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Nevirapine (Viramune) is a medication used in the treatment of HIV, but it carries specific safety considerations that you should be aware of. Below is vital safety and warning information regarding the use of nevirapine:

• Liver Problems: Nevirapine can lead to serious, potentially fatal liver issues, especially within the first 4 months of treatment. Those with a history of moderate to severe liver conditions should not use this medication. Monitoring your liver function is crucial, and your healthcare provider will require blood tests before and during treatment. If you notice symptoms such as persistent nausea, loss of appetite, vomiting, abdominal pain, dark urine, pale stools, yellowing skin or eyes, or unusual tiredness, seek medical attention immediately.

• Severe Skin and Allergic Reactions: This drug may cause severe skin and allergic reactions, which can be life-threatening. These reactions are most likely to occur in the first 6 weeks of treatment, with the risk remaining high for up to 4 months. Starting the medication at a lower dose can help monitor your response. If you experience symptoms like a severe rash, fever, general discomfort, muscle or joint pain, mouth sores, blisters, or facial swelling, discontinue use and contact a healthcare professional right away.

• Special Considerations for Women: Women are at a higher risk for developing severe reactions, both liver and skin-related. Additionally, individuals with high T-cell counts at the start of treatment are at an increased risk for liver issues. Nevirapine is typically only initiated if the T-cell count is fewer than 250 in women or fewer than 400 in men.

• Immune System Changes: Nevirapine, used in combination with other HIV medications, can trigger immune reconstitution syndrome. This condition occurs when the immune system becomes more active and starts fighting off infections it couldn't before. In rare cases, it may begin to attack healthy cells. Watch for new symptoms such as fever, pain, hair loss, bulging eyes, or excessive sweating and report them to your healthcare provider.

• Changes in Body Fat: Some individuals on HIV medications, including nevirapine, may experience changes in body fat distribution. This may manifest as fat accumulation in certain areas, such as the neck and abdomen, or fat loss in areas like the arms, legs, and face. If you notice such changes, inform your healthcare provider.

• Drug Interactions: Nevirapine can interact with other medications, impacting how it is metabolized and increasing the risk of side effects. Discuss all medications you are taking with your healthcare provider to manage potential interactions.

• Emergency Measures for Overdose: In the case of an overdose, seek immediate medical assistance. Overdose symptoms can exacerbate the risks mentioned above and require urgent intervention.

• Contraindications: Do not use nevirapine if you have moderate to severe liver problems or are undergoing post-exposure prophylaxis (PEP) treatment without consulting your healthcare provider.

It's imperative to maintain regular medical and laboratory appointments to monitor your response to nevirapine. If you ever discontinue nevirapine due to liver or skin/allergic reactions, do not restart the medication, and ensure all healthcare providers are informed of this history.

When taking this medication, some individuals may experience common side effects that are generally mild, such as tiredness, nausea, vomiting, diarrhea, and headaches. A rash is also relatively common, occurring in a small percentage of users, but it is usually not serious. However, if any of these symptoms persist or worsen, it's important to seek advice from your healthcare provider.

In some cases, the immune system's response to the medication may cause symptoms like unexplained weight loss, severe tiredness, persistent muscle aches, or headaches. These issues can arise as the immune system becomes more active, potentially triggering infections or conditions you may have had previously. Changes in body fat distribution, although the cause and long-term effects are not fully understood, may also occur with this treatment.

Serious side effects, though rare, require immediate medical attention. These include severe allergic reactions characterized by fever, rash, discomfort, muscle or joint pain, mouth sores, blisters, or facial swelling. Liver injury is another serious concern, marked by symptoms such as nausea, vomiting, loss of appetite, stomach pain, yellowing of the skin or eyes, dark urine, and pale stools.

It is crucial to be vigilant about these side effects, seeking prompt medical care if severe reactions occur. This is not an exhaustive list, so if you notice any other unusual effects, contacting your healthcare provider for guidance is recommended.

Nevirapine can interact with several drugs, which may alter its effectiveness or the effectiveness of other medications you are taking. Some drugs, like orlistat, rifabutin, and warfarin, may interact with nevirapine. Medications such as rifamycins (e.g., rifampin) and St. John's wort can influence how nevirapine is removed from your body, potentially changing how it works. Additionally, nevirapine can accelerate the elimination of various other drugs from your body, affecting their efficacy. These drugs include certain antiarrhythmics (like amiodarone), atazanavir, cobicistat, elvitegravir, some seizure medications (such as clonazepam), azole antifungals (like itraconazole and ketoconazole), macrolide antibiotics (such as clarithromycin), and methadone.

It is important to avoid using prednisone to prevent a rash during the first six weeks of starting nevirapine, as it might increase the risk of developing a rash. Consult your doctor for more guidance on this matter.

Furthermore, nevirapine may reduce the effectiveness of hormonal birth control methods, such as pills, patches, or rings, which could lead to pregnancy. It is advisable to speak with your healthcare provider about using additional reliable birth control methods while on nevirapine. Notify your doctor if you experience any unusual spotting or breakthrough bleeding, as these could indicate that your birth control is not working effectively.