Nevirapine

Generic name: Nevirapine

Drug class: Non-nucleoside reverse transcriptase inhibitor (NNRTI)

Dosage form: Immediate-release tablets, extended-release tablets, oral suspension

Route of administration: Oral

Dose:

• Adults: 200 mg once daily for 14 days (lead-in period), then 200 mg twice daily or 400 mg once daily (extended-release formulation)
• Children: Dosing varies based on age and weight; consult prescribing information for specific recommendations

Mechanism of action: Nevirapine binds directly to HIV-1 reverse transcriptase, inhibiting its function in viral DNA replication, thereby reducing HIV replication.

Drug usage cases:

• Treatment of HIV-1 infection in combination with other antiretroviral agents
• Prevention of mother-to-child transmission of HIV during labor and delivery

Drug contraindications:

• Severe hypersensitivity to nevirapine or any component of the formulation
• Moderate or severe hepatic impairment (Child-Pugh Class B or C)

Side effects:

• Common: Rash, headache, nausea, fatigue, liver enzyme abnormalities
• Serious: Severe skin reactions (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis), life-threatening liver toxicity, hypersensitivity reactions

Warnings:

• Monitor for signs of severe skin reactions and liver toxicity, especially during the first 18 weeks of treatment
• Not recommended for post-exposure prophylaxis (PEP) due to risk of severe liver toxicity
• Use with caution in patients with a history of liver disease
• Potential drug interactions due to induction of cytochrome P450 enzymes; adjust doses of co-administered medications accordingly

Use during pregnancy or breastfeeding:

Nevirapine is classified as a Category B3 drug in Australia, indicating that it is not expected to harm the fetus. However, its safety during pregnancy has not been well established. It is recommended for use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Nevirapine is excreted in breast milk; therefore, breastfeeding is not recommended during treatment to avoid potential transmission of HIV to the infant.