Nevirapine Teva (Nevirapine)

• Nevirapine is an antiretroviral medication used in the treatment of HIV-1 infection.
• HIV-1 infection (adults): reduces viral load when combined with other antiretrovirals.
• HIV-1 infection (children): part of pediatric combination therapy to control disease progression.
• Treatment‑experienced HIV-1 patients: offers an alternative NNRTI option when resistance patterns allow.

• Nevirapine binds to a specific allosteric site on the HIV‑1 reverse transcriptase enzyme, distinct from the nucleoside binding pocket. This binding induces a conformational change that directly inhibits the enzyme’s activity, preventing the transcription of viral RNA into DNA and thereby halting viral replication within infected cells.

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: feeling of tiredness or weakness.
• Headache: transient cranial discomfort.
• Abdominal pain: mild stomach discomfort.
• Dizziness: occasional light‑headedness.

Serious or Rare Side Effects

• Stevens‑Johnson syndrome: severe skin reaction requiring immediate discontinuation.
• Hepatic failure: significant liver injury with elevated enzymes.
• Severe hypersensitivity: systemic allergic response with fever and malaise.
• Liver toxicity: jaundice or hepatitis.
• Severe neutropenia: marked reduction in white blood cells.
• Life‑threatening skin reactions: toxic epidermal necrolysis.

• When prescribing Nevirapine, clinicians should observe several safety measures.
• Liver function monitoring: assess baseline and periodic liver enzymes due to risk of hepatotoxicity.
• Skin reactions: discontinue if severe rash or Stevens‑Johnson syndrome develops.
• Drug resistance: avoid monotherapy; use only in combination regimens.
• Pregnancy: evaluate risk‑benefit; use only if benefits outweigh potential fetal risks.
• Store at ambient temperature: keep below 25°C, retain original packaging, and protect from moisture.

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

Major Interactions (Avoid)

• Ritonavir‑boosted protease inhibitors: may increase nevirapine levels and toxicity.
• St. John’s wort: induces metabolism, reducing nevirapine effectiveness.
• Efavirenz: combined use may heighten hepatotoxic risk.
• Azole antifungals (e.g., ketoconazole): can raise nevirapine concentrations.

Moderate Interactions (Monitor Closely)

• CYP3A4 substrates (e.g., certain statins): may require dose adjustment.
• Oral contraceptives: efficacy may be reduced; consider alternative contraception.
• Methadone: nevirapine may lower methadone levels, necessitating monitoring.