nevirapine at a glance
Medicine class
Non-nucleoside reverse transcriptase inhibitor (NNRTI)
Main use
Combination treatment of HIV-1 infection
Food
May be taken with or without food
Important early risks
Serious skin and liver reactions require particularly close early monitoring
What is nevirapine used for?
Nevirapine is used with other antiretrovirals to treat HIV-1 infection.
Immediate-release tablets are licensed for adults, adolescents and children where the formulation is suitable.
The selected prolonged-release tablets are licensed for adults, adolescents and eligible children who can swallow tablets.
Use for post-exposure prophylaxis in people without HIV is unlicensed and strongly discouraged because serious liver toxicity has occurred.
How does nevirapine work?
HIV-1 uses reverse transcriptase to copy its genetic material. Nevirapine binds to this enzyme at a non-active site and inhibits it, reducing viral replication. Using other active antiretrovirals alongside it helps suppress HIV and limits resistance.
nevirapine preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 400 mg
Tablet
Route: Oral
Strengths: 200 mg
How to take nevirapine
Take nevirapine exactly as prescribed by the specialist HIV team and always as part of combination treatment.
Swallow tablets with liquid; do not crush or chew them.
It can be taken with or without food.
Immediate-release tablets may be broken along the score line only to make swallowing easier; the halves are not equal doses.
Prolonged-release tablets must be swallowed whole and must not be divided, broken or chewed.
The prolonged-release formulation is not suitable for the SmPC-defined treatment-initiation lead-in phase.
Do not change formulation or restart after an interruption without specialist advice.
nevirapine side effects
Common or expected effects
- Rash
- Nausea or vomiting
- Diarrhoea or abdominal pain
- Headache
- Fever or fatigue
- Abnormal liver blood tests
- Allergic reactions
- Reduced granulocyte count
Get urgent medical advice
- Severe, blistering or peeling rash, particularly with fever, mouth sores, eye inflammation or facial swelling
- Symptoms of hepatitis or liver failure, such as jaundice, dark urine, pale stools, loss of appetite or persistent abdominal symptoms
- A widespread rash with fever, swollen glands, blood abnormalities or signs of kidney or liver involvement
- Severe allergic reaction with swelling or breathing difficulty
nevirapine in pregnancy
Available pregnancy data have not identified a malformation or fetal toxicity signal, but evidence is not complete and liver risk requires consideration. Discuss pregnancy, planned pregnancy or a positive test promptly with the specialist HIV and maternity teams; do not stop effective HIV treatment without advice.
nevirapine while breastfeeding
In the UK, formula feeding is considered the safest way to avoid HIV transmission after birth because transmission through breast milk remains possible despite effective treatment. Anyone considering breastfeeding should discuss this before delivery with the specialist HIV maternity team so that risks, alternatives and any enhanced monitoring can be considered.
nevirapine interactions
Nevirapine can substantially alter other medicines' concentrations. The HIV team should check prescribed, non-prescription and herbal products.
St John's wort
Must not be used because it can reduce nevirapine exposure and compromise HIV control.
Rifampicin
Can markedly reduce nevirapine exposure; co-administration is not recommended.
Common questions about nevirapine
Answers are fully visible for fast scanning and source review.
Can nevirapine cure HIV?
No. It suppresses HIV-1 as part of combination antiretroviral treatment but does not eradicate the infection.
Why is nevirapine taken with other HIV medicines?
Using several active antiretrovirals improves viral suppression and reduces the chance that HIV will become resistant.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.