Nevirapine Teva Lp (Nevirapine)

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

• HIV‑1 infection (treatment‑naïve): suppresses viral load when used in first‑line regimens.
• HIV‑1 infection (treatment‑experienced): provides an alternative option for patients with prior therapy.
• Combination antiretroviral therapy: contributes to overall viral suppression as part of multi‑drug regimens.

• Nevirapine binds to a non‑nucleoside site on the HIV‑1 reverse transcriptase enzyme, inducing a conformational change that blocks the enzyme’s ability to transcribe viral RNA into DNA. This inhibition prevents the synthesis of proviral DNA, halting the replication cycle of HIV‑1 and reducing viral load in the patient.

Nevirapine may cause a range of adverse reactions, from mild to severe. Patients should be monitored for any new symptoms during therapy.

Common Side Effects

• Rash: mild to moderate skin eruptions.
• Nausea: occasional gastrointestinal upset.
• Fatigue: feeling of tiredness or weakness.
• Headache: transient cranial discomfort.
• Dizziness: light‑headed sensation.
• Abdominal pain: mild stomach discomfort.

Serious or Rare Side Effects

• Stevens‑Johnson syndrome: severe skin reaction requiring immediate medical attention.
• Hepatic failure: signs of liver toxicity such as jaundice.
• Severe hypersensitivity: including fever and systemic rash.
• Neutropenia: marked reduction in white blood cells.
• Hepatotoxicity: elevated liver enzymes or liver injury.
• Life‑threatening rash: extensive skin involvement.

Before initiating Nevirapine therapy, clinicians should assess patient history and monitor for potential risks.

• Hepatic monitoring: perform baseline liver function tests and repeat periodically.
• Skin reactions: educate patients to report any rash promptly.
• Pregnancy considerations: evaluate benefits versus risks in pregnant women.
• Drug resistance: avoid use in patients with known NNRTI resistance.
• Concomitant medications: review for interactions that may affect drug levels.
• Store at ambient temperature: keep below 25 °C, in original packaging, protected from moisture and direct sunlight.

Nevirapine can alter the plasma concentrations of several co‑administered drugs, requiring careful management.

Major Interactions (Avoid)

• Rifampicin: induces metabolism, markedly reducing Nevirapine exposure.
• St. John's wort: strong enzyme inducer that lowers Nevirapine levels.
• Protease inhibitors (e.g., ritonavir): may increase toxicity risk.

Moderate Interactions (Monitor Closely)

• Azole antifungals (e.g., fluconazole): can increase Nevirapine concentrations.
• Macrolide antibiotics (e.g., erythromycin): may affect hepatic metabolism.
• Warfarin: monitor INR for potential anticoagulant effect changes.
• Oral contraceptives: efficacy may be reduced; consider alternative contraception.