Nevirapine: A Key HIV Treatment and What You Need to Know

10 Apr 2025

Nevirapine: What You Need to Know

Nevirapine is one of the earlier and well-established medications used to treat HIV. It works by blocking an enzyme (reverse transcriptase) that HIV needs to replicate in the body. This helps keep the viral load in check and slows down the progression of HIV to AIDS.

How Nevirapine Works

Nevirapine works by binding to reverse transcriptase, a crucial enzyme that HIV uses to make copies of itself. By inhibiting this enzyme, nevirapine prevents the virus from spreading throughout the body, helping to maintain a person's immune system function.

Side Effects of Nevirapine

While nevirapine is effective, it does come with potential side effects. Some are mild, while others can be more serious:

Common (and Usually Mild):
- Rash (this can be a sign of an allergic reaction, so it’s important to monitor it closely)
- Nausea
- Fatigue
- Headache
Serious Side Effects (Rare):
- Liver problems: Nevirapine can cause severe liver damage in some people, so liver function should be monitored regularly.
- Severe skin reactions: In rare cases, serious rashes and skin reactions can occur, which may require stopping the medication.
- Hypersensitivity: An allergic reaction that can include fever, fatigue, and gastrointestinal symptoms.

Who Should Not Take Nevirapine?

Nevirapine is not for everyone. It’s particularly important for the following groups to be cautious or avoid it:

People with severe liver disease
Nevirapine can stress the liver, so it’s not recommended for people with liver problems like hepatitis or cirrhosis.
Pregnant women (in certain cases)
Nevirapine is sometimes used during pregnancy to prevent mother-to-child transmission of HIV, but it needs to be carefully prescribed. For some pregnant individuals, other medications might be a safer option due to concerns about liver toxicity.
People with a history of hypersensitivity reactions
If you’ve had a bad reaction to nevirapine before, you should not take it again.
People with moderate liver issues
If you have any liver impairment, your doctor will monitor you closely, but nevirapine may not be the best choice.

Nevirapine vs Dolutegravir: What’s the Difference?

While both are effective treatments for HIV, they work in different ways:

Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI), blocking the reverse transcriptase enzyme directly.
Dolutegravir, on the other hand, is an integrase strand transfer inhibitor (INSTI) that prevents HIV from integrating into your DNA.

Both medications are part of combination therapies, and a healthcare provider will often select the one that fits the patient's needs, considering factors like drug resistance, side effects, and other medical conditions.