Viramune suspension is supplied in plastic bottles with child-resistant closures containing 240 ml of suspension ndc 0597-0047-24 .
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Because virus resistant to all available NNRTIs can be selected rapidly during failure of a nevirapine-containing regimenit is important to assess patient motivation and discuss possible side effects and strategies for their management before treatment with nevirapine is initiated.
A number of studiesfor example 9have found that switching from a protease inhibitor to nevirapine in the setting of a fully suppressive regimenwith undetectable viral load at the time of switchingdoes not increase the risk of virologic failureHoweverthis risk may be increased in antiretroviral-experienced individuals10)
It is not recommended to co-administer fosamprenavir and Viramune if fosamprenavir is not co-administered with ritonavirsee section 4.4
Immune Reactivation SyndromeIn HIV-infected patients with severe immune deficiency at the time of institution of combination antiretroviral therapyCARTan inflammatory reaction to asymptomatic or residual opportunistic pathogens may arise and cause serious clinical conditionsor aggravation of symptomsTypicallysuch reactions have been observed within the first few weeks or months of initiation of CARTRelevant examples are cytomegalovirus retinitisgeneralised and/or focal mycobacterial infectionsand Pneumocystis jirovecii pneumoniaAny inflammatory symptoms should be evaluated and treatment instituted when necessaryAutoimmune disorderssuch as Gravesdiseasehave also been reported to occur in the setting of immune reactivationhoweverthe reported time to onset is more variable and these events can occur many months after initiation of treatment.
The available pharmacokinetic data suggest that the concomitant use of rifampicin and nevirapine is not recommendedFurthermorecombining the following compounds with Viramune is not recommendedefavirenzketoconazoledelavirdineetravirinerilpivirineelvitegravirin combination with cobicistatatazanavirin combination with ritonavirboceprevirfosamprenavirif not co-administered with low dose ritonavirsee section 4.5
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