It acts as non-nucleotide reverse transcriptase inhibitor.

Nevirapine noncompetitively binds to a site other than catalytic site in the HIV- 1 reverse transcriptase enzyme .This binding will results in a structural change in the enzyme and inhibits its activity i.e. conversion of viral RNA to pro viral DNA and subsequent virus replication.

Pharmacokinetics
Absorption: It is rapidly absorbed after oral administration.
Distribution: It is widely distributed in the body in protein bound form.
Metabolism: It is extensively metabolised in the liver .
Excretion: The drug is primarily excreted through faeces and it is also excreted through urine.

Half Life
30 hours

Adverse Effects
1. Rash
2. Stevens-Johnson syndrome
3. Dizziness
4. Headache
5. Fatigue
6. Nausea
7. Diarrhoea
8. Fever
9. Somnolence

ContraIndications
Hypersensitivity to Nevirapine

Special Precautions
1. Renal impairment
2. Hepatic impairment

Pregnancy
Contraindicated

Breast Feeding
Contraindicated

Elderly
Use with caution

Children
Use with caution

Neonates
Contraindicated

Interactions
Analgesics : Possible reduction in plasma concentration of methadone.
Antibacterials: Rifampicin and Rifabutin reduce plasma concentration of nevirapine.
Antidepressants: Plasma concentration of nevirapine reduced by St. John’s Wort.
Other Antivirals: Nevirapine reduces plasma concentration of saquinavir also plasma concentration of indinavir and possibly amprenavir and lopinavir.
Oestrogen and Progestogens: Reduced contraceptive effect of oral and other hormonal contraceptives.

Indications
HIV-1 infection

Dosage
Adult: 200 mg / day for 2 weeks followed by 400 mg / day in 2 divided doses along with other antiretroviral agents
Children : 2 months: 4 mg / kg body weight / day in single dose for 2 weeks followed by 8 - 14 mg / kg body weight / day in 2 divided doses; depending on the age of the patient the dose is selected by the treating specialist
Maximum Daily Dose: 400 mg

Storage
Store at 15 - 30 degree C in a tightly closed container. Protect away from heat and light. Keep out of the reach of Children.

Missed Dose
Take the missed dose as soon as noticed and if it is the time to take the next dose then skip the missed dose.

Over Dose
Give supportive measures and treatment.