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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIVIRALS FOR SYSTEMIC USE › DIRECT ACTING ANTIVIRALS › Non-nucleoside reverse transcriptase inhibitors
nevirapine
J05AG01
Forms & Strengths
- Tablet: 200 mg
- Extended-release tablet: 100 mg, 400 mg
- Oral suspension: 50 mg/5 mL
Adult Dosing
- Initial: 200 mg orally once daily for the first 14 days
- Maintenance: 200 mg orally twice daily or 400 mg extended-release once daily
- Lead-in period required to reduce risk of rash
Pediatric Dosing
- Neonates (15 days to <6 months): 150 mg/m2 or 4 mg/kg once daily for 14 days, then twice daily
- Children (6 months to <8 years): 4 mg/kg once daily for 14 days, then 7 mg/kg twice daily
- Children (>=8 years): 4 mg/kg once daily for 14 days, then 4 mg/kg twice daily (max 200 mg/dose)
Indications
- Treatment of HIV-1 infection in combination with other antiretroviral agents
- Prevention of mother-to-child HIV-1 transmission (PMTCT)
Mechanism of Action
- Non-nucleoside reverse transcriptase inhibitor (NNRTI) of HIV-1
- Binds directly to reverse transcriptase and blocks RNA-dependent and DNA-dependent DNA polymerase activities
- Does not require intracellular phosphorylation for activity
Contraindications
- Moderate to severe hepatic impairment (Child-Pugh Class B or C)
- Previous discontinuation due to severe rash, hypersensitivity, or severe hepatic toxicity
- Co-administration with St. John's wort
- Use as a single-agent post-exposure prophylaxis
Adverse Reactions
- Severe, life-threatening hepatotoxicity (including fatal fulminant hepatitis)
- Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
- Hypersensitivity reactions
- Nausea, fatigue, headache
- Asymptomatic transaminase elevations
Drug Interactions
- Inducer of CYP3A4 and CYP2B6 enzymes, potentially decreasing concentrations of co-administered drugs
- Co-administration with hormonal contraceptives significantly reduces contraceptive efficacy
- Decreases plasma concentrations of protease inhibitors (e.g., lopinavir, atazanavir)
- Concentrations decreased by strong inducers like rifampin
Curated Content: Needs Vetting Before Put to Clinical Use