Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Rarely, nevirapine has also caused serious (sometimes fatal) skin /allergic reactions. Centers for Disease Control. J Am Acad Dermatol 44 (2001): 354-7, 18. Dizziness (extreme) or faintness. Patients without HIV using this drug for postexposure prophylaxis have reported serious hepatotoxicity, including hepatic failure. AIDS 22 (2008): 435-6, 53. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Joy S, Poi M, Hughes L, et al. Some side effects of nevirapine can be serious. Piacenti FJ "An update and review of antiretroviral therapy." This will make your medicines work better. Pain, numbness, or tingling of the hands, arms, legs, or feet, blistering, peeling, or loosening of the skin, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals, muscle cramps, spasms, pain, or stiffness, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue, red skin lesions, often with a purple center, sores, ulcers, or white spots in the mouth or on the lips, feeling of constant movement of self or surroundings, painful, red lumps under the skin, mostly on the legs. Dube M, Fenton M "Lipid abnormalities." Aids 14 (2000): 1655-6, 26. "Risk factors for acute generalized exanthematous pustulosis (AGEP)-results of a multinational case-control study (EuroSCAR)." License: Except as otherwise noted, this work is licensed under a Creative Commons … This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Call your doctor for medical advice about side effects. Barreiro P, Soriano V, Casas E, Estrada V, Tellez MJ, Hoetelmans R, deRequena DG, JimenezNacher I, GonzalezLahoz J "Prevention of nevirapine-associated exanthema using slow dose escalation and/or corticosteroids." However, elderly patients are more likely to have age-related kidney, liver, or heart problems which may require caution and an adjustment in the dose for patients receiving nevirapine. Hepatitis C—Use with caution. The incidence of grade 4 elevated AST (greater than 10 x ULN) was 2% with each formulation. Nevirapine may increase the hepatotoxic activities of Pexidartinib. Phenelzine: The metabolism of Nevirapine can be decreased when combined with Phenelzine. Prakash M, Poreddy V, Tiyyagura L, Bonacini M "Jaundice and hepatocellular damage associated with nevirapine therapy." Gallant JE "Drug resistance after failure of initial antiretroviral therapy in resource-limited countries." The greatest risk of these problems is during the first 6 weeks of treatment with nevirapine. Pharmacotherapy 26 (2006): 1111-33, 8. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. This medicine may decrease the effects of some birth control pills. Viramune XR (nevirapine)." Sidoroff A, Dunant A, Viboud C, et al. Panel on Antiretroviral Guidelines for Adults and Adolescents The risk of these serious side effects is high in the first 18 weeks and highest during the first 6 weeks of nevirapine treatment. Clin Pharmacokinet 42 (2003): 599-605, 16. Copyright © 2021 IBM Watson Health. Conway B "Initial therapy with protease inhibitor-sparing regimens: Evaluation of nevirapine and delavirdine." Portions of this document last updated: Feb. 01, 2021, Original article: https://www.mayoclinic.org/drugs-supplements/nevirapine-oral-route/side-effects/DRG-20065048. Check transaminase levels immediately for all patients who develop a rash during the first 18 weeks of treatment. Soriano V, Puoti M, Sulkowski M, et al. You may report side effects to FDA at 1-800-FDA-1088. "Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?" For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. If you are taking two doses per day, the doses should be spaced about 12 hours apart. In 1 study, after the lead-in period, the incidence of any hepatic event was 9% with the immediate-release formulation and 6% with the extended-release formulation. Timmermans S, Tempelman C, Godfried MH, et al. Bonnet F, Lawson-Ayayi S, Thiebaut R, et al. However, these side effects may occur at any time while taking this medication. This is followed by 400 mg of Viramune XR® once a day, together with other HIV medicines. Available from: URL: https://aidsinfo.nih.gov/contentfiles/lvguidelines/pediatricguidelines.pdf." J Antimicrob Chemother 59 (2007): 342-6, 46. Rarely, nevirapine has also caused serious (sometimes fatal) skin/ allergic reactions. Do not allow yourself to run out of this medicine. Grade 3 decreased phosphate was reported in 6% and 7% of patients using the immediate-release and extended-release formulations, respectively. However, use is not recommended in children younger than 6 years of age. https://www.mayoclinic.org/drugs-supplements/nevirapine-oral-route/side-effects/DRG-20065048, Advertising and sponsorship opportunities. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. 