Viramune: Advanced Antiretroviral Therapy for HIV Management
Viramune
| Product dosage: 200mg | |||
|---|---|---|---|
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Synonyms | |||
Viramune (nevirapine) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) specifically developed for the treatment of Human Immunodeficiency Virus type 1 (HIV-1) infection. It is indicated for use in combination with other antiretroviral agents as part of a comprehensive highly active antiretroviral therapy (HAART) regimen. This medication works by binding directly to reverse transcriptase, blocking RNA-dependent and DNA-dependent DNA polymerase activities. Clinical studies have demonstrated its efficacy in reducing viral load and increasing CD4+ cell counts in appropriate patient populations when used according to established treatment guidelines.
Features
- Contains nevirapine as the active pharmaceutical ingredient
- Available in immediate-release 200mg tablets and oral suspension formulations
- Demonstrated bioavailability not significantly affected by food intake
- Metabolized primarily through the cytochrome P450 system
- Exhibits linear pharmacokinetics with dose proportionality
- Shows extensive tissue distribution, including penetration across the blood-brain barrier
Benefits
- Effectively reduces HIV-1 viral load in treatment-naïve and experienced patients
- Increases CD4+ lymphocyte counts, supporting immune reconstitution
- Convenient twice-daily dosing regimen after initial lead-in period
- Well-established safety profile with extensive clinical experience
- Available in multiple formulations for flexible dosing strategies
- Demonstrated efficacy in prevention of mother-to-child transmission
Common use
Viramune is primarily indicated for the treatment of HIV-1 infection in adults and pediatric patients aged 15 days and older, in combination with other antiretroviral agents. It is commonly prescribed as part of initial therapy regimens for treatment-naïve patients with CD4+ counts below specific thresholds. The medication may also be used in certain scenarios for prevention of mother-to-child transmission during pregnancy and labor, following established protocol guidelines. Healthcare providers typically consider Viramune as part of comprehensive antiretroviral strategy based on individual patient factors, resistance testing, and treatment history.
Dosage and direction
Adult patients: Initiate with 200mg once daily for first 14 days (lead-in period), then increase to 200mg twice daily if no rash or other hypersensitivity reactions occur. Pediatric patients: Dosage based on body surface area or weight, with similar lead-in period. Oral suspension: Shake well before use; administer using appropriate measuring device. Tablets may be taken with or without food. Adherence to the prescribed schedule is critical for maintaining therapeutic efficacy and minimizing resistance development. Dosage adjustments may be necessary in patients with hepatic impairment or when co-administered with certain other medications.
Precautions
Monitor hepatic function closely during first 18 weeks of therapy, as severe hepatotoxicity may occur. Perform baseline and frequent liver function tests. Watch for signs of hypersensitivity reactions, particularly skin rash, which may progress to severe reactions. Use with caution in patients with pre-existing liver disease or impaired renal function. Women with CD4+ counts >250 cells/mm³ and men with CD4+ counts >400 cells/mm³ have increased risk of hepatic events. Avoid use in patients with moderate to severe hepatic impairment. Monitor for immune reconstitution syndrome and fat redistribution.
Contraindications
Hypersensitivity to nevirapine or any component of the formulation. Use in patients with moderate or severe hepatic impairment (Child-Pugh Class B or C). Contraindicated as part of occupational and non-occupational post-exposure prophylaxis regimens. Do not use in patients who experienced severe rash, rash with constitutional symptoms, or hepatic toxicity during previous nevirapine therapy. Contraindicated in patients receiving certain drugs that are highly dependent on CYP3A4 for clearance and for which elevated plasma concentrations are associated with serious adverse events.
Possible side effects
Common: Rash (including maculopapular eruptions), headache, nausea, fatigue, fever. Serious: Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis), hepatotoxicity (including fulminant hepatitis), hypersensitivity reactions. Other: Increased liver enzymes, granulocytopenia, myalgia, diarrhea. Monitor for signs of immune reconstitution inflammatory syndrome. Long-term use may be associated with lipid abnormalities and body fat redistribution. Report any new symptoms promptly to healthcare provider.
Drug interaction
Nevirapine induces CYP3A4 and may decrease concentrations of: protease inhibitors, methadone, ethinyl estradiol, ketoconazole, itraconazole, and certain anticonvulsants. Drugs that induce CYP3A4 may decrease nevirapine concentrations. Avoid concomitant use with St. John’s wort. Use caution with other hepatotoxic drugs. Monitor international normalized ratio (INR) when used with warfarin. May decrease concentrations of hormonal contraceptives—alternative contraception methods recommended. Potential interactions with rifampin, rifabutin, and certain antifungal agents.
Missed dose
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and continue with regular dosing schedule. Do not double the dose to make up for a missed dose. Maintain consistent dosing intervals to ensure stable drug levels. Inform healthcare provider about pattern of missed doses, as inconsistent adherence may lead to treatment failure and development of resistance. Consider using adherence aids if missing doses becomes frequent.
Overdose
Symptoms may include edema, erythema nodosum, fatigue, fever, headache, insomnia, nausea, pulmonary infiltrates, rash, vertigo, vomiting, and weight decrease. There is no specific antidote for nevirapine overdose. Treatment should consist of general supportive measures, including monitoring of vital signs and observation of clinical status. Charcoal administration may be used if presented soon after ingestion. Hemodialysis may remove approximately 15% of the dose, but its clinical benefit is uncertain. Contact poison control center for latest guidance.
Storage
Store at 20-25°C (68-77°F); excursions permitted to 15-30°C (59-86°F). Keep container tightly closed. Protect from light and moisture. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Tablets should be kept in original blister packaging until administration. Oral suspension should be discarded 6 months after first opening the bottle. Do not freeze the suspension. Proper storage ensures medication stability and efficacy throughout treatment duration.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Always consult qualified healthcare professionals for diagnosis and treatment decisions. Individual patient responses may vary. Full prescribing information should be reviewed before initiation of therapy. The manufacturer and distributors are not liable for any consequences arising from the use or misuse of this information. Treatment decisions should be based on comprehensive patient assessment and current clinical guidelines.
Reviews
Clinical trials demonstrate Viramune’s efficacy in viral suppression and immune recovery when used appropriately. Many healthcare providers report satisfactory outcomes in compliant patients with proper monitoring. Some patients experience excellent tolerance with minimal side effects, while others may develop hypersensitivity reactions requiring discontinuation. The lead-in period has proven effective in identifying patients at risk for severe reactions. Long-term follow-up studies show sustained virological response in appropriate patient populations. Regular monitoring remains essential for optimal outcomes and early detection of potential adverse events.