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 is not a cure for HIV or AIDS.
Nevirapine may also be used for purposes other than those listed in this medication guide.
What is the most important information I should know about Viramune (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 if you have any type of skin rash. Even a minor skin rash could be an early sign of a serious reaction. Later signs include fever, sore throat, and headache with a severe blistering, peeling, and red skin rash. 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 the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.
HIV/AIDS is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.
Taking nevirapine will not prevent you from passing HIV to other people through unprotected sex or sharing of needles. Talk with your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.
What should I discuss with my healthcare provider before taking Viramune (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 if you have any type of skin rash. Even a minor skin rash could be an early sign of a serious reaction. Later signs include fever, sore throat, and headache with a severe blistering, peeling, and red skin rash. This type of reaction is a medical emergency. Do not use this medication if you are allergic to nevirapine.
Before taking nevirapine, tell your doctor if you are allergic to any drugs, or if you have:
- liver disease;
- kidney disease (or if you are on dialysis); or
- if you have ever taken delavirdine (Rescriptor) or efavirenz (Sustiva) and they were not effective in treating your condition.
If you have any of these conditions, you may not be able to use nevirapine, or you may need a dosage adjustment or special tests during treatment.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Nevirapine may also 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 the baby if the mother is not properly treated during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Take all of your HIV medicines as directed to control your infection while you are pregnant. 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.
Your name may need to be listed on an antiviral pregnancy registry when you start using nevirapine. The purpose of this registry is to track the outcome of the pregnancy and delivery to evaluate whether nevirapine had any effect on the baby.
You should not breast-feed while you are using nevirapine. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.
How should I take Viramune (nevirapine)?
Take nevirapine exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. 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 7 days or longer, call your doctor before you start taking the medicine again. You may have to start with a lower dose.
Take nevirapine with a full glass of water. You may also take the medicine with milk or a soft drink.
Nevirapine can be taken with or without food.
Shake the oral suspension (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked 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 on a regular basis. This testing is especially important during the first 6 to 18 weeks you are taking nevirapine. Do not miss any scheduled visits to your doctor.
It is important to take nevirapine regularly to get the most benefit. Get your prescriptions 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.
To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor. Every person with HIV or AIDS should remain under the care of a doctor.
Store nevirapine at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine.
Symptoms of a nevirapine overdose may include skin rash, headache, dizziness, tired feeling, sleep problems, nausea, vomiting , weight loss, joint pain or swelling, red or tender bumps on your shins, wheezing, cough, or trouble breathing.
Viramune (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:
- fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
- nausea, stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
- fever, chills, body aches, flu symptoms; or
- any other signs of new infection.
Keep taking nevirapine if you have any of these less serious side effects:
- nausea, vomiting, stomach pain;
- headache, tired feeling; or
- changes in body fat (e.g., increased fat in the upper back, neck, breast, and trunk and loss of fat from the legs, arms, and face).
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect Viramune (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:
- St. John’s wort;
- a blood thinner such as warfarin (Coumadin);
- an antibiotic such as clarithromycin (Biaxin), itraconazole (Sporanox), rifabutin (Mycobutin), or rifampin (Rifadin, Rifater, Rifamate, Rimactane);
- ergot medicine such as ergotamine (Ergomar, Ergostat, Cafergot, Ercaf, Wigraine), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine);
- heart or blood pressure medications such as amlodipine (Norvasc), diltiazem (Tiazac, Cartia, Cardizem), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), nimodipine (Nimotop), nisoldipine (Sular), or verapamil (Calan, Covera, Isoptin, Verelan);
- medication to prevent organ transplant rejection;
- other HIV medicines such as nelfinavir (Viracept), efavirenz (Sustiva), indinavir (Crixivan), lopinovir/ritonavir (Kaletra), nevirapine (Viramune), or saquinavir (Invirase); or
- seizure medications such as carbamazepine (Tegretol), clonazepam (Klonipin), or ethosuximide (Zarontin).
If you are using any of these drugs, you may not be able to use nevirapine, or you may need dosage adjustments or special tests during treatment.
Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.
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