Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States
The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.
Non-Nucleoside Reverse Transcriptase Inhibitors
Nevirapine (Viramune, NVP)
Last Updated: December 7, 2018; Last Reviewed: December 7, 2018
Excerpt from Table 10
Note: When using FDCs, refer to other sections in Appendix B and Table 10 for information about the dosing and safety of individual drug components of the FDC during pregnancy.
|Formulation||Dosing Recommendationsa||Use in Pregnancy|
Viramune XR (Extended Release)
Note: Generics available for some formulations.
|Standard Adult Dose:
Dosing in Pregnancy:
|High placental transfer to fetus.b
No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects and 2-fold increase in cardiovascular and genitourinary defects).
Increased risk of symptomatic, often rash-associated, and potentially fatal liver toxicity among women with CD4 cell counts ≥250/mm3 when first initiating therapy; pregnancy does not appear to increase risk.
NVP should be initiated in pregnant women with CD4 cell counts ≥250 cells/mm3 only if benefit clearly outweighs risk because of potential increased risk of life-threatening hepatotoxicity in women with high CD4 cell counts. Elevated transaminase levels at baseline may increase the risk of NVP toxicity.
Women who become pregnant while taking NVP-containing regimens and who are tolerating their regimens well can continue therapy, regardless of CD4 cell count.
a Individual ARV drug doses may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Guidelines Appendix B, Table 8).
b Placental transfer categories are determined by mean or median cord blood/maternal delivery plasma drug ratio:
d Generic formulation available
Key to Acronyms: : ARV = antiretroviral; CD4 = CD4 T lymphocyte; NVP = nevirapine; PK = pharmacokinetic
- AIDSinfo Drug Database
- AIDSinfo Patient Materials: Preventing Mother-to-Child Transmission of HIV
- AIDSinfo Patient Materials: HIV Medicines During Pregnancy and Childbirth
- AIDSinfo Patient Materials: Protecting Baby from HIV
- AETC National HIV Curriculum
- How to Cite These Guidelines
- Perinatal Guidelines Archive