Generic Name: nevirapine, Oral tablet

Viramune

All Brands

  • Viramune
SECTION 1 of 4

Highlights for nevirapine

Oral tablet
1

Viramune is an oral medication used in combination with other drugs to treat human immunodeficiency virus (HIV) infection.

2

Doses of Viramune are started gradually in order to reduce the risk of a serious skin reaction.

3

Most side effects are mild. However, there is a risk of liver toxicity.

4

Skin rashes from Viramune can be very serious and can be a sign of liver toxicity. Call your doctor right away if you get a severe rash or a rash that develops quickly while taking this medication.

IMPORTANT INFORMATION

FDA Warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). Though the medication can still be sold and used, a black box warning alerts doctors and patients to potentially dangerous effects.

May cause severe and life-threatening liver toxicity. This is most likely to happen within the first 18 weeks of treatment. People at a higher risk of liver toxicity while taking this drug include women with a CD4 cell count greater than 250 and men with a CD4 cell count greater than 400 before they start taking the drug. See a doctor immediately if you develop any of the following symptoms while taking this drug:

  • appetite loss
  • nausea and vomiting
  • diarrhea
  • dark-colored urine and pale bowel movements
  • stomach pain
  • yellowing of skin and whites of the eyes

You shouldn’t take Viramune if you have moderate to severe liver disease.

May cause severe, life-threatening skin reactions. These are most likely to happen during the first 18 weeks of treatment. Call your doctor right away if you have a severe skin rash or a rash with any of these symptoms:

  • fever
  • blistering
  • mouth sores
  • redness or swelling of your eyes or face
  • muscle or joint aches

You should not take Viramune again if you have a serious rash or other drug hypersensitivity reaction.

May require close monitoring from your doctor. Because Viramune can cause serious side effects, your doctor will monitor you very closely during the first 18 weeks of treatment. This may include taking a sample of your blood to check your liver function, especially if you develop a rash.

Immune reconstitution syndrome risk

In this condition, your recovering immune system may start fighting infections that are lying dormant in your body. Examples of these infections include fungal infections, pneumonia, or tuberculosis. Your doctor will need to treat these infections if this happens. It’s important to keep taking your Viramune even if you come down with an infection.

Fat redistribution

This drug may cause changes in the distribution of your body fat, including fat buildup on the back of your neck.

Drug Features

Viramune is a prescription drug. It is available in these forms: oral tablet, oral extended-release tablet, and oral suspension.

Viramune is available in its generic form. Generic drugs may cost less but don't always come in the same strengths or forms as brand name drugs. Talk to your healthcare provider to see if the generic will work for you.

Viramune is used as part of a combination therapy. That means you will need to take it in combination with other drugs.

Why It's Used

Viramune is used in combination with other antiretroviral drugs to slow the progression of human immunodeficiency virus (HIV) infection. It’s approved to treat adults and children at least 15 days old. Viramune isn’t a cure for HIV, but it may help to slow its progression.

How It Works

Viramune belongs to a class of medications called non-nucleoside reverse transcriptase inhibitors (NNRTIs). A class of drugs refers to medications that work similarly. They are often used to treat similar conditions.

More Details

How It Works

Viramune belongs to a class of medications called non-nucleoside reverse transcriptase inhibitors (NNRTIs). A class of drugs refers to medications that work similarly. They are often used to treat similar conditions.

NNRTIs work by blocking the action of an enzyme called reverse transcriptase. Human immunodeficiency virus (HIV) uses this enzyme to make copies of itself. By blocking the enzyme, the medication may be able to slow the progression of HIV.

SECTION 2 of 4

nevirapine Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with Viramune include:

  • rash. Many people experience a skin rash when they start this drug. This is most likely to develop within the first 6 weeks of treatment. Most rashes are mild or moderate. But a severe rash can also be a sign of other life-threatening side effects, such as serious skin disorders, liver toxicity, or drug hypersensitivity. See a doctor right away if you experience a severe rash or a rash and the following symptoms:

    • fever
    • blistering
    • mouth sores
    • redness or swelling of your eyes
    • muscle or joint aches
  • increased cholesterol levels

  • abnormal liver function test results

  • nausea

  • fatigue

  • stomach problems

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • liver toxicity, which can be severe and life threatening. This is most likely to happen within the first 18 weeks of treatment. See a doctor immediately if you develop any of the following symptoms while taking this drug:

