Nevirapine

[neh-VYE-rah-peen] Pregnancy Category: C Viramune [Rx] Classification: Antiviral

See also Antiviral Drugs. Action/Kinetics: By binding tightly to reverse transcriptase, nevirapine prevents viral RNA from being converted into DNA. In combination with a nucleoside analogue, it reduces the amount of virus circulating in the body and increases CD4+ cell counts. Readily absorbed, with peak plasma levels occurring 4 hr after a 200-mg dose. Extensively metabolized in the liver. Excreted through both the urine (about 90%) and the feces (about 10%). Induces its own metabolism such that following chronic use the half-life decreases from about 45 hr following a single dose to 25 to 30 hr following multiple dosing with 200 or 400 mg daily. Uses: In combination with nucle-oside analogues (e.g., AZT, lamivu-dine, didanosine, zalcitabine) for the treatment of HIV-1 infections in adults who have experienced clinical and immunologic deterioration. Always use in combination with at least one other antiretroviral agent, as resistant viruses emerge rapidly when nevirapine is used alone. The use of nevirapine with protease inhibitors (e.g., saquinavir, indinavir, ri-tonavir) is not recommended. Contraindications: Lactation. Special Concerns: The duration of benefit from therapy may be limited. Nevirapine is not a cure for HIV infections; clients may continue to experience illnesses associated with HIV infections, including opportunistic infections. Nevirapine has not been shown to reduce the risk of transmitting HIV to others through sexual contact or blood contamination. Use with caution in impaired renal or hepatic function. Safety and efficacy have not been determined in children.

Side Effects: Oral: Ulcerative sto-matits. GI: Nausea, abnormal LFTs, diarrhea, abdominal pain, hepatitis. CNS: Headache, fatigue, paresthesia. Hematologic: Decreased hemoglobin, decreased platelets, decreased neutrophils. Miscellaneous: Rash (may be severe and life-threatening), fever, peripheral neuropathy, myalgia. Drug Interactions: None reported that may have potential dental concerns. However, nevirapine can induce cytochrome P450 enzymes. How Supplied: Tablet: 200 mg

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