Used For:

• Treatment of HIV-1 infection in adults and adolescents (>16 years)Used in combination with other antiretrovirals (not as monotherapy) to

Adult Dosage:

• Extended-release (ER) tablet:Once daily: 400 mg orally after the first 14 days of lead-in periodLead-in period (to reduce rash/hepatotoxicity):200 mg once daily for the first 14 daysTake on an empty stomach or with food, consistent with regimen timingPart of a triple-drug antiretroviral regimen

Contraindications:

• Do not use in:Hypersensitivity to nevirapine or NNRTIsSevere hepatic impairment (Child-Pugh C)Active liver disease or elevated baseline liver enzymes (ALT/AST >5x ULN)Pregnancy (use only if benefits outweigh risk, careful monitoring required)Concurrent use with drugs contraindicated with nevirapine (e.g., rifampicin may reduce effectiveness)

Side Effects:

• Common Side EffectsRash (may be mild to moderate)Fatigue, headache, dizzinessNausea, vomiting, diarrheaInsomniaSerious (but rare) Side EffectsSevere skin reactions: Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN)Hepatotoxicity: liver failure, hepatitis, elevated liver enzymesImmune reconstitution syndrome (unmasking of opportunistic infections)Hypersensitivity reactions: fever, malaise, eosinophilia

Precautions:

• Liver function monitoring: baseline and periodic ALT/AST tests (especially first 18 weeks)Monitor for rash, especially in the first 6 weeksAvoid abrupt discontinuation; may cause resistance developmentUse effective contraception in women of childbearing age (nevirapine can interact with hormonal contraceptives)Drug interactions: induces CYP3A4 → may reduce effectiveness of other drugs (e.g., oral contraceptives, antifungals, some antivirals)Caution in pre-existing liver disease or hepatitis B/C coinfection

Dietary Restrictions:

• No specific food restrictions; can be taken with or without foodAvoid alcohol, which may increase risk of hepatotoxicityMaintain good hydration to support liver functionDo not start any new medications, herbal supplements, or over-the-counter remedies without consulting a doctor (risk of drug interactions)