VIRAMUNE XR

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Generic Name for VIRAMUNE XR Nevirapine 400mg; ext-rel tabs. Legal Classification: Rx Pharmacological Class for VIRAMUNE XR Non-nucleoside reverse transcriptase inhibitor. Manufacturer of VIRAMUNE XR Boehringer Ingelheim Pharmaceuticals

Indications for VIRAMUNE XR

HIV-1 infection.

Adult dose for VIRAMUNE XR

Swallow whole. Initially Viramune 200mg once daily for 14 days, then Viramune XR 400mg once daily. If mild-to-moderate rash develops during the 14-day lead in period, do not start Viramune XR until rash has resolved. Lead-in period not necessary if patient already on a regimen of immediate-release Viramune twice daily. Total duration of once daily lead-in period should not exceed 28 days; consider alternative regimen. If severe rash or hepatic event occurs, discontinue permanently. Retitrate if stopped for >7 days.

Children's dosing for VIRAMUNE XR

Not recommended.

Also:

Contraindications for VIRAMUNE XR

Moderate-to-severe (Child-Pugh B or C) hepatic impairment. Use as part of occupational or non-occupational post-exposure prophylaxis regimens.

Warnings/Precautions for VIRAMUNE XR

Women with CD4 counts >250cells/mm³ or men with CD4 counts >400cells/mm³ (increased risk of rash-associated hepatic events): usually not recommended (see literature). Monitor liver function (at baseline, during 1^st 18 weeks, and throughout therapy). Suspend and discontinue permanently if signs/symptoms of hepatitis, elevated transaminases, severe rash, or rash with constitutional symptoms (eg, fever, blistering, oral lesions, conjunctivitis, swelling, muscle/joint aches or general malaise) occurs; do not restart after recovery. Co-infected with hepatitis B or C. Hepatitis fibrosis or cirrhosis; monitor. Renal dysfunction. Elderly. Pregnancy (Cat.B). Nursing mothers: not recommended.

Interactions for VIRAMUNE XR

Potentiated by fluconazole (monitor). Antagonizes atazanavir, ketoconazole, oral contraceptives: not recommended (use nonhormonal contraception), clarithromycin (consider alternative). Antagonized by St. John's wort, rifampin: not recommended. Possible increased adverse reactions with concomitant efavirenz: not recommended. May antagonize methadone (monitor for withdrawal symptoms; increase methadone dose if needed), or drugs metabolized by CYP3A4 or CYP2B6. Monitor warfarin, rifabutin, other CYP450 substrates.

Adverse Reactions for VIRAMUNE XR

Potentially severe, life-threatening hepatotoxicity (eg, hepatic necrosis, cholestatic hepatitis) or skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis); nausea, headache, abnormal liver function tests, fatigue, fever, vomiting, myalgia, abdominal pain, fat redistribution, immune reconstitution syndrome. Children: also granulocytopenia.

Notes for VIRAMUNE XR

Register pregnant patients exposed to nevirapine by calling (800) 258-4263.

How is VIRAMUNE XR supplied?

Tabs—60; Susp—240mL; XR—30

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