Nevirapine (By mouth)

Introduction

Nevirapine (ne-VIR-a-peen)

Used with other medicines to treat human immunodeficiency virus (HIV) infection. HIV causes acquired immune deficiency syndrome (AIDS). Nevirapine does not cure HIV or AIDS, but it may slow the worsening of the disease.

Brand Name(s)

Viramune, Viramune O/S, Viramune XR

When This Medicine Should Not Be Used

How to Use This Medicine

Liquid, Tablet, Long Acting Tablet

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to. The dose may need to be increased after the first 2 weeks.
• You may take this medicine with or without food.
• Take all other medicines your doctor prescribed as part of your combination treatment. Do not change your dose or stop using your medicine unless your doctor tells you to.
• Shake the oral liquid gently just before using it. Use a marked measuring spoon, oral syringe, or medicine cup to measure the right dose. If you are using a medicine cup, make sure you drink the full dose of medicine. After swallowing the medicine, add some water to the cup and drink the water. This will help get all of the medicine out of the cup.
• Swallow the extended-release tablet whole. Do not crush, break, or chew it.
• While taking the extended-release form of this medicine, part of the tablet may pass into your stools. This is normal and is nothing to worry about.
• Do not take more than one form of nevirapine at the same time. Talk to your doctor if you have any questions.
• This medicine works best if there is a constant amount in the blood. To keep blood levels constant, take this medicine at the same time each day and do not miss any doses. Also, when your supply of this medicine is running low, contact your doctor or pharmacist ahead of time. Do not allow yourself to run out of this medicine.
• If you stop taking this medicine for more than 7 days, ask your doctor how much to use before you start taking it again.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant, or if you have liver disease (including hepatitis B or C).
• You should not breast feed if you have HIV or AIDS, because you may give the infection to your baby through your breast milk.
• This medicine will not keep you from giving HIV to your partner during sex. Make sure you understand and practice safe sex, even if your partner also has HIV. Do not share needles with anyone.
• Stop using this medicine and check with your doctor right away if you or your child have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.
• When you start taking HIV medicines, your immune system may get stronger. If you or your child have certain infections, such as pneumonia or tuberculosis, you may notice new symptoms when your body tries to fight them. If this occurs, be sure to tell your doctor.
• Tell your doctor if you or your child get any type of skin rash, even a mild rash. Stop using the medicine and call your doctor right away if you have a rash with blisters, a fever, mouth sores, red or irritated eyes, swelling of the face, muscle or joint pain, or muscle weakness.
• Birth control pills may not work as well while you are using this medicine. To keep from getting pregnant, use another form of birth control along with your pills. Other forms include condoms, diaphragms, or contraceptive foams or jellies.
• This medicine may cause you to have excess body fat. Tell your doctor if you or your child notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area. You might also lose fat from your legs, arms, or face.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood tests may be needed to check for unwanted effects.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Any type of skin rash.
• Blistering, peeling, or red skin rash.
• Dark-colored urine or pale stools.
• Decrease in how much or how often you urinate.
• Fever, chills, cough, sore throat, and body aches.
• Nausea, vomiting, loss of appetite, tiredness, or pain in the upper stomach.
• Red or swollen eyes ("pink eyes").
• Swollen, painful, or tender lymph glands in your neck, armpit, or groin.
• Unusual bleeding, bruising, or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Diarrhea.
• Gaining weight around your neck, upper back, breast, face, or waist.
• Headache.
• Muscle or joint pain.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not take atazanavir (Reyataz®), fosamprenavir (Lexiva®), ketoconazole (Nizoral®), rifampin (Rifadin®, Rifamate®, Rifater®), or St. John's wort while you are being treated with this medicine, unless your doctor says it is okay.
• Make sure your doctor knows if you are taking cisapride (Propulsid®), clarithromycin (Biaxin®), cyclophosphamide (Cytoxan®), ergotamine (Ergomar®, Ergostat®), fluconazole (Diflucan®), itraconazole (Sporanox®), methadone (Dolophine®), or rifabutin (Mycobutin®).
• Make sure your doctor knows if you are also using other medicine to treat HIV or AIDS (such as efavirenz, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, Crixivan®, Fortovase®, Invirase®, Kaletra®, Norvir®, Sustiva®, or Viracept®).
• Tell your doctor if you are using a narcotic pain reliever (such as fentanyl, Sublimaze®), medicine to treat seizures (such as carbamazepine, clonazepam, ethosuximide, Klonopin®, Tegretol®, or Zarontin®), medicine that weakens the immune system (such as cyclosporine, sirolimus, tacrolimus, Gengraf®, Neoral®, Protopic®, Rapamune®, or Sandimmune®), medicine to treat heart rhythm problems (such as amiodarone, disopyramide, lidocaine, Cordarone®, or Norpace®), a blood thinner (such as warfarin, Coumadin®), or certain blood pressure medicines (such as diltiazem, nifedipine, verapamil, Adalat®, Calan®, or Cardizem®).