nevirapine
(NVP)

· Drug type:

• "NNRTI" family (Non-Nucleoside Reverse Transcriptase Inhibitor antiretroviral agent)

· Important prescribing information

• The most common side effect of nevirapine is rash, seen
  in up to 20% of patients, often in the first 8 weeks. Rash
  is usually mild to moderate, but requires discontinuation
  in 5-7% of patients. Life-threatening cutaneous reactions
  have been reported.
• Hepatotoxicity is also most common in the first weeks to
  months of nevirapine therapy. While usually mild, fatal
  hepatotoxicity has been reported, and providers may
  choose to monitor liver function tests during nevirapine
  initiation, particularly in patients whose baseline Iiver
  function tests are abnormal.
• RIF reduces 37%drug levels of Nevirapine If you use with Rif (not recommended) you should increase doses of NVP

 

· Contraindications:

• Severe renal insufficiency (creatinine > 3 times normal)
• Severe hepatic insufficiency (LFTs > 5 times normal)
• History of previous intolerance
  

· Usual dose:

• May be taken with or without food.
• One 200-mg pill once daily for 14 days, then one
  200-mg pill twice daily.
• Patients who develop a rash during the 14 day in leading period should not increase the dose to twice daily
  until the rash has resolved.
• In poor hospice some specific contexts impose other dosages. For instence, if you use NVP with RIF, you should increase doses of NVP. (See 01-ARVprotocols on those topics).