Common use

Viramune (nevirapine) is an antiretroviral medication classified as a non-nucleoside reverse transcriptase inhibitor (NNRTI). This HIV medication works by blocking the reverse transcriptase enzyme, preventing human immunodeficiency virus (HIV) cells from multiplying in your body and reducing the viral load in your bloodstream.

Viramune is used as part of combination antiretroviral therapy to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). By suppressing viral replication, nevirapine helps strengthen the immune system and slows the progression of HIV disease. It is important to understand that Viramune is not a cure for HIV or AIDS — it is a critical component of an ongoing HIV treatment regimen that must be taken consistently as prescribed to maintain viral suppression and prevent drug resistance.



Dosage and direction

Viramune is usually taken only once daily for the first 14 days of treatment, and then the dose is increased to twice daily. This gradual dose escalation is an important safety measure that can significantly reduce your risk of developing skin reactions and liver toxicity during the initial phase of nevirapine therapy. Follow your doctor's instructions precisely about how often to take the medication.

If you stop taking Viramune for longer than 7 days, call your doctor before you start taking the medicine again. You may need to restart with the lower once-daily dose to minimize the risk of adverse reactions. Take nevirapine with a full glass of water. You may also take the medicine with milk or a soft drink.

Viramune can be taken with or without food. For optimal HIV treatment outcomes, take your antiretroviral medication at the same times each day to maintain consistent drug levels in your blood and maximize viral load suppression.



Precautions

Do not use Viramune if you are allergic to nevirapine, or if you have moderate to severe liver disease. Liver function must be carefully monitored before and during treatment, especially during the first 18 weeks of therapy, when the risk of hepatotoxicity is highest.

Do not take nevirapine as your only HIV medication. HIV/AIDS treatment requires combination antiretroviral therapy with multiple drugs that attack the virus through different mechanisms. Taking Viramune alone would promote drug resistance and render the medication ineffective.

Avoid drinking alcohol, as it can increase the risk of liver damage. Practice safe sex and avoid sharing razors, toothbrushes, or needles. Even while on effective antiretroviral therapy, you can still transmit HIV to others through unprotected contact.



Contraindications

Call your doctor at once if you have any of these liver symptoms while taking Viramune: skin rash, nausea, stomach pain, loss of appetite, low fever, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes). Hepatic events, including fatal cases, have been reported with nevirapine use, and early detection is crucial.

If you have any of these other conditions, you may need a dose adjustment or special tests:

liver disease or elevated liver enzymes;

kidney disease (or if you are on dialysis);

hepatitis B or C co-infection; or

if you have ever taken delavirdine (Rescriptor) or efavirenz (Sustiva) and they were not effective in treating your condition, as cross-resistance between NNRTI medications may occur.

Viramune is not expected to be harmful to an unborn baby and is sometimes used to prevent mother-to-child HIV transmission. However, nevirapine may be more likely to cause liver damage in a pregnant woman, requiring careful monitoring.



Possible side effects

Stop taking Viramune and call your doctor at once if you have a serious side effect such as:

fever, sore throat, and headache with a severe blistering, peeling, and red skin rash (Stevens-Johnson syndrome) — this is a medical emergency;

nausea, stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes) — signs of liver toxicity;

fever, chills, body aches, flu symptoms indicating a possible immune reconstitution reaction; or

any other signs of new infection, which may occur as your immune system recovers.

Less serious side effects of nevirapine may include:

mild nausea, vomiting, or stomach pain;

headache, tired feeling; or

changes in the shape or location of body fat (lipodystrophy), especially in your arms, legs, face, neck, breasts, and waist — this is common with long-term antiretroviral therapy.



Drug interaction

Viramune can significantly affect the levels of other medications in your body, and vice versa. Your doctor or pharmacist can often prevent or manage interactions by changing how you use your medications or by close monitoring.

To help your doctor and pharmacist give you the best care, be sure to tell them about all the products you use, including prescription drugs, nonprescription drugs, and herbal products, before starting treatment with Viramune. Certain medications, including hormonal birth control, some antifungals, methadone, and other antiretrovirals, may interact with nevirapine. While using this NNRTI, do not start, stop, or change the dosage of any other medicines without your doctor's approval.



Missed dose

If you miss a dose of Viramune, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. Consistent adherence to your HIV medication schedule is critical for maintaining viral suppression and preventing drug resistance.



Overdose

If overdose is suspected, contact a poison control center or emergency room immediately. Overdose symptoms may include skin rash, headache, dizziness, tired feeling, sleep problems, nausea, vomiting, weight loss, fever, joint pain or swelling, red or tender bumps on your shins, wheezing, cough, or trouble breathing. Prompt medical attention is essential.



Storage

Store Viramune at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines, especially antiretroviral medications, away from children and pets. Do not use the medication past its expiration date.



Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. The specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.