Nevirapine — what it does and what to watch for
Nevirapine is an HIV drug from the NNRTI class. It stops the virus from copying itself and is part of combination antiretroviral therapy. It’s cheap and widely used in many countries, but it comes with specific risks you should know before starting.
How nevirapine works and dosing
Nevirapine blocks HIV reverse transcriptase, which helps lower viral load when you take it with other antiretrovirals. Typical adult dosing uses a two-week lead-in: 200 mg once daily for 14 days, then 200 mg twice daily. There’s also a 400 mg extended-release tablet taken once daily. Don’t use nevirapine alone — monotherapy leads to rapid resistance.
If you’re pregnant, breastfeeding, or on other medicines, dose and choice may change. For example, rifampicin (used for TB) can lower nevirapine levels, and some protease inhibitors affect its metabolism. Always tell your provider about every medicine and supplement you take.
Side effects, monitoring, and safety tips
The two main safety concerns are skin reactions and liver injury. A mild rash is common early on. If a rash becomes widespread, painful, or is paired with fever or blistering, stop the drug and call your doctor — that could be Stevens-Johnson syndrome. Serious liver toxicity can also happen, usually in the first 2–18 weeks.
Women with CD4 counts over 250 cells/mm3 and men over 400 cells/mm3 have a higher risk of severe liver problems when starting nevirapine. That threshold is used by many clinicians when deciding whether to start it.
Before you start nevirapine, get baseline liver function tests (LFTs). Recheck LFTs at 2, 4, and 6 weeks, and anytime you feel unwell. If ALT or AST rise significantly, your clinician may stop the drug. Also watch for symptoms like nausea, fatigue, jaundice, or dark urine — these can mean liver trouble.
Adherence matters. Missed doses increase the chance of resistance. If resistance develops, it can limit future NNRTI options because single mutations often cause cross-resistance.
Nevirapine has been used in programs to prevent mother-to-child HIV transmission, but guidelines and preferred drugs have changed. If you’re pregnant or planning pregnancy, discuss safer and newer options with your clinician.
Thinking about buying nevirapine online? Be cautious. Use only licensed pharmacies that require a prescription. Fake or substandard drugs are dangerous and may drive resistance. If you’re unsure about a site, ask your clinic or pharmacist for help.
Want a quick checklist: get baseline LFTs and CD4, start the 14-day lead-in, watch closely for rash or liver symptoms, avoid interactions (ask about TB meds and hormonal contraceptives), and never take nevirapine alone. Talk to your healthcare provider about safer alternatives if you have high CD4 counts or liver disease.
Questions about side effects, drug interactions, or how to get nevirapine safely? Reach out to your clinic — getting the right advice early prevents harm and keeps treatment working.