    • appetite loss
    • nausea and vomiting
    • diarrhea
    • dark colored urine and pale colored bowel movements
    • stomach pain
    • yellowing of your skin and the whites of your eyes
  • skin reactions, which can be severe and life-threatening. These are most likely to happen during the first 18 weeks of treatment. Call your doctor right away if you have a severe skin rash or rash accompanied by any of these symptoms:

    • fever
    • blistering
    • mouth sores
    • redness or swelling of your eyes
    • muscle or joint aches
  • immune reconstitution syndrome. In this condition, your recovering immune system may start fighting infections that are lying dormant in your body. Examples of these infections include fungal infections, pneumonia, or tuberculosis. Your doctor will need to treat these infections if this happens. It’s important to keep taking your Viramune even if you come down with an infection.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Viramune does not cause drowsiness.

Some people experience a mild rash while taking this drug. This rash is most common during the first 6 weeks of treatment and usually clears up on its own.

See your doctor right away if you experience:

  • severe rash
  • sudden rash
  • rash along with fever, blistering, mouth sores, redness or swelling of your eyes, or muscle or joint aches
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

nevirapine May Interact with Other Medications

Oral tablet

Viramune can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications That Might Interact with This Drug

Antibiotics, other infection drugs
  • clarithromycin (Biaxin)
  • rifabutin (Mycobutin)
  • rifampin (Rifadin)

Antiretroviral human immunodeficiency virus (HIV) drugs
  • atazanavir  (Reyataz)
  • delavirdine (Rescriptor)
  • efavirenz (Sustiva)
  • etravirine (Intelence)
  • fosamprenavir (Lexiva)
  • indinavir (Crixivan)
  • lopinavir/ritonavir (Kaletra)
  • nelfinavir (Viracept)
  • rilpivirine (Edurant)
  • saquinavir (Invirase)

Hepatitis C virus drugs
  • boceprevir (Victrelis)
  • telaprevir (Incivek)

Herbal supplement
  • St. John’s wort

Oral contraceptives/hormone
  • ethinyl estradiol/norethindrone

Pain drugs
  • methadone

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with liver disease

You should not take Viramune if you have moderate to severe liver disease. If you have liver disease, taking this drug may increase your risk of liver toxicity. If you have mild liver disease, your doctor may give you Viramune and monitor your liver function carefully.

Pregnant women

Viramune is a pregnancy category B drug. That means two things:

  1. Studies of the drug in pregnant animals have not shown risk to the fetus.
  2. There aren’t enough studies done in pregnant women to show the drug poses a risk to the fetus.

Serious, sometimes fatal, liver toxicity has happened to pregnant women taking Viramune in combination with other drugs. Viramune should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Discuss these risks with your doctor.

Women who are nursing

According to the U.S. Department of Health and Human Services, you shouldn’t breastfeed your infant if you have human immunodeficiency virus (HIV). There is a risk of passing HIV to your baby. Additionally, this drug passes through breast milk.

For Seniors

There are not enough tests of the drug in people aged 65 years and older to know if it affects them differently. If you are 65 years or older, you have a higher risk of reduced liver function. Your doctor may want to monitor your liver function more often while you take this drug.

For Children

Children can be curious about the taste of liquid medicine. If you have the oral solution (liquid) in your home, keep it away from children.

When to call the doctor

Call your doctor if you experience:

  • fever
  • weakness
  • chills
  • night sweats
  • sore throat
  • joint pain

These symptoms may be a sign the drug isn’t working, and you may need a different treatment.

Allergies

Most allergies to Viramune start with a rash. See a doctor right away if you experience a sudden rash or a rash with fever, welts, trouble breathing, or other signs of drug hypersensitivity.

Skin rash can also be a sign of liver toxicity. If you develop a rash, your doctor may give you blood tests to check your liver function.

SECTION 4 of 4

How to Take nevirapine (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Human immunodeficiency virus (HIV) infection

Brand: Viramune

Form: Oral extended-release tablet
Strength: 100 mg and 400 mg
Form: Oral tablet
Strength: 200 mg
Form: Oral suspension
Strength: 50 mg per 5 mL
Adult Dosage (ages 18-64 years)
  • 200 mg (oral immediate-release tablet or oral suspension), taken once per day for the first 2 weeks. After 2 weeks, the dose is usually increased to 200 mg, taken twice per day, evenly spaced throughout the day. The dose is gradually increased to reduce the chances of a drug rash and other side effects.
  • Some patients may be switched to the once daily extended-release tablet after they are stable on this drug.
Child Dosage (ages 15 days through 17 years)

Dosage for children is based on height and weight. Your doctor will calculate the correct dose for your child.

