Viramune

Nevirapine

Drug Class and Mechanism of Action of Viramune

Viramune is in a class of drugs called reverse transcriptase inhibitors (anti HIV drugs) which includes zidovudine (Retrovir), didanosine (Videx), and lamivudine (Epivir) etc. Viramune is an oral medication that is used for the treatment of infections with HIV (the human immunodeficiency virus) and is similar to efavirenz (Sustiva) and delavirdine (Rescriptor).

During infection with HIV, the virus multiplies within the cells of human body. The newly-formed viruses then are released from the cells and spread throughout the body where they infect other cells. This way, the HIV infection spreads to new, uninfected cells that the body is continually producing, and HIV infection is perpetuated. When producing new viruses, the HIV virus must manufacture new DNA for each virus and reverse transcriptase is the enzyme that the virus uses to form this new DNA. Viramune directly inhibits the activity of reverse transcriptase and blocks the production of DNA and new HIV viruses can not form.

Unlike zidovudine, Viramune does not need to be converted to an active form and it does not compete with the compound (thymidine triphosphate) that is required by HIV virus to make new DNA. Viramune does not kill existing HIV virus (it only prevent multiplication or duplication of HIV) and it is not a cure for HIV.

Therapeutic Uses of Viramune

Viramune is used in the treatment of infection with the HIV virus (the virus that causes AIDS). It is used in combination with other HIV medications in selected patients. As there is no cure for HIV infection, and the illnesses associated with it (infections, etc.) may continue. Because HIV can quickly become resistant to this medication if used alone, Viramune must be used with at least 1 other anti-HIV medicines that are available. Your doctor may change your treatment plan if this medication stops working well.

Direction of use of Viramune

Take Viramune by mouth as directed by your doctor. The usual dose is one tablet (200 mg) daily for the first 14 days, and then followed by one 200 mg tablet twice a day. Viramune is taken in combination with other antiretroviral medication for HIV.

Follow the dosing instructions carefully given by your doctor, in order to minimize serious side effects, such as rash. If a rash develops in the first two weeks, the Viramune dose is not increased until the rash disappears.

If treatment is stopped for more than 7 days, then re-treatment should begin as fresh treatment which is usually with one 200 mg tablet daily for 14 days, then one 200 mg tablet twice a day or as directed by your doctor.

Read the Patient Information Leaflet available with the medication. If you have any question regarding dosing of Viramune, consult your doctor or pharmacist.

If You Miss a Dose of Viramune

It is important not to miss any dose of Viramune. If you miss a dose of Viramune, take it as soon as you can remember. If it is within 2 hours of the next dose, skip the missed dose and resume your usual dosing schedule.

How to Store Viramune

Viramune should be stored at room temperature between 59 and 86 degrees F (15 to 30 degrees C). Store it away from moisture, heat and light as directed by your doctor. Do not store in the bathroom. Keep it in a tightly closed container. Keep Viramune out of reach of children.

More Information About Viramune

Viramune can not reduce the chance of transmitting the HIV virus to others. Laboratory tests (liver function especially if rash occurs) should be performed to monitor side effects of this drug. These laboratory tests should be done frequently and will be monitored closely by your doctor especially during the first 18 weeks of treatment. Keep all appointments with your doctor while taking this medication. If you have any question about Viramune, consult your doctor.

Precautions to be Taken While Taking Viramune

• Viramune should not be used if you have certain medical conditions and before you start using this medicine, consult your doctor or pharmacist, especially if you have any severe liver disease. Inform your doctor about your medical history, especially if you suffered from liver disease like Hepatitis B or Hepatitis C infections, severe kidney disease, or any allergies.
• Viramune should be used during pregnancy only when clearly needed. You need to discuss the risks and benefits of using Viramune during pregnancy, with your doctor. Viramune is excreted into breast milk and breast milk also can transmit HIV, you should not breast-feed if you are HIV infected.
• Viramune has caused severe and sometimes fatal liver and skin reactions (e.g., Stevens-Johnson syndrome, allergic reaction), although infrequently, especially during the first 18 weeks of treatment with Viramune. These severe and sometimes fatal reactions are most likely to occur during the first 6 weeks of therapy but can occur at any time while taking Viramune.
• Seek immediate medical attention if you develop a rash at any time while using this medication. Also consult your doctor immediately if you develop unusual fatigue, abdominal or stomach pain, dark urine, loss of appetite, or yellowing of the skin or eyes. You should do liver function tests at this time. If you had a severe liver or skin reaction while on this drug in the past, you should not restart therapy with Viramune again. Consult your doctor or pharmacist for more details.

Possible Adverse Effects of Viramune

• Nausea, headache etc. are common and less serious side effects of Viramune. Notify your doctor if these problems become persistent or worsen.
• Consult your doctor immediately if you develop fever, blistering, mouth sores, conjunctivitis, swelling, muscle pain joint aches, tingling or numb hands or feet.
• A serious allergic reaction to this drug is unlikely, but you should seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction are severe rash, itching, swelling, dizziness, chest pain, trouble in breathing etc.
• Changes in body fat distribution may during treatment with this medication (increased fat in the upper back and stomach areas, decreased fat in the arms and legs). The cause of these changes in body fat distribution and long-term effects are unknown. Discuss the risks and benefits of therapy with your doctor, as well as the possible role of exercise to reduce this side effect (changes in body fat distribution).
• If you notice other effects not listed above, contact your doctor or other health care provider.

Desease

• HIV virus infection