Viramune XR

Generic Name: nevirapine (ne VYE ra peen)
Brand Name: Viramune, Viramune XR

What is Viramune XR (nevirapine)?

Nevirapine is an antiviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in your body.

Nevirapine is used to treat HIV, which causes the acquired immunodeficiency syndrome (AIDS). Nevirapine will not prevent or cure HIV or AIDS.

Nevirapine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Viramune XR (nevirapine)?

You should not use nevirapine if you have moderate to severe liver disease. Nevirapine should not be used to prevent HIV.

Your blood will need to be tested often during the first few months you are taking nevirapine. Every person with HIV or AIDS should remain under the care of a doctor.

Slideshow: Flashback: FDA Drug Approvals 2013

Nevirapine can cause severe or fatal liver problems. Stop taking this medicine and call your doctor at once if you have any of signs of liver damage: nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Nevirapine may also cause severe or life-threatening skin reactions. Contact your doctor at once if you have fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. This type of reaction is a medical emergency.

What should I discuss with my healthcare provider before taking Viramune XR (nevirapine)?

You should not use this medicine if you are allergic to nevirapine, or if you have moderate to severe liver disease. Nevirapine should not be used to prevent HIV.

Some medicines can interact with nevirapine and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • atazanavir;

  • efavirenz;

  • itraconazole;

  • ketoconazole;

  • rifampin; or

  • St. John's wort.

To make sure you can safely take nevirapine, tell your doctor if you have any of these other conditions:

  • skin problems;

  • liver disease (or a history of hepatitis or cirrhosis);

  • kidney disease (or if you are on dialysis); or

  • if you have ever taken delavirdine or efavirenz and they were not effective in treating your condition.

FDA pregnancy category B. Nevirapine is not expected to be harmful to an unborn baby. However, nevirapine may be more likely to cause liver damage in a pregnant woman. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

HIV can be passed to your baby if you are not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection.

Nevirapine can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking nevirapine.

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of nevirapine on the baby.

Women with HIV or AIDS should not breast-feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

Nevirapine should not be given to a child younger than 6 years old.

How should I take Viramune XR (nevirapine)?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Nevirapine is usually taken only once daily for the first 2 weeks, and then increased to twice daily. Starting with a low dose can reduce your risk of skin reactions. Follow your doctor's instructions about how often to take the medication.

If you stop taking nevirapine for longer than 7 days, call your doctor before you start taking the medicine again. You may have to start with a lower dose.

Nevirapine can be taken with or without food. You may also take the medicine with milk or a soft drink.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Shake the oral suspension (liquid) well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

To be sure this medication is helping your condition, your blood cells and liver function will need to be tested often, especially during the first 6 to 18 weeks of treatment. Visit your doctor regularly.

Use nevirapine regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not take nevirapine as your only HIV medication. HIV/AIDS is usually treated with a combination of different drugs. Your disease may become resistant to nevirapine if you do not take it in combination with other HIV medicines your doctor has prescribed.

Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

If you have not taken nevirapine for 7 days in a row, call your doctor before you start taking the medicine again.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Viramune XR (nevirapine)?

Avoid drinking alcohol. It may increase your risk of liver damage.

Taking this medication will not prevent you from passing HIV to other people. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Viramune XR (nevirapine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: tired feeling, joint or muscle pain, muscle weakness, skin rash, bruising, severe tingling, numbness, mouth sores, trouble breathing, or swelling of your face, lips, tongue, or throat.

Nevirapine can cause life-threatening effects on the liver. Call your doctor at once if you have any of these liver symptoms while taking nevirapine: skin rash, nausea, stomach pain, loss of appetite, low fever, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Nevirapine may also cause severe or life-threatening skin reactions. Contact your doctor at once if you have fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling. This type of reaction is a medical emergency.

Stop using nevirapine and call your doctor at once if you have:

  • fever, swollen gums, painful mouth sores, pain when swallowing, skin sores, cold or flu symptoms, cough, trouble breathing;

  • any other signs of new infection; or

  • the first sign of any skin rash, no matter how mild.

Common side effects may include:

  • mild nausea, vomiting, diarrhea, or stomach pain;

  • muscle pain;

  • headache, tired feeling; or

  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Viramune XR (nevirapine)?

Many drugs can interact with nevirapine, or make it less effective. Not all possible interactions are listed here. Tell your doctor about all your medications and any you start or stop using during treatment with nevirapine, especially:

  • maraviroc;

  • fentanyl, methadone;

  • a blood thinner (warfarin, Coumadin);

  • an antibiotic such as clarithromycin or rifabutin;

  • antifungal medicine such as fluconazole or voriconazole;

  • ergot medicine such as ergotamine, dihydroergotamine, ergonovine, or methylergonovine;

  • heart or blood pressure medications such as amiodarone, diltiazem, disopyramide, felodipine, nifedipine, verapamil, and others;

  • medication to prevent organ transplant rejection;

  • other HIV medicines such as darunavir, fosamprenavir, nelfinavir, indinavir, ritonavir, or saquinavir; or

  • seizure medication such as carbamazepine, clonazepam, or ethosuximide.

This list is not complete and many other drugs can interact with nevirapine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about nevirapine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 18.01. Revision Date: 2013-05-20, 9:37:07 AM.

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