Indications 

Viramune is a prescription medicine indicated for use in combination with other antiretroviral agents for the treatment of human immunodeficiency virus (HIV) 1 infection.  

As a non-nucleoside reverse transcriptase inhibitor (NNRTI), Viramune functions by reducing HIV levels in the bloodstream. 

Uses and Dosage 

Before starting treatment with Viramune and with every prescription refill, carefully review the medication guide and patient information leaflet provided by your pharmacist. If you have any questions or concerns, contact your doctor or pharmacist for guidance. 

Viramune dosage may vary per individual based on their medical condition and response to the treatment. For pediatric patients, the dosage is further determined by body size. 

Typically, Viramune is taken once daily during the initial 14-day period of treatment, followed by a switch to a twice-daily regimen. 

In the event of liver complications or skin allergies arising during the once-daily administration of this medication, seek immediate medical assistance and refrain from escalating the dosage to twice daily. 

To optimize efficacy, take this medication at regular intervals at the same time of the day daily. 

Adhere strictly to your doctor’s prescribed regimen for Viramune and other HIV medications. Avoid missing doses, altering your dosage, increasing frequency, or discontinuing treatment, unless instructed by your doctor. Deviating from the prescribed regimen may lead to increased viral levels, treatment resistance, or exacerbate side effects. 

If you have not taken Viramune for 7 days or more, consult your doctor before resuming treatment. Your doctor will initiate a regimen with a low initial dose and gradually escalate it after 2 weeks. 

Side Effects 

Listed below are the potential adverse effects of Viramune. Immediately inform your doctor if any of these symptoms persist or worsen. 

Common Side Effects 

• Skin rash 
• Alterations in body fat distribution, particularly in the arms, legs, face, neck, breasts, and waist 

Serious Side Effects 

• Liver issues, especially in women, presenting with symptoms like: 
  • Nausea 
  • Loss of appetite 
  • Upper stomach pain 
  • Fatigue 
  • Fever 
  • Unexplained muscle pain or weakness 
  • Dark urine 
  • Clay-colored stools 
  • Jaundice (yellowing of the skin or eyes) 

Contact your doctor right away if any of the side effects above are experienced. 

Viramune can potentially lead to severe or life-threatening skin reactions. Discontinue taking this medication and immediately seek medical assistance if you experience symptoms such as: 

• Fever 
• Sore throat 
• Facial or tongue swelling 
• Eye irritation 
• Skin pain 
• A spreading red or purple rash with blistering and peeling 

Viramune may modify the immune system’s function, potentially increasing the risk of certain infections or autoimmune disorders. Symptoms may manifest weeks or months after treatment initiation. Inform your healthcare provider if you experience: 

• Indications of a new infection, such as: 
  • Fever 
  • Night sweats 
  • Swollen glands 
  • Mouth sores 
  • Diarrhea 
  • Stomach pain 
  • Weight loss 
• Chest discomfort, particularly while breathing, accompanied by a dry cough, wheezing, or shortness of breath 
• Cold sores or sores in the genital or anal area 
• Rapid heartbeat, anxiety, irritability, weakness, tingling sensations, or balance or eye movement difficulties 
• Speech or swallowing difficulties, severe lower back pain, or loss of bladder or bowel control 
• Neck or throat swelling (enlarged thyroid), menstrual alterations, impotence, or diminished interest in sexual activity 

Allergic Reactions 

In rare cases, Viramune may trigger a serious allergic response. Seek immediate medical assistance if you observe any indications of an allergic reaction, such as: 

• Joint or muscle pain 
• Fever 
• Mouth sores 
• Facial swelling 
• Blistering skin rash 
• Flu-like symptoms 
• Swollen glands 
• Weakness or fatigue 
• Severe tingling or numbness 
• Pain or burning during urination 
• Leg or foot swelling 
• Cough 
• Chest pain 
• Breathing difficulties 
• Swelling in lips, tongue, or throat 

Not all side effects of Viramune are included in this list. Inform your doctor of any additional side effects that may arise. 

Cautions 

Before starting Viramune treatment, notify your doctor of any existing allergies, specifically to nevirapine. 

Consult your pharmacist for more details about Viramune, as it may contain inactive components that may lead to allergic reactions or other complications. 

To ensure Viramune is safe for you, disclose to your doctor your medical background, especially if you have a history of: 

• Hepatic issues (e.g., hepatitis B or C, cirrhosis) 
• Kidney dialysis 
• Lactose or galactose intolerance 

Some products may interact with Viramune, including orlistat, rifabutin, and warfarin. To lower the risk of such drug interactions, inform your healthcare providers about all your medications, including prescription and non-prescription drugs, vitamins, and herbal supplements. 

Various medications can affect the elimination of nevirapine from the body, potentially influencing Viramune’s effectiveness. These medications include rifamycins (e.g., rifampin) and St. John’s wort, among others. 

Viramune can accelerate the metabolism of various other medications in the body, potentially altering their efficacy. Affected drugs encompass: 

• Antiarrhythmics (e.g., amiodarone) 
• Asunaprevir  
• Atazanavir 
• Cobicistat 
• Elvitegravir 
• Select seizure medications (e.g., clonazepam)  
• Azole antifungals (e.g., itraconazole, ketoconazole) 
• Macrolide antibiotics (e.g., clarithromycin) 
• Methadone 

Refrain from taking prednisone as a preventive measure for a rash, as it may elevate the risk of developing a rash within the initial 6 weeks of Viramune treatment. Consult your doctor for additional information. 

Viramune does not prevent HIV transmission to others. Avoid unprotected sex, as well as sharing razors or toothbrushes. Consult your doctor for guidance on safe practices to prevent HIV transmission during sexual activity. Remember that sharing drugs or medicine needles is never safe, regardless of your health status. 

The safety of Viramune for unborn babies is uncertain, and it may cause liver damage in pregnant women. Inform your doctor if you are pregnant or planning to be. Untreated HIV during pregnancy can transmit the virus to the baby. Take all prescribed HIV medications to manage the infection. 

Viramune may reduce the efficacy of hormonal birth control methods like pills, patches, or rings, potentially leading to pregnancy. Consult your doctor regarding alternative and reliable contraception options and consider the use of latex or polyurethane condoms/dental dams during sexual activity to lower the risk of HIV transmission.  

Inform your doctor if you experience new spotting or breakthrough bleeding, as these may indicate reduced effectiveness of your hormonal birth control. 

Breastfeeding is not recommended for women with HIV or AIDS, as it can potentially transmit the virus to their baby through breast milk, regardless of the baby’s initial HIV status.