Nevirapine (Nevirapine)
Overview of Nevirapine
Nevirapine is a first-generation oral non-nucleoside reverse transcriptase inhibitors (NNRTI), with activity against human immunodeficiency virus (HIV-1). Nevirapine is used in combination with nucleoside reverse transcriptase inhibitors (antiretroviral agents) for the treatment of HIV infection. It should not be given alone because of rapid emergence of resistant HIV isolates. It was approved under the FDAs accelerated approval program June 24, 1996 based on changes in surrogate markers (e.g., CD4 cell counts and HIV viral load) in studies lasting up to 48 weeks.
Indication of Nevirapine
Nevirapine is primarily indicated in conditions like HIV infection, Multiple myeloma, Promyelocytic leukemia.
Contraindication of Nevirapine
Nevirapine is contraindicated in conditions like Breast feeding.
Side Effects of Nevirapine
The severe or irreversible adverse effects of Nevirapine, which give rise to further complications include Hepatitis, Anaemia, Neuropsychiatric reactions, Granulocytopenia (more frequent in children).,Nevirapine produces potentially life-threatening effects which include Stevens Johnson syndrome, Stevens Johnson syndrome. which are responsible for the discontinuation of Nevirapine therapy.,The symptomatic adverse reactions produced by Nevirapine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Headache, Fatigue, Nausea, Vomiting, Diarrhea, Fever, Myalgia, Abdominal pain, Urticaria, Skin RashX, Somnolence, Arthralgia, Anaphylaxis.
Precautions of Nevirapine
Hepatic impairment; chronic hepititis B or C; high CD4 cell count, and women (all greatest risk of hepatic side effects); pregnancy. HEPATIC DISEASE. Potentially life-threatening hepatotoxicity including fatal hepititis reported in first 6 weeks; close monitoring required during first 18 weeks; monitor liver function before treatment then every 2 weeks for 2 months then after 1 month and then regularly; discontinue permanently if abnormalities in liver function test accompanied by hypersensitivity reactions (rash, fever, arthralgia, myalgia, lymphadenopathy, hepatitis, renal impairment, eosinophilia, granulocytopenia); suspended if severe abnormalities in liver function test but no hypersensitivity reaction ---discontinue permanently if significant liver function abnormalities recur; monitor patient closely if mild to moderate abnormalities in LFT with no hypersensitivity reaction. RASH: rash usually in 6 weeks, is most common side effect; incidence reduced if introduced at low dose and dose increase gradually; monitor closely for skin reaction during first 18 weeks; discontinue permanently if severe rash or if rash accompanied by blistering, oral lesions, conjunctivitis, facial oedema, general malaise, or hypersensitivity reaction; if rash mild to moderatemay continue without interruption but dose should not be increased until rash resolves.COUNSELLING: Patients should be told how to recognise hypersensitivity reactionsand advised to seek immediate medical attention if symptoms develop.