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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.