An HIV Information Site & HIV Educational Resource Site (HIS & HERS)

Viramune - nevirapine

General Information This drug is almost always used as one component of a multidrug combination to suppress the human immunodeficiency (HIV) viral load.  In the setting of pregnancy it may be used by itself. 
Specifics Zidovudine is the oldest drug approved to treat HIV.  Many, many people with HIV and AIDS have been treated with this drug and it actually has the longest track record of effectiveness and safety.  Despite many people dying while taking this drug, very few if any have died as a result of problems from this drug although many people (superstitiously?) believe that it is an excessively dangerous drug.  This should be filed under "Urban Myth."
Dosing Generally zidovudine is taken at 300 mg twice a day either without food or with a low-fat food.  Fat in food may decrease the levels of Retrovir and compromise its potency. 
(this refers to your willingness, ability, and actual performance in taking your medications)
As with any antiviral drug or antibiotic, try not to ever miss a dose.  If you miss a dose and notice that you have done so within a few hours of its scheduled time, you may take the dose as usual and take the next dose at its regular time. 

If you miss more than one dose, look at the reasons why you missed them and come up with a plan to avoid it in the future.  For example, if you fell asleep too early, take the medicine earlier in the evening, with your later meal, set an alarm, or have someone appointed to wake you up for your medicine.  

It is strongly recommended that you consider using weekly pill boxes and arrange all of your doses a week in advance.  Buy a small pill box so that you can carry a dose or two of your medicines with you in case you are away from home.

Possible Side Effects
The package insert for most drugs including stavudine is often overwhelming and scary with perhaps an overemphasis on side effects.  We have summarized the important and more common problems here.

Most people take zidovudine without many side effects. 

Possible side effects include nausea, headache, muscle aches, liver problems, anemia (low red blood cells) or low white blood cells.  Usually you will have blood tests done in the first month to look for the beneficial effects of zidovudine and any side effects. 

Many minor side effects will either stay constant or get better with time.  It is mainly the side effects that are severe or get worse that may cause significant health risks for you.

Occasionally you may be prescribed an injectable hormone and iron pills to increase red blood cell production if you get anemic on zidovudine. 

All drugs of this type can cause or contribute to abnormal fat redistribution characterized by thinning of the face, arms, or legs.  In most cases this would be also accompanied by elevated cholesterol levels, elevated triglyceride levels, and perhaps a tendency to develop diabetes. 

Rarely, a build-up of (lactic) acid may occur due to taking medications of this type.  Persons taking multiple nukes (NRTIs), those taking d4T (stavudine, Zerit), those on the combination of d4T (stavudine, Zerit) and ddI (didanosine, Videx), and those persons with hepatitis C are the most likely to encounter this rare, but potentially fatal problem.  Pregnancy may also raise the risk of this problem.  The symptoms are vague but troublesome including nausea, vomiting, muscle aches, weakness, turning yellow with jaundice, and just feeling plain bad.

Report to you healthcare provider or go to an Emergency Room if you have severe side effects, increasing side effects, shortness of breath, uncontrollable diarrhea, fever, weakness, jaundice (eyes and skin turn yellow,) muscle pain, nausea and vomiting so that you cannot hold down your food and liquids.
You can download this handout in PDF format by clicking HERE.