Classifications: antiretroviral agent; nonnucleoside reverse transcriptase inhibitor (nnrti);
; nnrti
Prototype: Efavirenz
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.

Therapeutic Effect

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.

Cautious Use

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 120–200 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: Fever, paresthesia, myalgia. CNS: Headache. GI: Nausea, diarrhea, 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, neutropenia. Skin: Rash, Stevens-Johnson syndrome.


Drug: 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.


Absorption: Rapidly from GI tract. Peak: 4h. Distribution: 60% protein bound, crosses placenta, distributed into breast milk. Metabolism: In liver (CYP3A). Elimination: Primarily in urine. Half-Life: 25–40 h.

Nursing Implications

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.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

© 2006-2023 Last Updated On: 01/31/2023 (0)
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