Nevirapina Aurovitas (Nevirapine)

Nevirapine is an antiretroviral medication used to manage HIV‑1 infection by inhibiting viral replication.

• Adult HIV‑1 infection: reduces viral load when combined with other antiretrovirals.
• Pediatric HIV‑1 infection (≥2 years): part of combination therapy to control disease progression.
• Prevention of mother‑to‑child transmission: used under specialist supervision to lower transmission risk during pregnancy and delivery.

• Nevirapine binds to a non‑nucleoside site on the HIV‑1 reverse transcriptase enzyme, inducing a conformational change that blocks the enzyme's activity. This inhibition prevents the conversion of viral RNA into DNA, thereby halting viral replication and reducing the amount of virus in the bloodstream.

Nevirapine may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Rash: mild to moderate skin eruptions.
• Nausea: occasional stomach upset.
• Fatigue: feeling of tiredness.
• Headache: mild to moderate intensity.
• Dizziness: transient light‑headedness.
• Abdominal pain: discomfort in the stomach area.

Serious or Rare Side Effects

• Stevens‑Johnson syndrome: severe skin reaction requiring immediate medical attention.
• Hepatotoxicity: liver inflammation that may present with jaundice or elevated enzymes.
• Severe hypersensitivity: systemic allergic response with fever and malaise.
• Anaphylaxis: life‑threatening allergic reaction.
• Hepatic failure: loss of liver function.
• Severe rash: extensive skin involvement beyond mild eruptions.

Nevirapine requires careful monitoring due to potential risks.

• Hepatic monitoring: assess liver function before initiation and periodically during therapy.
• Skin reactions: discontinue if severe rash or signs of Stevens‑Johnson syndrome develop.
• Pregnancy considerations: use only under specialist guidance due to possible fetal risk.
• Drug resistance: avoid monotherapy and ensure adherence to combination regimens.
• Concomitant medications: review all co‑administered drugs for interaction potential.
• Store at ambient temperature: keep below 25°C, retain in original packaging, protect from moisture.

Nevirapine interacts with several medicines that can alter its effectiveness or safety.

Major Interactions (Avoid)

• Rifampicin: markedly reduces nevirapine plasma levels.
• St. John's wort: induces metabolism, lowering drug exposure.
• Protease inhibitors (e.g., ritonavir): can increase nevirapine concentrations leading to toxicity.
• Carbamazepine: induces hepatic enzymes, decreasing nevirapine efficacy.
• Efavirenz (high dose): may increase risk of hepatotoxicity.

Moderate Interactions (Monitor Closely)

• Didanosine: combined use may heighten risk of pancreatitis.
• Lamivudine: monitor for additive hepatic effects.
• Warfarin: observe INR for potential changes.
• Oral contraceptives: efficacy may be reduced; consider alternative contraception.