Precautions and Warnings With Nevirapine XR

Make sure your healthcare provider is aware of any liver problems or allergies you may have before starting treatment with nevirapine XR. Warnings and safety precautions with this medicine include potential risks for developing liver damage or a life-threatening skin rash. Also, you may not be able to take this drug if you are pregnant or breastfeeding.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking nevirapine XR (Viramune® XR™) if you have:
  • Liver disease, such as liver failure, cirrhosis, or hepatitis
  • Any allergies, including to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Nevirapine XR Precautions and Warnings

Some warnings and precautions to be aware of prior to taking this medicine include the following:
  • Nevirapine XR can cause severe liver damage. This is more likely to occur if you have high CD4 counts (high levels of certain immune cells). You should not start taking nevirapine XR if your CD4 count is higher than 250 cells/mm3 (for women) or 400 cells/mm3 (for men). Let your healthcare provider know right away if you have any signs of liver damage, such as:
    • Fatigue or a general ill feeling (malaise)
    • Loss of appetite
    • Nausea
    • Yellowing of the whites of the eyes or skin (jaundice)
    • Tenderness near the liver, in the upper-right area of the abdomen (stomach)
    • Pale stools.
  • In some cases, nevirapine XR may cause life-threatening skin rashes, which can result in severe infections or a loss of large amounts of skin. Let your healthcare provider know right away if you develop a skin rash, especially if you also have any of the following symptoms:
    • A general ill feeling (malaise)
    • Fatigue
    • Muscle aches or joint pain
    • Skin blisters
    • Mouth sores
    • Eye redness
    • Swelling of the face
    • Liver problems.
  • Your healthcare provider should monitor you closely for the first 18 weeks you take nevirapine XR, as the risk for liver damage is highest during this time.
  • Nevirapine XR can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.
  • You may notice the remainder of the tablet shell in your stool. This is normal and should not be a cause for concern.
  • Nevirapine XR is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safe sex practices, regardless of whether you are taking medications.
  • As with all HIV medications, it is important that you take nevirapine XR exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
  • Nevirapine XR is a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are unknown (see Viramune XR and Pregnancy).
  • Nevirapine XR passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Viramune XR and Breastfeeding). It is important to understand that it is generally not recommended for women to breastfeed if they have HIV or AIDS, as the HIV virus can be transmitted through breast milk.

Nevirapine XR Drug Information

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