Viramune: Advanced HIV-1 Management with NNRTI Efficacy
| Product dosage: 200mg | |||
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Synonyms | |||
Viramune (nevirapine) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) indicated for the treatment of HIV-1 infection in combination with other antiretroviral agents. It is specifically designed to reduce viral load and increase CD4 cell counts in affected individuals. This medication is a critical component in the management of HIV, offering a well-established option within combination therapy regimens. Proper adherence and monitoring are essential to maximize therapeutic outcomes and minimize risks.
Features
- Active ingredient: nevirapine
- Formulation: immediate-release tablets and oral suspension
- Standard tablet strength: 200 mg
- Mechanism: binds directly to reverse transcriptase, blocking RNA-dependent and DNA-dependent DNA polymerase activities
- Bioavailability: over 90% following oral administration
- Half-life: approximately 25–30 hours
- Metabolism: hepatic, primarily via cytochrome P450 isoenzymes
- Excretion: mainly via urine (over 80% as metabolites)
Benefits
- Effectively reduces HIV-1 viral load in treatment-naïve and experienced patients
- Helps increase CD4+ T-cell counts, supporting immune reconstitution
- Convenient twice-daily dosing supports regimen adherence
- Available in multiple formulations for flexible administration
- Demonstrated long-term efficacy in combination antiretroviral therapy
- Well-characterized safety profile with appropriate monitoring
Common use
Viramune is used as part of combination antiretroviral therapy for the treatment of HIV-1 infection in adults and pediatric patients aged 15 days and older. It is not recommended as monotherapy due to the rapid emergence of resistance. The medication is often included in first-line regimens, particularly in resource-limited settings, and may be used in prevention of mother-to-child transmission under specific protocols.
Dosage and direction
For treatment-naïve adults: 200 mg orally once daily for the first 14 days (lead-in period), then increased to 200 mg twice daily if no rash or hepatic events occur. For pediatric patients, dosing is based on body surface area or weight. Tablets should be swallowed whole with water; oral suspension must be shaken well before each use. Always take as prescribed, with or without food consistently.
Precautions
Monitoring of hepatic function is strongly recommended prior to initiation and frequently during the first 18 weeks of therapy. Patients should be advised about the potential for severe skin reactions and hepatotoxicity. Use with caution in patients with renal impairment or those coinfected with hepatitis B or C. Avoid use in patients with moderate to severe hepatic impairment. Adherence to the lead-in dosing is critical to reduce the risk of rash.
Contraindications
Viramune is contraindicated in patients with moderate or severe hepatic impairment (Child-Pugh B or C). It should not be used in patients who have experienced a previous hypersensitivity reaction to nevirapine, including severe rash, rash with constitutional symptoms, or hepatotoxicity. Coadministration with rifampin is not recommended. Do not use for occupational or non-occupational post-exposure prophylaxis.
Possible side effect
Common side effects include rash, nausea, headache, fatigue, and abnormal liver function tests. Serious side effects may include severe skin reactions (e.g., Stevens-Johnson syndrome), hepatotoxicity, and hypersensitivity reactions. Other reported effects include fever, myalgia, and granulocytopenia. Patients should seek immediate medical attention for symptoms such as blistering, mouth sores, jaundice, or dark urine.
Drug interaction
Nevirapine is a moderate inducer of CYP3A4 and may decrease concentrations of drugs metabolized by this enzyme, such as methadone, oral contraceptives, and certain antifungals. Concurrent use with other hepatotoxic agents may increase the risk of liver injury. Use caution with protease inhibitors and other NNRTIs. Consult full prescribing information for a comprehensive list of interactions.
Missed dose
If a dose is missed, take it as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for a missed one. Consistent adherence is vital to maintain virologic suppression and prevent resistance development.
Overdose
There is no specific antidote for nevirapine overdose. Management should include supportive measures and monitoring of vital signs, hepatic function, and hematologic parameters. Hemodialysis may not be effective due to high protein binding. Contact a poison control center or healthcare provider immediately if overdose is suspected.
Storage
Store tablets and oral suspension at room temperature (15–30°C or 59–86°F). Keep the container tightly closed and protect from light and moisture. Do not freeze the oral suspension. Keep out of reach of children and pets. Discard any unused medication after the expiration date.
Disclaimer
This information is for educational purposes and does not replace professional medical advice. Always consult a healthcare provider for diagnosis, treatment decisions, and personalized recommendations. Dosage and suitability depend on individual patient factors, including medical history, concomitant conditions, and other medications.
Reviews
Clinical studies and post-marketing reports indicate that Viramune is effective in reducing viral load and improving immune status when used appropriately in combination therapy. Many healthcare providers value its role in certain patient populations, though attention to monitoring and adherence is emphasized. Patient experiences vary, with effectiveness noted in maintaining undetectable viral loads, though some report tolerability issues such as rash or hepatic events. Overall, it remains a significant option in HIV management protocols.