NEVIRAPINE = NVP oral

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    Prescription under medical supervision

     

    Therapeutic action

    • Antiretroviral, HIV-1 non nucleoside reverse transcriptase inhibitor

    Indications

    • HIV-1 infection, in combination with other antiretroviral drugs

    Forms and strengths

    • 50 mg dispersible tablet
    • 200 mg tablet
    • 50 mg/5 ml oral suspension

    Dosage

    • Child from 2 months to 8 years: 4 mg/kg once daily for 14 days, then 7 mg/kg 2 times daily from the 15th day
    • Child over 8 years: 4 mg/kg once daily for 14 days, then 4 mg/kg 2 times daily from the 15th day (max. 400 mg daily)
    • Adult: 200 mg once daily for 14 days, then 200 mg 2 times daily from the 15th day

     

    Weight 10 mg/ml oral suspension 200 mg tablet
    Initial Maintenance Initial Maintenance

    5 to < 10 kg

    3 ml

    6 ml x 2

    Use oral suspension

    10 to < 15 kg

    5 ml

    10 ml x 2

    Use oral suspension

    ½ tab x 2

    15 to < 20 kg

    7 ml

    14 ml x 2

    ½ tab

    1 tab AM and ½ tab PM

    20 to < 25 kg

    10 ml

    < 8 years: 16 ml x 2

    ½ tab

    < 8 years: 1 tab AM and ½ tab PM

    > 8 years: 10 ml x 2

    > 8 years: ½ tab x 2

    25 to < 30 kg

    12 ml

    < 8 years: 20 ml x 2

    ½ tab

    < 8 years: 1 tab x 2

    > 8 years: 12 ml x 2 > 8 years: ½ tab x 2

    30 to < 40 kg

    14 ml

    14 ml x 2

    1 tab

    1 tab AM and ½ tab PM

    40 to < 50 kg

    1 tab

    1 tab x 2

    ≥ 50 kg

    1 tab

    1 tab x 2

     

    Duration

    • The duration of treatment depends on the efficacy and tolerance of nevirapine.

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with severe hepatic impairment, history of severe intolerance to nevirapine that led to permanent discontinuation of treatment.
    • May cause:
      • cutaneous reactions sometimes severe (Stevens-Johnson and Lyell syndromes), hepatic disorders possibly severe (fulminant hepatitis). In these cases, stop taking nevirapine immediately and permanently;
      • gastrointestinal disturbances, headache, myalgia.
    • Nevirapine reduces the efficacy of oral contraceptives: use a non-hormonal contraception or injectable medroxyprogesterone or an oral contraceptive containing 50 micrograms ethinylestradiol per tablet.
    • Avoid combination with rifampicin (decreases the efficacy of nevirapine). Use rifabutin if possible. If rifabutin is not available, use efavirenz rather than nevirapine.
    • Monitor liver enzyme level (ALAT) during the first 2 months, then every 3 to 6 months. If the enzyme level reaches 5 times the normal level, stop nevirapine immediately.
    • Pregnancy: no contra-indication

    Remarks

    • For prophylactic treatment to reduce mother-to-child transmission, check national recommendations.
    • To improve tolerance, respect the initial 14-day phase of treatment. In the event of restarting treatment after having stopped for more than 7 days, recommence initial 14-day phase.
    • Tablets are not scored. When half a tablet is required, use a cutter to cut the tablet into two equal parts.
    • Also comes in fixed-dose combination tablets incorporating nevirapine-lamivudine-zidovudine.

    Storage

    Below 25 °C
    Once opened, oral suspension keeps for 2 months maximum.