missed don't double up the next dose.

Cautions

The most serious adverse reactions associated with Viramune are hepatitis/hepatic failure, Stevens-Johnson syndrome, toxic epidermal necrolysis, and hypersensitivity reactions. Hepatitis/hepatic failure may be associated with signs of hypersensitivity which can include severe rash or rash accompanied by fever, general malaise, fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, facial edema, eosinophilia, granulocytopenia, lymphadenopathy, or renal dysfunction.
Possible side effects

Most common side effects include headache, nausea, vomiting and rash. The reason for the 14-day lead-in dosing is to reduce the frequency of rash and incidence of drug-induced hepatitis. A serious side effect of the NNRTI class is rash, which can be life-threatening. If you experience blistering, mouth sores, conjunctivitis (redness or inflammation of eye, or pink eye, which if untreated may result in permanent vision loss), swelling, muscle or joint aches, fever or general malaise (general ill feeling), stop taking Viramune and your other anti-HIV meds and seek immediate medical attention.

If you take too much

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.
• Symptoms of Viramune overdose may include:
Dizziness, fatigue, fever, headache, insomnia, nausea, rash, reddened bumps on the skin, respiratory problems, swelling, vomiting, weight loss

Additional information

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Drug interactions

If Viramune is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Viramune with the following:
Clarithromycin (Biaxin)
Efavirenz (Sustiva)
Fluconazole (Diflucan)
Indinavir (Crixivan)
Ketoconazole (Nizoral)
Lopinavir/Ritonavir (Kaletra)
Methadone (Dolophine)
Nelfinavir (Viracept)
Rifabutin (Mycobutin)
Rifampin (Rifadin, Rimactane)
St. John's wortSaquinavir (Fortovase)
Zidovudine (Retrovir)
Viramune may interfere with birth control pills and other hormonal contraceptives. Do not use this form of contraception during Viramune therapy.
Also, it's important to talk to your doctor before combining Viramune with any of the following:
Antiarrhythmic heart medications such as disopyramide (Norpace) Anticonvulsant (seizure) medications such as carbamazepine (Tegretol), clonazepam (Klonopin) Antifungal medications such as itraconazole (Sporanox) Blood-thinning medications such as warfarin (Coumadin) Calcium channel blocker (angina) medications such as diltiazem (Cardizem), nifedipine (Procardia), verapamil (Calan) Cancer chemotherapy medications such as cyclophosphamide (Cytoxan) Immunosuppressant medications such as cyclosporine (Sandimmune, Neoral) Migraine medications such as ergotamine (Cafergot) Opiate agonists (narcotic) pain medications such as fentanyl (Duragesic)