Viramune may cause serious side effects, including .
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In reproductive toxicology studiesevidence of impaired fertility was seen in rats.
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.
It is not recommended to co-administer efavirenz and Viramunesee section 4.4because of additive toxicity and no benefit in terms of efficacy over either NNRTI alonefor results of 2NN studysee section 5.1
Adult and adolescent treatment guidelines of the U.SDepartment of Health and Human Services designate regimens containing nevirapine asnot recommendedfor use in initial treatment of HIV infection.
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hepatic failure has also been reported in patients without hiv taking viramune for post-exposure prophylaxis pep .