Nevirapine is used in combination with other medicines to treat human immunodeficiency virus (HIV). HIV is the virus that causes acquired immune deficiency syndrome (AIDS). Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI). It works by binding to a hydrophobic allosteric site on the HIV-1 reverse transcriptase enzyme, inducing a conformational change that inhibits both RNA-dependent and DNA-dependent DNA polymerase activities and thereby preventing synthesis of proviral DNA; pharmacokinetically it is orally bioavailable, extensively metabolized by hepatic cytochromes CYP3A4 and CYP2B6 to hydroxylated metabolites, and exhibits time-dependent autoinduction of its own clearance with clinical implications for dose adjustment in initiation and steady state.
Parent: Nevirapine
Parent: Nevirapine Hemihydrate / Nevirapine
Typical active pharmaceutical ingredient specifications for nevirapine characterize related chemical substances and degradation products including synthesis intermediates, dealkylation products, oxidative N-oxides, hydrolytic fragments and polymeric dimers; regulatory specifications commonly set individual known impurity limits in the range of 0.05 to 0.5 percent w/w, unspecified impurity reporting thresholds at 0.05 to 0.2 percent w/w, and total impurities not to exceed approximately 1.0 to 2.0 percent w/w depending on the manufacturer and pharmacopeial monograph; impurity identification and control employ HPLC with validated retention and mass spectral confirmation, forced degradation studies to define degradants, and limits established on toxicological and regulatory risk assessment.
Nevirapine is a non-nucleoside reverse transcriptase inhibitor, abbreviated NNRTI, which directly inhibits HIV-1 reverse transcriptase by binding to an allosteric site distinct from the nucleotide binding site.
Neonatal prophylaxis regimens vary by guideline and exposure risk; a commonly used course is daily nevirapine for six weeks for infants born to HIV positive mothers, with extension of prophylaxis during breastfeeding up to several months if maternal viral suppression is absent or unknown; local national guidelines should be followed for exact duration and dosing in neonates.
Yes, nevirapine remains in use globally as part of combination antiretroviral therapy and for prevention of mother to child transmission in some settings, though its use has declined in some high-resource settings where alternatives with lower risk of severe rash and liver toxicity or more favorable resistance profiles are preferred.
The most common adverse effect is a cutaneous rash, which can range from mild maculopapular eruptions to severe hypersensitivity such as Stevens Johnson syndrome; rash typically appears within the first six weeks of therapy and liver enzyme elevations are another important adverse effect requiring monitoring.