Senior Dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal. If you’re a senior, you may need a lower dose or you may need a different schedule.

Special Considerations

Kidney Disease: Tell your doctor if you are on dialysis. If you are, your doctor may prescribe a different dose of Viramune.

Liver Disease: Viramune increases your risk for liver toxicity. If you have mild liver disease, your doctor may give you Viramune and monitor your liver function carefully. If you have moderate to severe liver disease, you should not take Viramune.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Keeping human immunodeficiency virus (HIV) infection under control requires lifelong treatment. There can be serious health consequences if you don’t take this drug exactly how your doctor tells you.

If You Don’t Take it at All

If you don’t take it at all, your HIV infection will eventually reduce your immunity to a point that your body won’t be able to defend itself against many types of infections, even infections that are commonly cured in people who don’t have HIV infection.

If You Stop or Miss Doses

If you stop taking this medication, miss doses, or don’t take it on schedule, the amount of medication in your body fluctuates. This can allow the HIV in your body to become resistant to the drug, which means the drug stops working.

If You Don’t Take it on Schedule

Taking your drug at the same time every day keeps a constant amount of the drug in your body. This helps make the drug as effective as possible at keeping the virus under control.

What to Do if You Miss a Dose

If you miss a dose, take it as soon as you remember. If it’s almost time for the next dose, wait and take the next dose at the usual time.

Never double up on doses to try and catch up. You risk more serious side effects and toxicity.

How Can I Tell if the Drug Is Working?

To see how well the drug is working, your doctor will check your:

  • virus count. A virus count or viral load measures the number of copies of HIV in your body. A decreased virus count is a sign that your treatment is working.
  • CD4 count. A CD4 cell count measures the number of CD4 cells in your body. CD4 cells are white blood cells that fight infection. An increased CD4 cell count is a sign that your HIV treatment is working.

Viramune is a long-term drug treatment.

Do not cut or crush the extended-release tablets

You can break the immediate-release tablet in half along the score line to make it easier to swallow. The score line is the indented line across the middle of the tablet.

Ask your doctor or pharmacist about the oral solution if you can’t take the tablet forms.

Store all forms of Viramune at 77°F (25°C)

You can store the medication briefly in temperatures as low as 59°F (15°C) and as high as 86°F (30°C).

Keep Viramune tightly sealed in its original container.

Note: Be careful of moist environments, including bathrooms. To keep drugs away from moisture, store them somewhere other than your bathroom and any other damp location.

If you travel, pack the medication in your carry-on bag

Don’t leave it in luggage or a car where the temperature can get too hot.

Make sure that the drug is kept at room temperature and doesn’t get warm or freeze.

When traveling by airplane with the oral solution, keep it in its original packaging from the pharmacy, so that it can be easily identified by security officials.

Clinical Monitoring

Your doctor may check your liver function before you start taking this medication.

To see how well your treatment is working, your doctor will check your:

  • symptoms
  • virus count. The virus count measures the number of copies of the human immunodeficiency virus (HIV) in your body. A decreased virus count is a sign that your treatment is working.
  • CD4 cell count. A CD4 cell count measures the amount of CD4 cells in your body. CD4 cells are white blood cells that play a role in your immune system. An increased CD4 cell count is a sign that your treatment is working.

Not every pharmacy stocks this drug, so call ahead

If you only need a few tablets, you should call and ask if your pharmacy dispenses only a small number of tablets. Some pharmacies can't dispense only part of a bottle.

This drug is often available from specialty pharmacies through your insurance plan. These pharmacies operate like mail order pharmacies and ship the drug to you.

In larger cities, there will often be human immunodeficiency virus (HIV) pharmacies where you can have your prescriptions filled. Ask your doctor if there's an HIV pharmacy in your area.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for Viramune.

What does the pill look like?

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Are There Any Alternatives?

There are other drugs and combinations that can treat human immunodeficiency virus (HIV). Some may be more suitable for you than others. Talk to your doctor about possible alternatives.


Show Sources

Content developed in collaboration with Susan J. Bliss, RPh, MBA

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on April 29, 2015

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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