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Nevirapine

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Summary

  • ▲ Nevirapine is a potent noncompetitive inhibitor of the retroviral enzyme reverse transcriptase, which is necessary for HIV replication. The agent selectively inhibits HIV-1 but not HIV-2, and it is >8000-fold more selective for infected than uninfected cells.

  • ▲ Nevirapine shows synergistic inhibitory activity in vitro in combination with a number of nucleoside anti-HIV agents. Three- and 4-drug combinations that include nevirapine tend to have a higher synergy than 2-drug combinations or nevirapine alone.

  • ▲ High (‘knock out’) concentrations of nevirapine (2.5 to 10 mg/L) completely suppress viral replication in cell cultures, prevent emergence of resistant variants and protect uninfected cells.

  • ▲ Addition of nevirapine to existing anti-HIV therapy produces a rapid and sustained immunological and virological response; a concurrent rather than an alternating regimen produces a better response. Emergence of viral resistance to nevirapine is rapid (≤12 weeks) irrespective of whether this agent is used as monotherapy or combination therapy. However, viral resistance has been prevented or delayed with 3-drug combinations containing nevirapine in previously untreated compliant patients.

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  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland 10, New Zealand

    Sanjay S. Patel & Paul Benfield

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  1. Sanjay S. Patel
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Patel, S.S., Benfield, P. Nevirapine. Clin. Immunother. 6, 307–317 (1996). https://doi.org/10.1007/BF03259093

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