Nevirapine

Please read this factsheet together with the patient information leaflet carefully before taking your medicine. If you have any questions or are unsure about anything, ask your doctor or pharmacist.

Nevirapine also known as Viramune, belongs to a class of drugs called non-nucleoside reverse transcriptase inhibitors (NNRTIs). NNRTIs are used for the treatment of HIV infection, in combination with other anti-HIV drugs. Please speak to your clinic doctor or pharmacist if you would like more information about how these drugs work.

Before taking Nevirapine
Tell your doctor about:

* All other drugs you are taking, including any that you buy over the counter in a community pharmacy and any herbal medicines or recreational drugs;
* Any previous allergy to any medicines;
* If you have ever had any liver or kidney disease;
* If you are pregnant or thinking about becoming pregnant

Taking your Nevirapine

* Nevirapine is available as a white oval shaped tablet embossed with 54/193 on one side, containing 200 mg of Nevirapine. Nevirapine is also available as a liquid containing 50mg in 5ml;
* The initial starting dose is 200 mg once each day for two weeks - then increased to 200 mg twice each day. This two-week lead-in period is recommended to reduce the frequency of side effects.
Some doctors are recommending patients take their nevirapine as 400mg (two tablets) once daily to help simplify their drug regime;
* You can take the tablets before, with or after food;
* The doses should be divided equally throughout the day. Try to take the doses at the same time each day;
* Nevirapine works best if there is a constant amount in your bloodstream. It is therefore very important to take the tablets regularly. If you forget a dose take it as soon as you remember. If it is almost time for your next dose anyway, forget about the missed dose. Wait and take the next dose at the regular time. Do not double the next dose;

Do not run out of nevirapine. If you are going on holiday and need additional supplies- tell your doctor. When receiving a supply from pharmacy, ensure that you have an adequate supply to last until your next appointment.

Other drugs and nevirapine
Nevirapine is metabolised (processed in the body) by the liver. Some other drugs are metabolised in the same way. This is why it is important to tell your doctor about all the medicines that you take even if you only take them occasionally, including herbal and recreational drugs. Examples of some drugs that are metabolised in the same way as nevirapine and should NOT be taken are rifampicin, phenytoin, phenobarbitone, simvastatin, ergotamine, certain benzodiazepines and St. John’s Wort.

Other examples of drugs that are metabolised in the same way as nevirapine include rifabutin, warfarin, methadone and the protease inhibitors. Your doctor may alter your doses if you are taking one of these drugs.

Nevirapine can stop hormonal contraceptives from working effectively so you must use an alternative form of contraception e.g. Barrier methods.

Side Effects
Nevirapine, like all other medicines, has some side effects. The most important ones are:

* Skin rash – If you experience a MILD skin rash do not stop taking your Nevirapine but contact your doctor and they will advise you what to do. If you experience a SEVERE SKIN RASH or a rash accompanied by other symptoms such as fever, blistering, oral lesions, conjunctivitis, facial swelling, muscle or joint aches or general malaise STOP taking your Nevirapine and contact your doctor IMMEDIATELY;
* Nausea;
* Headache;
* Tiredness;
* Liver damage (rarely occurs). It is more common in women and people with higher CD4 counts. You should be vigilant for signs of liver damage, especially through the first 18 weeks of therapy. These signs include anorexia, nausea, jaundice, rash, fever and liver tenderness. You should seek medical attention promptly if these occur.

If you experience any of these side effects or any other new symptoms after you start Nevirapine, tell your doctor who will advise you what to do. If you decide to stop taking Nevirapine, it is important that you tell your doctor so that he or she can discuss other treatment options with you.

Admission to hospital
If you are admitted to the hospital please bring all your medicines with you. This is especially important for anti-HIV medication, as it has to be taken regularly. Thomas Macaulay ward now operates a self medication programme. Some people are able to self-administer their own medicines to enable them to stick to the routine they have been used to at home.

Storing your Nevirapine
Nevirapine should be stored at room temperature.