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Viramune (Nevirapine)
Articles on Viramune
Full US Prescribing Information

Patient Information
What is Viramune?
Important Safety Information
What is known about side effects?
What about drug interactions?

Articles on Viramune

FDA Approves Once-Daily Nevirapine

WHO Updates Treatment Guidelines for Pregnant Women and Infants Using Single-dose Nevirapine

Does Nevirapine Lower Viral Load More than Efavirenz?

Reuse of Nevirapine in HIV-Infected Children after Protease Inhibitor–based Viral Suppression

Once-daily Extended Release Nevirapine (Viramune) Equals Twice-daily Immediate Release Formulation

Does Nevirapine Improve Response to Interferon-based Therapy in HIV/HCV Coinfected Patients?

No Significant Association between Nevirapine (Viramune) and Liver Enzyme Elevation Regardless of Pregnancy Status

Boehringer Ingelheim Announces Co-Pay Rebate Program for Nevirapine (Viramune)

Nevirapine (Viramune) and Boosted Atazanavir (Reyataz) Produce Comparable Early Virological and Immunological Response

Nevirapine (Viramune) Has Equal Efficacy but a More Favorable Lipid Profile Compared with Boosted Atazanavir (Reyataz)

Study Finds Nevirapine (Viramune) Suppresses Residual HIV Viremia More than Other Antiretroviral Drugs

First-line Therapy with Zidovudine/lamivudine plus Lopinavir/ritonavir Leads to Greater Bone Loss than Nevirapine plus Lopinavir/ritonavir


Lopinavir/ritonavir (Kaletra) Is Superior to Nevirapine (Viramune) for HIV-infected Children Who Received Single-dose Nevirapine at Birth

Safety of Switching from Twice-daily to Once-daily Nevirapine (Viramune) in HIV Patients with Suppressed Viral Load and High CD4 Count

Once-daily Regimen of Nevirapine (Viramune), Tenofovir (Viread), and Lamivudine (Epivir) Is Associated with Early Virological Failure

Risk Versus Benefit of a 6-week Course of Nevirapine (Viramune) for Infants to Prevent HIV Infection through Breast-feeding

Switching from Suppressive Protease Inhibitor-based to Nevirapine (Viramune)-based Regimens: A Meta-analysis

Study Shows Nevirapine (Viramune) Reaches Semen Better than Other NNRTIs or Protease Inhibitors

Nevirapine (Viramune) May Be Less Effective When Combined with Tuberculosis Treatment

Extended-dose Nevirapine (Viramune) for Infants to Prevent HIV Transmission via Breastfeeding in Ethiopia, India, and Uganda

Adding Tenofovir (Viread) plus Emtricitabine (Emtriva) to Short-course Zidovudine (Retrovir) and Single-dose Nevirapine (Viramune) Does Not Reduce the Risk of Mother-to-child HIV Transmission

Long-term Efficacy and Tolerability of Regimens Containing Efavirenz (Sustiva) and Nevirapine (Viramune) Regimens


What is Viramune?

Viramune is an anti-HIV medication. It is in a category of HIV medicines called non-nucleoside reverse transcriptase inhibitors (NNRTIs). Viramune prevents HIV from entering the nucleus of healthy T-cells. This prevents the cells from producing new virus and decreases the amount of virus in the body.

Viramune, manufactured by Boehringer-Ingelheim, was approved by the U.S. Food and Drug Administration for the treatment of HIV in 1996.

Viramune must be used in combination with other drugs to treat HIV. It is usually combined with two nucleoside analogues.

Important Safety Information

Viramune® (nevirapine) does not cure HIV or AIDS, and has not been shown to reduce the risk of passing HIV to others through sexual contact or blood contamination.

VIRAMUNE can cause severe liver disease and skin reactions that can cause death. These reactions occur most often during the first 18 weeks of treatment, but can occur later. Ask your healthcare provider about how to recognize symptoms of skin and liver problems. Stop taking VIRAMUNE if you have any of these reactions. Do not restart VIRAMUNE if you experience any of these reactions. Call your healthcare provider immediately if you have any of these reactions.

Any patient can experience liver problems with VIRAMUNE but women and patients who have higher CD4 counts when they begin VIRAMUNE treatment have a greater risk. If you are a woman with CD4+ >250 cells/mm3 or a man with CD4+ >400 cells/mm3 you should not begin taking VIRAMUNE unless you and your doctor have decided that the benefit of doing so outweighs the risk. Women, including pregnant women, with CD4+ cell counts >250 cells/mm3 are at the greatest risk.

The dose of VIRAMUNE for adults is one 200-mg tablet daily for the first 14 days, followed by one 200-mg tablet twice daily. The 14-day lead-in period is important because it can help reduce your chances of getting a potentially serious skin rash.

Other side effects that patients have experienced include nausea, fatigue, fever, headache, vomiting, diarrhea, abdominal pain and myalgia. Changes in body fat may occur in patients receiving antiretroviral therapy. Immune reconstitution syndrome has been reported in patients treated with combination ARV therapy.

What is known about side effects?

Liver problems have been reported in HIV-positive people treated with Viramune. The greatest risk of liver problems is during the first six weeks of treatment. Liver problems are more likely to occur in women (including pregnant women) with T-cell counts greater than 250 at the time of starting anti-HIV treatment for the first time. As for men, liver problems are more likely to occur if the T-cell count is above 400 at the time of starting anti-HIV treatment for the first time. HIV-positive people should work with their doctors very carefully if they have T-cell counts above these levels and are planning on starting therapy for the first time with a drug regimen that contains Viramune.

The most common side effect of Viramune is skin rash. In a small number of patients, rash has been serious and resulted in death. Therefore, if you develop a rash with any of the following symptoms, call your doctor immediately: general ill feeling, fever, muscle or joint aches, blisters, mouth sores, conjunctivitis (inflammation of the inner surface of the eyelids), swelling of the face, tiredness.

If you must stop treatment with Viramune because you have these types of serious reactions, you must not take Viramune again.

What about drug interactions?

The following medications should not be taken while you are being treated with Viramune:

Antibiotics: Rifadin (rifampin) and Priftin (rifapentine).

All of the available nucleoside reverse transcriptase inhibitors can be combined safely with Viramune.

Viramune can interact with some medications used to treat TB, MAC and other bacterial infections. Rifadin (rifampin) can decrease Viramune levels (Rifadin should not be used). Mycobutin (rifabutin) can also decrease Viramune levels (no dose change necessary). Viramune can also decrease Biaxin (clarithromycin) levels; similarly Biaxin can increase Viramune levels (an alternative to Biaxin is recommended).

Viramune can interact with some medications used to treat thrush (candidiasis) and other fungal infections. Viramune can decrease Nizoral (ketoconazole) levels in the bloodstream. Similarly, Nizoral can increase Viramune levels in the bloodstream. Taking these two drugs together is not recommended.

Viramune can interact with oral contraceptives/birth control pills (ethinyl estradiol). Viramune decreases the amount of ethinyl estradiol in the bloodstream, which can increase the risk of pregnancy.

If you take methadone, Viramune can decrease the amount of it in your blood. This might cause you to experience withdrawal symptoms and may require that your doctor or your rehabilitation program increase your dose of methadone.

It is not yet known what effect Viramune has on blood levels of Viagra (sildenafil) or Levitra (vardenafil), two drugs used for erectile dysfunction.