Viramune (Nevirapine)

Do’s

• Before starting treatment with Viramune, read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist. If you have any questions, consult your healthcare provider.
• The dosage of Viramune is based on your medical condition and response to treatment. In children, the dosage is also based on body size.
• Typically, Viramune is taken once daily for the first 14 days when starting treatment. This initial once-daily dosing helps to minimize the risk of serious side effects. After the initial 14 days, the dosage is usually increased to twice daily.
• If you experience liver problems or skin/allergic reactions while taking Viramune once daily, seek immediate medical help.
• If you are using the liquid suspension form of Viramune, shake the bottle gently before each dose. Use a special measuring device/spoon to carefully measure the dose. 
• After taking the medication, rinse the dosing cup with water and drink all of the rinse water to ensure you take the full dose.
• If you miss a dose of Viramune, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule.
• Take Viramune (and other HIV medications) exactly as prescribed by your healthcare provider.

Don’ts

• Do not increase the dose of Viramune to twice daily if you experience liver problems or skin/allergic reactions.
• Do not use a household spoon when measuring the liquid suspension as it may not provide the correct dose. 
• Do not stay on the once-daily dosing schedule for more than 28 days. If you approach that period of time, your healthcare provider should consider switching you to another medication.
• Do not take extra medicine to make up for the missed dose
• Do not skip any doses, increase your dose, take the drug more often than prescribed, or stop taking it (or other HIV medicines) without approval from your healthcare provider. Skipping or changing your dose without medical approval may lead to increased viral levels, treatment resistance, or worsened side effects.

Common Side Effects:

• Rash
• Fever
• Headache
• Tiredness
• Nausea
• Vomiting
• Diarrhea
• Stomach pain
• Changes in liver function tests

Severe side effects:

• Severe rash
• Hepatotoxicity
• Hypersensitivity reactions
• Immune reconstitution syndrome

This is not an exhaustive list of side effects. If you are taking Viramune and experiencing any unusual symptoms or side effects, consult with your healthcare provider for further evaluation and guidance.

Viramune can cause liver problems, including hepatitis and hepatic failure. Monitor liver function and transaminase levels, especially for patients who develop a rash within the first 18 weeks of treatment. If any signs of liver problems occur, such as nausea, loss of appetite, upper stomach pain, tiredness, fever, unexplained muscle pain or weakness, dark urine, clay-colored stools, or jaundice, seek medical attention immediately.

Viramune may cause severe or life-threatening skin reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis. If you experience symptoms such as a fever, sore throat, swelling in the face or tongue, burning in the eyes, skin pain, and a red or purple skin rash that spreads and causes blistering and peeling, stop taking Viramune and seek emergency medical help.

Hypersensitivity reactions, including severe rash accompanied by fever, general malaise, fatigue, muscle or joint aches, blisters, oral lesions, conjunctivitis, facial edema, eosinophilia, granulocytopenia, lymphadenopathy, or renal dysfunction, have been observed with Viramune use. If any signs of hypersensitivity reactions occur, seek medical attention.

Viramune can interact with other drugs, including prescription and over-the-counter medicines, vitamins, and herbal products. Inform your healthcare provider about all the medicines you are taking to avoid potential interactions.

Viramune may cause harm to an unborn baby. Discuss the risks and benefits of using Viramune during pregnancy with your healthcare provider. 

Viramune can also pass into breast milk. Consult with your healthcare provider if you are breastfeeding or planning to breastfeed.

This is not an exhaustive list of warnings and precautions. Please consult with a healthcare provider for more detailed information.