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Nevirapine is used to treat HIV. It works by helping stop the spread of HIV in your body. Common side effects include rash and liver damage, which can sometimes be severe. Call your health care provider right away if you have any symptoms of liver problems, such as dark-colored pee, light-colored poop, loss of appetite, or your skin or the whites of your eyes turning yellowish.

Uses

What is nevirapine used for?

Nevirapine is commonly used to treat human immunodeficiency virus (HIV).

Nevirapine may also be used for other conditions as determined by your health care provider.

How does nevirapine work (mechanism of action)?

Nevirapine works to help stop the spread of HIV in your body. A lower amount of HIV in your body helps protect and preserve the immune system.

How is nevirapine supplied (dosage forms)?

Brands and other names

  • Viramune
  • Viramune XR

Dosage forms and strengths

  • 400 mg extended-release oral tablets
  • 200 mg oral tablets
  • 50 mg/5 mL oral suspension

How should I store nevirapine?

Nevirapine should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). They can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of nevirapine?

The most common side effects of nevirapine are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Rash (see below)
  • Liver damage (see below)

There may be other side effects of nevirapine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of nevirapine?

While less common, the most serious side effects of nevirapine are described below, along with what to do if they happen.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking nevirapine. You may be at higher risk if you already have liver problems. Keep all appointments for blood tests to check the health of your liver. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever or flu-like symptoms
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish (also called jaundice)

Rash or Skin Reactions. Nevirapine can commonly cause a rash. Sometimes it can cause a severe rash or skin reaction, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), that can lead to death if not treated. Your health care provider may start you at a low dose to help prevent a serious rash. If you get a rash, call your health care provider right away. Stop taking nevirapine and get emergency help if you have a rash with any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Flu-like symptoms, including fever, chills, tiredness, and muscle or joint aches
  • Swelling of your face

Immune System Changes. When you start nevirapine, your immune system might get stronger and start fighting infections that have been hiding inside your body for a long time. The type of symptoms you may have will depend on the infection. Tell your health care provider right away if you notice any of the following new symptoms of infection.

  • Fever, sweats, chills, or muscle aches
  • Swollen lymph nodes
  • Vision problems
  • Confusion, problems talking, or headache
  • Skin problems, such as a painful rash or warts
  • Cough or coughing up blood
  • Weakness or coordination problems

Fat Redistribution. Some people taking nevirapine have changes in how their body stores fat. You may get more fat around the belly, breasts, or upper back (buffalo hump). You may lose fat in your arms, legs, face, or butt. Tell your health care provider right away if you have any of these symptoms.

Severe Allergic Reactions. Nevirapine may cause allergic reactions, which can be serious. Stop taking nevirapine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives, which can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use nevirapine?

Allergies to Ingredients. People who are allergic to any of the following should not take nevirapine.

  • Nevirapine
  • Viramune
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific nevirapine products they stock.

Liver Problems. Nevirapine should not be taken if your liver is not working as well as it should be. If there is a concern about the health of your liver, your health care provider may do tests to determine if it is working well enough to take this medicine.

Post-Exposure Prophylaxis. Nevirapine should not be taken to lower your risk of becoming infected with HIV after coming in contact with the virus. This is called HIV post-exposure prophylaxis (PEP). Nevirapine is used to treat HIV after you are infected.

What should I know about nevirapine before using it?

Do not take nevirapine unless it has been prescribed to you by a health care provider. Take it exactly as prescribed.

Do not share nevirapine with other people, even if they have the same condition as you. It may harm them.

Keep nevirapine out of the reach of children.

There are multiple forms of nevirapine available. Read and follow the instructions for the product you have and make sure you understand how to use it properly. If you have any questions, talk to your health care provider.

If you are taking nevirapine oral liquid, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist what measuring device to use. Shake the liquid gently before each dose.

If you are taking nevirapine extended-release oral tablets, swallow the tablet whole. Do not chew, cut, or crush nevirapine extended-release tablets. You may see soft pieces of these tablets in your poop. This is normal and harmless.

It is important to keep all appointments, including for blood tests. This helps your health care provider make sure it is safe for you to take this medicine.

While nevirapine can help keep the HIV infection under control, it does not cure it. Nevirapine does not help protect against or prevent the spread of sexually transmitted infections (STIs), such as herpes, gonorrhea, or chlamydia.

Nevirapine may make it hard for you to get pregnant. If you have concerns, talk to your health care provider.

Women can be at greater risk of some side effects from nevirapine. Talk to your health care provider if you have concerns.

What should I tell my health care provider before using nevirapine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if nevirapine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Other Medicines and Supplements. Nevirapine may interact with other medicines and supplements. Before taking nevirapine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how nevirapine could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should take nevirapine while you are pregnant or trying to get pregnant. If you become pregnant while taking nevirapine, you can register for the Antiretroviral Pregnancy Registry by calling 800-258-4263 or at www.apregistry.com. This registry collects safety information about the use of HIV medicines during pregnancy.

Breastfeeding. Nevirapine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take nevirapine while breastfeeding. There may be risks with breastfeeding while taking nevirapine and having HIV.

Interactions

Does nevirapine interact with foods or drinks?

There are no known interactions between nevirapine and foods or drinks.

It is unknown if drinking alcohol will affect nevirapine. The risk of liver problems may increase if you drink alcohol while taking this medicine.

Does nevirapine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using nevirapine.

  • Any other medicine for HIV or AIDS
  • Methadone, which is an opioid medicine used to treat pain or opioid use disorder
  • A medicine for an irregular heart rate or rhythm, such as amiodarone or disopyramide
  • Clarithromycin, which is a medicine used for bacterial infections
  • Rifampin (Rifadin) or rifapentine (Priftin), which are medicines commonly used to treat an infection called tuberculosis
  • Rifabutin (Mycobutin), which is a medicine used to prevent Mycobacterium avium complex infection
  • Any medicine for seizures, such as carbamazepine, clonazepam, or ethosuximide
  • Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), or ketoconazole, which are medicines used for fungal infections
  • Warfarin, which is a blood thinner
  • A medicine for high blood pressure 
  • Cyclophosphamide, which is a medicine used to treat certain cancers and a type of kidney problem
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), sirolimus (Rapamune), or tacrolimus (Prograf, Astagraf XL), which are medicines that suppresses your immune system
  • A birth control pill, patch, vaginal ring, implant, injection, or intrauterine device (IUD) that contains hormones
  • St. John’s wort, which is a supplement that may be used for depression

Many other medicines may alter the blood levels of nevirapine, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with nevirapine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much nevirapine?

If you or someone else has used too much nevirapine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of nevirapine?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

Missing doses of nevirapine can cause it to not work as well over time. So it is important not to miss or skip doses.