Nevirapine Oral Suspension and Sustiva

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using nevirapine together with efavirenz. Combining these medications may not be more effective than either medication alone, and it may lead to increased side effects. If your doctor does prescribe these medications together, you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Coadministration of nevirapine and efavirenz has resulted in increased toxicity without additional therapeutic benefit over either agent alone. The mechanism of interaction has not been established, although this combination has exhibited strong antagonistic anti-HIV-1 activity in cell culture. In the double nonnucleoside study 2 NN, 1216 treatment-naive patients with plasma HIV-1 RNA greater than 5000 copies/ml at baseline were randomized to nevirapine 400 mg once daily, nevirapine 200 mg twice daily, efavirenz 600 mg once daily, or nevirapine 400 mg and efavirenz 800 mg once daily, plus stavudine and lamivudine for 48 weeks. Simultaneous use of nevirapine 400 mg and efavirenz 800 mg once daily was associated with the highest frequency of clinical adverse events and a higher rate of treatment failure (53.1%) at or before 48 weeks compared to nevirapine 200 mg twice daily (43.7%) or efavirenz 600 mg once daily (37.8%). Pharmacokinetically, nevirapine has been shown to reduce the plasma concentrations of efavirenz, presumably due to induction of the CYP450 3A4-mediated metabolism of efavirenz. In 14 HIV-positive subjects treated with an antiretroviral regimen containing efavirenz 600 mg once a day, the addition of nevirapine (200 mg once daily for 2 weeks followed by 400 mg once daily for 2 weeks) resulted in median decreases in efavirenz steady-state peak plasma concentration (Cmax), systemic exposure (AUC) and trough plasma concentration (Cmin) of 17%, 22% and 36%, respectively, compared to baseline. The clinical significance of these changes is unknown. The combination was well tolerated overall, with no reports of rash or other serious adverse events. Efavirenz did not appear to significantly alter the pharmacokinetics of nevirapine based on a comparison to historical control data.

MANAGEMENT: The combination of nevirapine and efavirenz is not recommended due to the efavirenz pharmacokinetic changes and the increased risk of toxicity associated with their coadministration. Moreover, no improvement in efficacy is observed during coadministration over either agent used alone. There has also been no determination of appropriate dosages for the safe and effective use of this combination.

Nevirapine Oral Suspension

Generic Name: nevirapine

Brand name: Viramune, Viramune XR

Synonyms: Nevirapine

What is Nevirapine Oral Suspension?

Sustiva

Generic Name: efavirenz

Brand name: Sustiva

Synonyms: n.a.

What is Sustiva?