Nevirapina Generis (Nevirapine)

Nevirapine is an antiretroviral drug that targets HIV‑1 reverse transcriptase, a key enzyme in the viral replication cycle.

• HIV‑1 infection: suppresses viral replication when used in combination antiretroviral regimens.
• AIDS: helps improve immune function and reduce opportunistic infections as part of therapy.
• Prevention of mother‑to‑child transmission: reduces the risk of vertical HIV transmission when administered to pregnant women in combination therapy.

• Nevirapine binds to a non‑nucleoside site on the HIV‑1 reverse transcriptase enzyme, inducing conformational changes that inhibit its activity. This blockade prevents the conversion of viral RNA into DNA, thereby halting the synthesis of proviral DNA and interrupting the HIV replication cycle.

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.
• Headache: transient cranial discomfort.
• Fatigue: general tiredness.
• Dizziness: occasional light‑headedness.
• 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 hypersensitivity: systemic allergic response.
• Anaphylaxis: life‑threatening allergic reaction.
• Hepatotoxicity: elevated liver enzymes and possible liver injury.

Before initiating therapy, clinicians should consider several safety measures.

• Monitor liver function: obtain baseline and periodic liver enzyme tests.
• Assess for rash: discontinue promptly if severe cutaneous reactions develop.
• Avoid in known hypersensitivity: do not prescribe to patients with prior nevirapine allergy.
• Use caution in pregnancy: limited safety data; weigh benefits against potential risks.
• Store at room temperature: keep in the original pack, protect from moisture and direct sunlight.

Nevirapine interacts with several drugs that can alter its plasma levels or increase toxicity.

Major Interactions (Avoid)

• Rifampicin: induces metabolism, markedly reducing nevirapine concentrations.
• St. John’s wort: herbal inducer that lowers nevirapine exposure.
• Protease inhibitors (e.g., ritonavir): increase nevirapine levels, raising toxicity risk.

Moderate Interactions (Monitor Closely)

• Efavirenz: may enhance central nervous system side effects.
• Zidovudine: combined use can affect hematologic parameters.
• Didanosine: concurrent therapy may increase risk of pancreatitis.