nevirapine hemihydrate at a glance
Class
Non-nucleoside reverse transcriptase inhibitor (NNRTI).
Licensed role
Combination treatment of HIV-1 in adults and children of any age.
Food
May be taken with or without food.
Key early risk
Serious skin and liver reactions require close monitoring when treatment begins.
What is nevirapine hemihydrate used for?
The selected product is licensed only as part of combination antiretroviral treatment.
Treatment of HIV-1 infection in adults, adolescents and children of any age alongside other active antiretrovirals.
It should not be used alone because viral resistance can emerge.
Use for HIV post-exposure prophylaxis is unlicensed and strongly discouraged because serious liver toxicity has occurred in people without HIV.
How does nevirapine hemihydrate work?
HIV-1 uses reverse transcriptase to copy its genetic material. Nevirapine binds to this enzyme away from its active site and inhibits it non-competitively, reducing production of new virus. It has no clinically meaningful activity against HIV-2.
nevirapine hemihydrate preparations and strengths
Oral suspension
Route: Oral
Strengths: 50 mg/5 mL
How to take nevirapine hemihydrate
Take nevirapine exactly as directed by the specialist HIV team and with the other prescribed antiretrovirals. The oral suspension can be taken with or without food.
Shake the suspension gently before measuring it.
Use the supplied oral syringe to measure and give the full prescribed volume.
If another measuring device is used, rinse it with water and give the rinse so the complete amount is taken.
Do not restart nevirapine after an extended interruption without contacting the HIV team.
nevirapine hemihydrate side effects
Common or expected effects
- Rash
- Headache
- Nausea or vomiting
- Abdominal pain or diarrhoea
- Fever or fatigue
- Abnormal liver-test results
Get urgent medical advice
- Severe, blistering or peeling rash, including Stevens–Johnson syndrome or toxic epidermal necrolysis
- Rash with fever, facial swelling, swollen glands or internal-organ involvement
- Hepatitis, jaundice or liver failure
- Severe allergic reaction or angioedema
- Marked reduction in granulocytes, particularly when combined with zidovudine
nevirapine hemihydrate in pregnancy
Available pregnancy data have not identified malformation or fetal or neonatal toxicity, but controlled evidence is limited and liver-risk factors require specialist review. Anyone pregnant, planning pregnancy or becoming pregnant while taking nevirapine should contact their HIV and maternity teams and should not stop treatment without advice.
nevirapine hemihydrate while breastfeeding
Nevirapine enters breast milk, and HIV can be transmitted through breastfeeding. In current UK practice, formula feeding eliminates postnatal HIV transmission risk and is the safest option. A person with sustained viral suppression who chooses to breastfeed should receive early planning and close monitoring from the specialist perinatal HIV team.
nevirapine hemihydrate interactions
Nevirapine induces CYP3A and CYP2B6 and can lower concentrations of many medicines. The HIV team or pharmacist should check prescribed, non-prescription and herbal products.
St John’s wort
Contraindicated because it can reduce nevirapine exposure and antiviral effectiveness.
Rifampicin
Substantially reduces nevirapine exposure; co-administration is not recommended.
Efavirenz, etravirine or rilpivirine
Combining NNRTIs is not recommended because of toxicity, reduced concentrations or lack of added benefit.
Common questions about nevirapine hemihydrate
Answers are fully visible for fast scanning and source review.
Is nevirapine hemihydrate used on its own for HIV?
No. It must be combined with other active antiretrovirals because using it alone can rapidly select resistant HIV.
Does nevirapine hemihydrate cure HIV?
No. It suppresses HIV-1 replication as part of combination treatment but does not eliminate the infection.
Does nevirapine hemihydrate treat HIV-2?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.