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Viramune XR
Viramune XR (generic name: nevirapine extended-release) is an antiretroviral medication used to treat HIV-1 infection in combination with other antiretroviral agents. It belongs to a class of drugs known as non-nucleoside reverse transcriptase inhibitors (NNRTIs), which work by blocking the reverse transcriptase enzyme, an essential component that HIV needs to replicate. Viramune XR helps reduce the viral load in the body, improve immune function, and prevent the progression of HIV to AIDS.
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Frequently Asked Questions
How long does it take for Viramune XR to start working?
Viramune XR begins to work immediately, but it may take several weeks for viral load to decrease significantly. Regular monitoring of HIV levels is important to track progress.
Can I stop taking Viramune XR if my viral load is undetectable?
No, you must continue taking Viramune XR as prescribed, even if your viral load is undetectable. Stopping treatment can lead to viral rebound and drug resistance.
What should I do if I miss a dose of Viramune XR?
If you miss a dose, take it as soon as you remember. If it’s close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up doses.
Can Viramune XR be taken during pregnancy?
Viramune XR may be used during pregnancy, but close monitoring is required due to potential liver risks. Always discuss your treatment options with your healthcare provider if you are pregnant or planning to become pregnant.
What are the signs of liver problems while taking Viramune XR?
Symptoms of liver problems include jaundice (yellowing of the skin or eyes), dark urine, severe fatigue, nausea, and upper abdominal pain. Contact your healthcare provider immediately if you experience any of these symptoms.
Comprehensive Drug Guide
How Does Viramune XR Work?
Viramune XR works by inhibiting reverse transcriptase, an enzyme that HIV uses to make copies of its RNA. By blocking this enzyme, Viramune XR prevents the virus from multiplying and reduces the amount of HIV in the body. This helps to maintain immune function and lowers the risk of developing AIDS-related illnesses.
Common Dosages
- 100 mg extended-release tablets
- 400 mg extended-release tablets
Typical Dosing
- The typical dose for adults is 400 mg once daily, after a lead-in period with immediate-release nevirapine (200 mg once daily for 14 days) to reduce the risk of side effects.
- For pediatric patients, dosing is based on body weight, and the healthcare provider will adjust accordingly.
Typical Dosing
FDA Approved Indications
- Treatment of HIV-1 infection in adults and children aged 6 years or older, in combination with other antiretroviral medications.
Who Shouldn't Take Viramune XR?
- Moderate or severe liver impairment
- A history of hypersensitivity reactions to nevirapine
- Severe skin reactions such as Stevens-Johnson syndrome while taking Viramune XR
Advice From The Pharmacist
- Take Viramune XR once daily at the same time each day, with or without food. Do not crush or chew the tablet; swallow it whole.
- Adherence is crucial for maintaining viral suppression. Missing doses can increase the risk of developing drug resistance.
- Regular monitoring of liver function is required, as Viramune XR can cause serious liver problems, especially during the first 18 weeks of treatment.
Side Effects of Viramune XR
Common Side Effects
- Rash
- Fatigue
- Nausea
- Headache
- Diarrhea
Uncommon/Severe Side Effects
- Severe liver damage (jaundice, dark urine, fatigue)
- Severe skin reactions (rash, blistering, peeling)
- Hypersensitivity reactions (fever, swelling, difficulty breathing)
Risks and Warnings of Viramune XR
- Liver Toxicity: Viramune XR can cause serious, potentially life-threatening liver damage, particularly during the first 18 weeks of treatment. Regular liver function tests are essential.
- Severe Skin Reactions: Viramune XR may cause severe skin reactions, such as Stevens-Johnson syndrome. Any new rash or skin irritation should be reported immediately to a healthcare provider.
- Immune Reconstitution Syndrome: As the immune system recovers during HIV treatment, some patients may experience an inflammatory response to previously undiagnosed infections.
Interactions with Viramune XR
Common Drug Interactions
- Rifampin: This antibiotic may reduce the effectiveness of Viramune XR by decreasing its blood levels.
- St. John’s Wort: This herbal supplement can lower the effectiveness of Viramune XR by increasing its metabolism.
- Oral Contraceptives: Nevirapine may reduce the effectiveness of hormonal contraceptives. An additional non-hormonal form of contraception is recommended.
Alternatives to Viramune XR
- Sustiva (efavirenz): Another NNRTI used in combination therapy for HIV-1 treatment.
- Edurant (rilpivirine): A newer NNRTI used as part of combination antiretroviral therapy.
- Tivicay (dolutegravir): An integrase inhibitor often used as an alternative in combination regimens for HIV.
