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No significant effect on rifabutin and Viramune mean PK parameters is seenRifabutin and Viramune can be co-administered without dose adjustmentsHoweverdue to the high interpatient variability some patients may experience large increases in rifabutin exposure and may be at higher risk for rifabutin toxicityThereforecaution should be used in concomitant administration.
The prolonged-released tablets are not suitable for the initial two week phase for patients starting on Viramune and should not be used until any rash has clearedThe prolonged-release tablets have not been tested in children under three years of ageThe prolonged-release tablets must not be broken or chewed.
It is recommended that HIV-infected mothers do not breast-feed their infants to avoid risking postnatal transmission of HIV and that mothers should discontinue breast-feeding if they are receiving nevirapine.
If clinical hepatitis occurscharacterised by anorexianauseavomitingicterus AND laboratory findingssuch as moderate or severe liver function test abnormalitiesexcluding GGTnevirapine must be permanently stoppedViramune must not be readministered to patients who have required permanent discontinuation for clinical hepatitis due to nevirapine.
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