Nevirapine Wockhardt (Nevirapine)

Nevirapine is used to manage HIV‑1 infection and is incorporated into combination antiretroviral regimens.

• HIV‑1 infection (adults): reduces viral replication and improves immune function.
• HIV‑1 infection (children): provides viral suppression as part of pediatric treatment protocols.
• Combination antiretroviral therapy: contributes to multi‑drug regimens to achieve durable viral load suppression.

• 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 transcription of viral RNA into DNA, thereby halting the replication cycle of HIV and reducing viral load in the patient.

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

Common Side Effects

• Rash: mild to moderate skin eruptions.
• Nausea: occasional gastrointestinal discomfort.
• Fatigue: general tiredness.
• Headache: transient cranial pain.
• Dizziness: occasional light‑headedness.
• Diarrhoea: loose stools.

Serious or Rare Side Effects

• Stevens‑Johnson syndrome: severe skin reaction requiring immediate medical attention.
• Hepatic failure: signs of liver dysfunction such as jaundice.
• Severe hypersensitivity: fever, eosinophilia, or organ involvement.
• Neutropenia: marked reduction in white blood cells.
• Anemia: decreased red blood cell count.
• Hepatotoxicity: elevated liver enzymes or hepatitis.

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

• Liver function monitoring: perform baseline and periodic liver enzyme tests.
• Rash assessment: evaluate any skin changes promptly.
• Hypersensitivity vigilance: watch for fever, eosinophilia, or organ involvement.
• Hepatic impairment avoidance: avoid in patients with severe liver disease.
• Pregnancy counseling: discuss unknown fetal risk and consider alternatives.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

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

Major Interactions (Avoid)

• Rifampin: induces metabolism, reducing nevirapine levels.
• St. John’s wort: strong enzyme inducer, decreasing drug exposure.
• Protease inhibitors (e.g., ritonavir): can increase nevirapine concentrations and toxicity.

Moderate Interactions (Monitor Closely)

• Azole antifungals: may raise nevirapine levels; monitor liver function.
• Warfarin: potential alteration of anticoagulant effect; check INR regularly.