Nevirapina Farmoz (Nevirapine)

Nevirapine is an NNRTI used in the treatment of HIV‑1 infection, typically as part of combination antiretroviral regimens.

• HIV‑1 infection (adult): Reduces viral load when combined with other antiretrovirals.
• HIV‑1 infection (adolescent): Improves immune function as part of a pediatric regimen.
• HIV‑1 infection (treatment‑experienced): Provides an alternative NNRTI option for patients with prior therapy.

• Nevirapine binds to a non‑nucleoside site on the HIV‑1 reverse transcriptase enzyme, inducing conformational changes that inhibit the enzyme's RNA‑dependent DNA polymerase activity. This blockade prevents the conversion of viral RNA into DNA, thereby halting viral replication and reducing plasma HIV levels when used with other antiretroviral agents.

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

Common Side Effects

• Rash: mild to moderate skin eruptions.
• Nausea: occasional gastrointestinal upset.
• Fatigue: general feeling of tiredness.
• Headache: transient cranial discomfort.
• Insomnia: difficulty falling or staying asleep.
• Abdominal pain: mild stomach discomfort.

Serious or Rare Side Effects

• Stevens‑Johnson syndrome: severe skin reaction requiring immediate discontinuation.
• Hepatic failure: signs of liver toxicity such as jaundice.
• Severe rash: extensive or bullous skin lesions.
• Hypersensitivity: systemic allergic response.
• Neutropenia: marked reduction in white blood cells.
• Anemia: significant drop in red blood cell count.

Before initiating therapy, clinicians should assess patient-specific risk factors and monitor for adverse events.

• Monitor liver function: baseline and periodic tests are recommended.
• Assess for rash: discontinue if severe skin reactions develop.
• Check for hepatitis B/C co‑infection: increased risk of hepatotoxicity.
• Avoid use in patients with known hypersensitivity to nevirapine.
• Pregnancy considerations: evaluate risk‑benefit under medical supervision.
• Store at ambient temperature: keep below 25°C, protect from moisture and light.

Nevirapine interacts with several drugs that affect its metabolism or increase toxicity risk.

Major Interactions (Avoid)

• Ritonavir: potent CYP3A inhibition increases nevirapine levels.
• Efavirenz: additive central nervous system toxicity.
• St. John's wort: induces metabolism, reducing nevirapine efficacy.

Moderate Interactions (Monitor Closely)

• Other protease inhibitors (except ritonavir): may alter nevirapine concentrations.
• Anticonvulsants such as carbamazepine: may reduce nevirapine exposure.
• Oral contraceptives: nevirapine may decrease hormonal efficacy, requiring additional contraception.