Nevirapine

IUPAC name 11-cyclopropyl-4-methyl-5,11-dihydro-6H-dipyrido 1,4diazepin-6-one. Formula C15H14N4O. Nevirapine, also marketed under the trade name Viramune by Boehringer Ingelheim, is a non-nucleoside reverse transcriptase inhibitor (NNRTI) used to treat HIV-1 infection and AIDS.

As with other antiretroviral drugs, HIV rapidly develops resistance if nevirapine is used alone, so recommended therapy consists of combinations of three or more antiretrovirals.

Nevirapine in triple combination therapy has been shown to suppress viral load effectively when used as initial antiretroviral therapy. Some clinical trials have demonstrated comparable HIV suppression with nevirapine-based regimens to that achieved with protease inhibitors or efavirenz. Although concerns have been raised about nevirapine-based regimens in those starting therapy with high viral load or low CD4 count, some analyses suggest that nevirapine may be effective in these patients.

Nevirapine may also form a useful component of salvage regimens after virological failure, usually in combination with one or more PIs as well as nRTIs, especially in those who have not previously taken an NNRTI.

The most common adverse effect of nevirapine is the development of mild or moderate rash, observed in 13% of patients. Severe or life-threatening skin reactions have been observed in 1.5% of patients, including Stevens-Johnson syndrome, toxic epidermal necrolysis and hypersensitivity. Nevirapine may cause severe or life-threatening liver toxicity, usually emerging in the first six weeks of treatment. All prior information have been sourced from Wikipedia.

At the RITM, I was initially put on a once-a-day dosage of Nevirapine. I had surpassed the two week trial period, and had graduated onto a twice-a-day regimen, at which point I had started experiencing low-grade fevers in the first couple of days. On the fifth day, however, my fever went up into the 40s, and at that point I was instructed to stop taking it, and to report as soon as possible to the RITM. Apparently I had begun experiencing allergic reactions to the drug, which was later on replaced with Efavirenz. I was able to observe rashes as well, even around five days after stopping the Nevirapine. The rash has subsided since, not really being too noticeable to begin with. Dealing with Nevirapine is not impossible, as I had met at least one other person who was well into the treatment, and not experiencing any allergic reactions.

One thing I was looking forward to with Nevirapine, is that people who were on it are said to tend to gain weight, a huge fantasy for a hard gainer as myself. Too bad it didn't work out.