NEVIMUNE
NEVIRAPINE · by A. J. MIRZA
Composition
Tab: Nevirapine 200 mg. Susp: Per 5 ml: Nevirapine 50 mg.
Indications & Dosage
HIV-1 infection in combination with other antiretroviral agents: ORAL TAB: Adults: 200 mg daily for 1st 14 days followed by 200 mg twice daily, in combination with at least 2 additional antiretroviral agents; if rash occurs and is not resolved within 28 days, alternative treatment should be sought. If treatment interrupted for more than 7 days, restart using the lower dose for the first 14 days as for new treatment. Children 8 yrs: 4mg/kg once daily for 2 week followed by 4 mg/kg b.i.d thereafter, 2 months-8 yr:4 mg/kg once daily for 2 week followed by 7 mg/kg twice daily thereafter. Max for any patient: 400 mg/day; if rash occurs and is not resolved within 28 days, alternative treatment should be sought. If treatment interrupted for more than 7 days, restart using the lower dose for the first14 days as for new treatment. Prevention of mother to child transmission of HIV-1 in pregnant women: Administer to pregnant mother in labour: 200 mg as a single dose, followed by 2 mg/kg as a single dose to neonate within 72 hr of birth. ORAL SUSP: Adults & 16 yrs: 20 ml once daily for first 14 days, then 20 ml twice daily. Children 8 yrs: By body surface area: 150 mg/m2 once daily for two week, then 150 mg/m2twice daily. Alternatively, 4 mg/kg once daily for two week, then 7 mg/kg twice daily; 8-16 yr; 4 mg/kg once daily for two week, then 4 mg/kg twice daily; max 400 mg daily.
Contraindications
Acute porphyrias, post-exposure prophylaxis,re-administration to patient with history of hypersensitivity to drug.
Precautions
Females patients at greater risk of hepatic side effects, patients having high CD4 cell count at greater risk of hepatic side effects; Vigilant monitoring of liver function is required.Caution during 1st 8 week of therapy, patients experiencing rash during the 14 day lead-in period should not have their dose increased until rash has resolved.
Interactions
Drugs metabolized by hepatic enzymes, keto-conazole, oral contraceptive, methadone.
Pregnancy
Avoid, use only when no safer alternative exists for a serious problem.
Lactation
Contraindicated
Side Effects
Abdominal pain, diarrhoea, fatigue, fever, granulocytopenia, headache, hepatitis, hypersensitivity reactions (including hepatic reactionsand rash), nausea, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, hepatotoxicity such as atalfulminant hepatitis. Abnormal liver function tests, jaundice, hepatitis,vomiting, anaemia,arthralgia, myalgia,osteonecrosis