( Once-daily nevirapine (Viramune) is ass...)Once-daily Nevirapine Has More Side-effects Than Twice-daily Dose,Health

Once-daily nevirapine (Viramune) is associated with a higher risk of rash, leading to treatment discontinuation or interruption//, than twice-daily dosing of the drug, according to Canadian research published in the January edition of HIV Medicine. The investigators also found that individuals who took nevirapine once daily were more likely to experience liver complications than patients who took the drug twice a day. For these reasons, the authors conclude that once-daily nevirapine cannot be recommended.

Once-daily dose of antiretroviral therapy is becoming increasingly available, and may be a way of improving patient adherence to treatment. Nevirapine has a long plasma half-life and high steady state plasma concentrations meaning that it may be a suitable candidate for once-daily use.

To determine how suitable the drug is for use on a once-daily basis, investigators from Ottawa conducted a literature review to establish the pharmacokinetics, efficacy and safety of once-daily nevirapine (400mg once a day) versus twice-daily (200mg twice a day) dose of the drug.

A Medline search was performed to identify published, peer-reviewed studies examining this question. Abstracts from major international HIV meetings were also reviewed.

The pharmacokinetic data suggested that once-daily nevirapine dosing resulted in lower minimum nevirapine plasma concentrations compared with twice-daily treatment. However these studies theoretically support once-daily dosing assuming that optimal adherence was maintained.

Several clinical trials have evaluated the safety and efficacy of nevirapine in a once-daily dosing regimen. The 2NN study is the largest and best known of these. The Canadian reviewers therefore focused on once-daily and twice-daily nevirapine recipients enrolled in the 2NN study.

The investigators found that the proportion of treatment failures by, or before, week 48 of the 2NN study were comp
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