Nevirapine, Oral neh-VY-ra-peen

What are other names for this medicine?

Type of medicine: non-nucleoside reverse transcriptase inhibitor; antiretroviral; anti-HIV

Generic and brand names: nevirapine, oral; Viramune; Viramune XR

What is this medicine used for?

This medicine is taken by mouth along with other medicines to treat HIV infection. This medicine must be taken with other anti-HIV medicines to keep from developing resistant strains of HIV.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• dialysis
• liver or kidney disease
• hepatitis B or hepatitis C

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not change your dosage on your own. Do not stop taking this medicine without your healthcare provider's approval. Do not run out of this medicine. If you are not sure of how much and how often to take this medicine, ask your healthcare provider or pharmacist to explain.

Take this medicine with other medicines your healthcare provider prescribes. Follow your healthcare provider's instructions exactly.

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

You may take this medicine with or without food. Your healthcare provider will start you on a low dose of this medicine, and increase the dose after 2 weeks. You will be monitored closely for side effects, especially a rash. Follow instructions carefully.

This medicine comes in the form of tablets, liquid, and extended-release tablets. If you have the liquid form of this medicine, shake the bottle gently before use. Use the measuring device given to you by the pharmacist (not a common kitchen spoon) to make sure you get the right dose. The average household teaspoon may not hold the right amount of liquid. After drinking the medicine, fill the measuring device with water and drink it to make sure you get all the medicine.

If you have extended-release tablets, do not break, crush, or chew them. Swallow them whole. Ask your pharmacist if you have the extended-release tablets.

If you stop taking this medicine for more than 7 days, ask your healthcare provider how much to take before you start taking it again. You may need to start with a different dose.

What if I miss a dose?

Do not miss any doses. If you do miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: rash, headache, dizziness, tiredness, trouble sleeping, nausea, vomiting, weight loss, joint pain or swelling, cough, trouble breathing.

What should I watch out for?

This medicine is not a cure for HIV infection. You may continue to get illnesses associated with advanced HIV infection, including other infections. There is no evidence that this medicine will reduce the risk of spreading HIV through sexual contact or blood contamination.

You will need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

You may develop a rash. This usually goes away without any change in treatment. Occasionally, the rash becomes serious. Report any rash to your healthcare provider right away, especially if it lasts for more than 2Â days.

This medicine may also cause severe liver problems. Contact your healthcare provider right away if you develop severe tiredness, nausea, vomiting, loss of appetite, dark urine, fever, headache, muscle or joint pain, light-colored stools, pain in the upper right part of the stomach, yellowing of your eyes and skin. These are signs of possible liver damage.

Your body fat may change as a result of taking this medicine. Your legs and arms may be thin but your chest, belly, back, and neck may have more fat. Discuss this with your healthcare provider.

This medicine may cause immune reconstitution syndrome (IRS). As the immune system gets stronger, the body's responses to diseases such as pneumonia or tuberculosis may also get stronger. Talk with your provider about this.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider about any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Severe rash with fever, blistering skin, red eyes, mouth sores; muscle or joint pain; severe weakness; severe nausea or vomiting; loss of appetite; dark urine; light-colored bowel movements; yellowing of the eyes and skin.

Other: Mild nausea, vomiting, headache, diarrhea, drowsiness, tiredness, stomach pain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antiarrhythmics (medicines to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dronedarone (Multaq), and quinidine
• antibiotics such as clarithromycin (Biaxin), erythromycin (Ery-Tab, E.E.S.), rifabutin (Mycobutin), rifampin (Rifadin), and rifapentine (Priftin)
• antidepressants such as citalopram (Celexa), escitalopram (Lexapro), mirtazapine (Remeron, Remeron SolTab), nefazodone, trazodone, and venlafaxine (Effexor)
• antifungal medicines such as caspofungin (Cancidas), fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• anti-HIV medicines such as amprenavir (Agenerase), atazanavir (Reyataz), delavirdine (Rescriptor), didanosine (Videx, Videx EC), efavirenz (Sustiva), efavirenz/emtricitabine/tenofovir (Atripla), etravirine (Intelence), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir mesylate (Viracept), nevirapine (Viramune), ritonavir (Norvir), and saquinavir (Invirase)
• antiseizure medicines such as carbamazepine (Tegretol), clonazepam (Klonopin), ethosuximide (Zarontin), phenytoin (Dilantin), and phenobarbital
• birth control pills, patches, vaginal rings, and shots (talk to your healthcare provider if you need birth control)
• boceprevir (Victrelis)
• calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cartia XT, Cardizem Tiazac), felodipine, isradipine (DynaCirc CR), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), nimodipine, nisoldipine (Sular), and verapamil (Calan, Covera-HS, Isoptin SR, Verelan)
• cyclophosphamide
• dapsone
• ergot medicines such as dihydroergotamine (D.H.E. 45), ergotamine (Ergomar, Cafergot, Migergot), ergonovine, and methylergonovine (Methergine)
• fentanyl (Duragesic, Actiq)
• imatinib (Gleevec)
• immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Prograf)
• maraviroc (Selzentry)
• medicines to treat erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra)
• pimozide (Orap)
• methadone (Dolophine, Methadose)
• rivaroxaban (Xarelto)
• sedatives as alprazolam (Xanax), diazepam (Valium), midazolam (Versed), and triazolam (Halcion)
• St. Johns wort
• ranolazine (Ranexa)
• vandetanib (Caprelsa)
• warfarin (Coumadin)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.