Classifications: antiretroviral agent; nonnucleoside reverse transcriptase inhibitor (nnrti); Therapeutic:antiretroviral; nnrti
Pregnancy Category: C
200 mg tablets; 10 mg/mL suspension
Nonnucleoside reverse transcriptase inhibitor (NNRI) of HIV-1. Binds directly to reverse transcriptase and blocks RNA- and
DNA-dependent polymerase activities, thus preventing replication of the virus.
Prevents replication of the HIV-1 virus. Does not inhibit HIV-2 reverse transcriptase and DNA polymerases such as alpha,
beta, gamma, and delta polymerases. Resistant strains appear rapidly.
In combination with nucleoside analogs for treatment of HIV.
Hypersensitivity to nevirapine; hormonal contraceptives; pregnancy (category C), neonates; lactation.
Liver or renal disease, hemodialysis; hepatitis B or C; CNS disorders.
Route & Dosage
Adult: PO 200 mg once daily for first 14 d, then increase to 200 mg b.i.d.
Child: PO 120 mg/m2 q.d. x 14 d, then increase q12h, if tolerated, to 120200 mg/m2 q12h (max: 200 mg/dose)
- Reinitiate with 200 mg/d for 14 d, then increase to b.i.d. dosing, when dosing is interrupted for >7 d.
- Store at 15°30° C (59°86° F) in a tightly closed container.
Adverse Effects (≥1%)Body as a Whole:
, myalgia. CNS:
, abdominal pain, hepatitis
, increased liver function tests, hepatotoxicity
(including fulminant and cholestatic hepatitis, hepatic necrosis, and hepatic failure,
especially with long-term use). Hematologic: Anemia
. Skin: Rash, Stevens-Johnson syndrome.
May decrease plasma
concentrations of protease inhibitors
, oral contraceptives
; may decrease methadone
levels inducing opiate withdrawal. Herbal: St. John's wort , garlic
may decrease antiretroviral activity.
Rapidly from GI tract. Peak:
60% protein bound, crosses placenta, distributed into breast milk. Metabolism:
In liver (CYP3A). Elimination:
Primarily in urine. Half-Life:
Assessment & Drug Effects
- Lab tests: Obtain baseline and periodic liver and kidney function tests, routine blood chemistry, and CBC.
- Monitor weight, temperature, respiratory status with chest x-ray throughout therapy.
- Monitor carefully, especially during first 6 wk of therapy, for severe rash (with or without fever, blistering, oral lesions,
conjunctivitis, swelling, joint aches, or general malaise).
- Withhold drug and notify physician if rash develops or liver function tests are abnormal.
Patient & Family Education
- Learn about common adverse effects.
- Withhold drug and notify physician if severe rash appears.
- Do not drive or engage in potentially hazardous activities until response to drug is known. There is a high potential for
drowsiness and fatigue.
- Use or add barrier contraceptive if using hormonal contraceptive.