Starting on nevirapine

Nevirapine is recommended as an alternative NNRTI. This is largely because of the small risk of serious side effects.

Nevirapine has some similar side effects as efavirenz (although not the sleep or mood disturbance). This includes risk of rash and liver toxicity, which can be serious and occasionally fatal. Careful monitoring is essential.

The risk of side effects with nevirapine was found to be linked to starting treatment with a higher CD4 count (over 250 for women, and over 400 cells/mm3 for men). Whether the risk is reduced by observing these upper CD4 cut-offs is the subject of ongoing research.
Nevirapine is started at 1 tablet a day for the first 2 weeks, and then increased to 1 tablet twice-daily.
A serious allergic reaction called Stevens- Johnson Syndrome (SJS) has been reported in 0.3% of people starting nevirapine compared to 0.1% in people starting efavirenz.
Nevirapine is not routinely recommended in people with hepatitis C and HIV, because it may increase liver disease.

The reactions with nevirapine usually only occur in the first two months. Over this time, you should be monitored more carefully. Otherwise, nevirapine is reported as an easy drug to tolerate.

This is the web edition of the i-Base guide Introduction to combination therapy. This guide is available in UK clinics. You can order free printed copies or download a PDF version (516 Kb). Translations. Authors and credits. Glossary. Full section index.

Decisions relating to your treatment should always be taken in consultation with your doctor. Information in this guide is intended to support those discussions.