Nevirapine

Nevirapine is a prescription medication used to treat the symptoms of HIV Infection.

• Nevirapine is available under the following different brand names: NVP, Viramune, Viramune XR

Adult and pediatric dosage

Oral suspension

• 10mg/mL

Tablet, immediate-release

• 200mg

Tablet, extended-release

• 100mg
• 400mg

HIV Infection

Adult dosage

• 200 mg orally once a day for 14 days, THEN
• If no rash, increase to 200 mg every 12 hours; if rash occurs wait until it is resolved before increasing
• Prevention of maternal-fetal HIV transmission: 200 mg orally as a single dose at the onset of labor, in combination with Intravenous zidovudine

Extended-release tablets

• Initial therapy: When initiating therapy, give an immediate-release tablet of 200 mg orally once a day for 14 days, then an extended-release tablet of 400 mg orally once a day thereafter
• Switch from immediate-release: If already taking an immediate-release regimen, may switch to extended-release 400 mg orally once a day without a 14-day lead-in period of immediate-release nevirapine

Pediatric dosage

Immediate-release

• Children below 15 days: Safety and efficacy not established
• Children above 15 days to 16 years: 150 mg/m² orally once a day for 2 weeks; if no rash, then increase to 150 mg/m² orally every12hour; not to exceed 200 mg/dose  
• Children above 16 years: As adults; 200 mg orally once a day for 2 weeks; if no rash or untoward effect occurs, then increase to 200 mg orally every 12 hours

Extended-release

• Children below 6 years: Safety and efficacy not established
• Children 6-18 years
• Switch from immediate-release tabs: If already taking immediate-release, may switch to extended-release without a 14-day lead-in period of immediate-release nevirapine
• Initial therapy: Initiate with immediate-release 150 mg/m² orally once a day for 14 days (not to exceed 200 mg/day), THEN  

Extended-release dose based on BSA as follows:

• 0.58-0.83 m²: 200 mg orally once a day
• 0.84-1.16 m²: 300 mg orally once a day
• above1.17 m²: 400 mg orally once a day
• Alternate dosing based on HIV treatment guidelines (March 2016)

Immediate-release and suspension formulations

Children below1 month (investigational dose)

• 34-37 weeks gestational age: 4 mg/kg/dose orally two times a day for 1 week, then increase to 6 mg/kg/dose two times a day thereafter
• Above 37 weeks gestational age: 6 mg/kg/dose orally two times a day

Children above1 month

• Children above 1 month to children below 8 years: 200 mg/m² orally two times a day
• Children above 8 years: 120-150 mg/m² orally two times a day
• Not to exceed 200 mg two times a day

Prevention of Maternal-Fetal HIV Transmission in Neonates

Pediatric dosage

• Birth weight 1.5-2 kg: 8 mg/dose orally
• Birth weight above 2 kg: 12 mg/dose orally
• Administer 3 doses in the first week of life; 1st dose 48 hr after birth, give 2nd dose 48 hours after the 1st dose, and 3rd dose 96 hr after 2nd dose
• Recommended in combination with 6 weeks of zidovudine

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”