93-95a Single-dose nevirapine, however, is associated with alarming rates of NNRTI resistance in … Available from: URL: https://aidsinfo.nih.gov/contentfiles/lvguidelines/adultandadolescentgl.pdf." Am J Obstet Gynecol 194 (2006): 199-202, 39. AIDS 19 (2005): 993-994, 36. Do not double doses. Although not all of these side effects may occur, if they do occur they may need medical attention. Clin Infect Dis 39 (2004): 1024-9, 25. Learn about Nevirapine from patients' first hand experiences and trusted online health resources, including dosage, side effects and interactions. Haas DW, Bartlett JA, Andersen JW, et al. These side effects may go away during treatment as your body adjusts to the medicine. Decreased neutrophils (less than 750/mm3), hemoglobin (less than 8 g/dL), and platelets (less than 50,000/mm3) have been reported in up to 13%, up to 3%, and up to 1% of patients, respectively. This medicine works best when there is a constant amount in the blood. Data sources include IBM Watson Micromedex (updated 3 Mar 2021), Cerner Multum™ (updated 1 Mar 2021), ASHP (updated 3 Mar 2021) and others. Sankatsing SU, Schouten WE "Diffuse interstitial pulmonary opacities induced by nevirapine." In some cases, patients presented with nonspecific prodromal signs/symptoms of hepatitis (including fatigue, malaise, anorexia, nausea, jaundice, liver tenderness/hepatomegaly, with or without initially abnormal transaminase levels). Liver disease, moderate or severe—Should not be used in patients with this conditions. Adverse effects. All rights reserved. The incidence of grade 4 decreased neutrophils (less than 500/mm3) was 1% with each formulation. Author information: (1)Department of Internal Medicine-Infectious Diseases, Hospital del Mar, Barcelona, Spain. Severe, life-threatening, and in some cases fatal, hepatotoxicity (including fulminant and cholestatic hepatitis, hepatic necrosis, and hepatic failure) has been reported. The most serious side effects have included hepatitis, hepatic failure, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms, and hypersensitivity reactions. Liver enzyme abnormalities (AST, ALT, GGT) occurred more often in patients using this drug than in controls. Symptomatic hepatic events (anorexia, jaundice, vomiting) were reported in 3% and 2% of patients using the immediate-release and extended-release formulations, respectively. DRESS was characterized by rash with constitutional symptoms (e.g., fever, arthralgia, myalgia, lymphadenopathy) plus visceral involvement (e.g., hepatitis, eosinophilia, granulocytopenia, renal dysfunction). HIV is the virus that causes acquired immune deficiency syndrome (AIDS). Nevirapine is used along with other medications to treat human immunodeficiency virus (HIV) infection in adults and children 15 days of age and older. Rivero A, Mira JA, Pineda JA "Liver toxicity induced by non-nucleoside reverse transcriptase inhibitors." Martinez E, Blanco JL, Arnaiz JA, PerezCuevas JB, Mocroft A, Cruceta A, Marcos MA, Milinkovic A, GarciaViejo MA, Mallolas J, "Hepatotoxicity in HIV-1-infected patients receiving nevirapine-containing antiretroviral therapy." For oral dosage form (extended-release tablets): Adults—At first, one 200 milligram (mg) Viramune® immediate-release tablet once a day for the first 14 days. "Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV Follow your doctor's orders or the directions on the label. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Gangar M, Arias G, O'Brien JG, Kemper CA "Frequency of cutaneous reactions on rechallenge with nevirapine and delavirdine." Monitor patients intensively during the first 18 weeks of therapy with nevirapine to detect potentially life-threatening hepatotoxicity or skin reactions. "Product Information. "Product Information. Panos G, Kopterides P, Falagas ME "Hyperlactatemia due to nevirapine." Tell your doctor if you or your child notice changes in your body shape, including an increased amount of body fat in your neck or upper back, face, around your chest, or stomach area. Blood tests may be needed to check for unwanted effects. The incidence of grade 3 decreased neutrophils (500 to 749/mm3) was 2% with each formulation. This product is available in the following dosage forms: In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. [Ref], Frequency not reported: Arthromyalgia, arthritis, Postmarketing reports: Rhabdomyolysis (associated with skin and/or liver reactions), arthralgia, -Frequency not reported: Osteonecrosis[Ref], Uncommon (0.1% to 1%): Increased blood pressure, Frequency not reported: Hyperlactatemia, unspecified metabolic alterations, anorexia, acute porphyria, Postmarketing reports: Redistribution/accumulation of body fat (including central obesity, dorsocervical fat enlargement, peripheral wasting, facial wasting, breast enlargement, "cushingoid appearance")[Ref], Frequency not reported: Immune reconstitution syndrome, autoimmune disorders in the setting of immune reconstitution (e.g., Graves' disease, polymyositis, Guillain-Barre syndrome), Frequency not reported: Dry cough, dyspnea, interstitial pulmonary infiltration[Ref]. Viramune (nevirapine)." Do not take more than one dosage form of nevirapine at the same time. "Drugs for HIV infection." feeling cold. Grade 4 decreased phosphate was reported in less than 1% of patients using the immediate-release formulation. It is very important that your doctor check your or your child's progress to make sure that this medicine is working properly.
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