Nevirapine

Nevirapine is a first-generation oral non-nucleoside reverse transcriptase inhibitors (NNRTI), with activity against human immunodeficiency virus (HIV-1). Nevirapine is used in combination with nucleoside reverse transcriptase inhibitors (antiretroviral agents) for the treatment of HIV infection. It should not be given alone because of rapid emergence of resistant HIV isolates. It was approved under the FDAs accelerated approval program June 24, 1996 based on changes in surrogate markers (e.g., CD4 cell counts and HIV viral load) in studies lasting up to 48 weeks.

Brands
PIVIR ZEVIRAN TRIOMUNE TRIOMUNE NEVIMUNE
Adult Dose
Dose: 200 mg
Single Dose: 200 (200)
Frequency: 24 hourly
Route: PO
Instructions: For first 14 days then 200mg BD
Neonatal
Paedriatic
Dose: 4 mg/kg
Single Dose: 4 (4)
Frequency: 24 hourly
Route: for 14 days and then inf no rash is present 7mg/kg twice daily.
Instructions:
Characteristics
. It is of Synthetic origin. . The Molecular Weight of Nevirapine is 266.30.
Contraindications
Nevirapine is contraindicated in conditions like Breast feeding.
Effects
The severe or irreversible adverse effects of Nevirapine, which give rise to further complications include Hepatitis, Anaemia, Neuropsychiatric reactions, Granulocytopenia (more frequent in children).Nevirapine produces potentially life-threatening effects which include Stevens Johnson syndrome, Stevens Johnson syndrome. which are responsible for the discontinuation of Nevirapine therapy.The symptomatic adverse reactions produced by Nevirapine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Headache, Fatigue, Nausea, Vomiting, Diarrhea, Fever, Myalgia, Abdominal pain, Urticaria, Skin RashX, Somnolence, Arthralgia, Anaphylaxis.
Indications
Nevirapine is primarily indicated in conditions like HIV infection, Multiple myeloma, Promyelocytic leukemia.
Interactions
Nevirapine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAmiodarone (HCl)AstemizoleCisaprideClarithromycinDidanosineDihydroergotamine (Mesylate)DolutegravirAvoid concomitant use of nevirapine with any dosage of dolutegravirErgotamine (Tartrate)ErythromycinEstrogens ConjugatedFlecainide (Acetate)Indinavir (Sulphate)KetoconazoleMidazolamNitrendipineNevirapine may decrease the levels/effects of nitrendipine.ProgesteroneQuinidineRifabutinRifampicinSaquinavirSaquinavirSt.Johns Wort ExtractThe oral clearance of nevirapine was significantly increased in patients treated with nevirapine and concomitant St. Johns wort.TerfenadineTheophyllineTriazolamZolpidem (Tartrate) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to patients suffering from Kidney dysfunction, and patients suffering from Liver Malfunction.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab Store in a well closed container, at room temperature.
Warnings
Hepatic impairment; chronic hepititis B or C; high CD4 cell count, and women (all greatest risk of hepatic side effects); pregnancy. HEPATIC DISEASE. Potentially life-threatening hepatotoxicity including fatal hepititis reported in first 6 weeks; close monitoring required during first 18 weeks; monitor liver function before treatment then every 2 weeks for 2 months then after 1 month and then regularly; discontinue permanently if abnormalities in liver function test accompanied by hypersensitivity reactions (rash, fever, arthralgia, myalgia, lymphadenopathy, hepatitis, renal impairment, eosinophilia, granulocytopenia); suspended if severe abnormalities in liver function test but no hypersensitivity reaction ---discontinue permanently if significant liver function abnormalities recur; monitor patient closely if mild to moderate abnormalities in LFT with no hypersensitivity reaction. RASH: rash usually in 6 weeks, is most common side effect; incidence reduced if introduced at low dose and dose increase gradually; monitor closely for skin reaction during first 18 weeks; discontinue permanently if severe rash or if rash accompanied by blistering, oral lesions, conjunctivitis, facial oedema, general malaise, or hypersensitivity reaction; if rash mild to moderatemay continue without interruption but dose should not be increased until rash resolves.COUNSELLING: Patients should be told how to recognise hypersensitivity reactionsand advised to seek immediate medical attention if symptoms develop.
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