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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Food and Drug Administration (FDA) granted accelerated approval to nevirapine (Viramune) on June 24, 1996. Nevirapine is the first of another new class of anti-HIV drugs, non-nucleoside reverse transcriptase inhibitors, to receive approval. Studies have shown viral load drops of 95 percent or more, but the participants in the study were limited to those who had never used antiretroviral therapy before. The drug must be taken in combination with nucleoside analogues, as resistance to nevirapine monotherapy develops in two weeks.
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PMID:Nevirapine approval expands combo possibilities--and HIV suppression. 1136 91

Now available in pharmacies, the first of a new class of non-nucleoside reverse transcriptase inhibitors (NNRTIs) has been licensed. Nevirapine (marketed as Viramune) is different from nucleoside reverse transcriptase inhibitors because it binds at a different location on the HIV-1 virus and at a different point in the reproduction process in its effort to block HIV replication. Also, HIV-1 mutant strains, which become resistant to other drugs, have remained sensitive to nevirapine. The Food and Drug Administration (FDA) Antiviral Drugs Advisory Committee recommended that nevirapine be used only in combination therapy, but did not complicate the label by stating whether to include one or two additional drugs. They recommended approval for both treatment-naive and experienced individuals. Although suppression of viral replication is modest, the NNRTIs appear to penetrate the central nervous system and offer an alternative for people either intolerant of or resistant to the currently available nucleoside analogs. A major side effect of the drug is the development of a severe rash. The manufacturer, Boehringer Ingelheim, has promised to issue a booklet on how to manage a nevirapine-related rash. Individuals interested in the patient assistance program may call Boehringer Ingelheim for more information.
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PMID:Nevirapine, the first of a new class of NNRTI drugs arrives in pharmacies. 1136 27

Nevirapine, the ninth approved anti-HIV drug, is the first of a new class of pharmaceuticals developed for HIV treatment. A non-nucleoside reverse transcriptase inhibitor (NNRTI), nevirapine targets the same HIV enzyme as AZT, ddI, ddC, d4T and 3TC. A three-drug treatment including AZT and ddI was shown to be significantly better than an AZT/ddI combination in patients who had received no prior treatment. The drug has a long half-life, which means that it can be administered less often.
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PMID:Nevirapine approved by FDA. Food and Drug Administration. 1136 18

Nevirapine received its initial Food and Drug Administration (FDA) approval based on its use in combination with nucleoside analogs. However, AIDS treatment standards changed shortly thereafter with the introduction of viral load testing and protease inhibitors. Nevirapine's use may change now, with its target audience being those patients who cannot tolerate or afford protease inhibitors or who have failed other drug regimens. A number of recent studies are described that tested the efficacy of nevirapine with other medications, its safety in HIV-infected infants and children, and the interactions between nevirapine and protease inhibitors. Drug specifications are included, covering indications, dosage, adverse reactions, interactions, and dietary restrictions.
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PMID:Update on nevirapine: quest for a niche. 1136 13

Nonnucleoside transcriptase inhibitors (NNRTIs) are potent antiretroviral agents that can successfully be used in appropriate HIV/AIDS triple-therapy regimens, although resistance can develop rapidly. The two primary advantages of initiating NNRTIs therapy are that it delays the use of protease inhibitors and the NNRTIs regimen is easier to adhere to and can be given once per day. Nevirapine and delavirdine, two NNRTIs that have been approved for clinical use, are examined, and loviride, efavirenz, and HBY 097, currently under development, are discussed. The advantages, disadvantages, and pharmacologic characteristics of each drug are highlighted.
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PMID:Nonnucleoside reverse transcriptase inhibitors. 1136 57

A 44-year-old man diagnosed with HIV in 1992 has become 3TC-resistant, has had adverse effects to ddI, and most likely will have the same adverse effects to d4T and ddC. The Ritonavir, Saquinavir, and Nevirapine combination he was switched to did not reduce his viral load, however, the patient was clinically stable without wasting or opportunistic infections, and his CD4 count was 220 cells/mm3. Based on past responses to medication and to the available NNRTIs, it is believed that the patient is currently cross-resistant to all first-generation protease inhibitors. It was suggested that the patient, now categorized as having virologic failure but clinical/immunologic success, is unlikely to achieve durable suppression, even with the new drugs becoming available. Mega-HAART therapy, which uses up to eight drugs, may work temporarily but appears to be intolerable in the long term for most patients. It is not known how long the patient's clinical/immunologic stability will last, but it is unlikely to continue indefinitely in the presence of high viral replication. In the case of worsening conditions, it is suggested that a phenotypic analysis be done to guide salvage therapy. In the absence of a phenotypic analysis, it is suggested to try a combination of ddI plus d4T plus Hydroxyurea plus Nelfinavir plus efavirenz.
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PMID:A patient with no options? 1136 84

Researchers at the 12th Worlds AIDS Conference in Geneva provided a strong case for offering alternative drug options to patients. Resistance problems continue to accompany protease inhibitors, but other studies are identifying new options for extended therapy, such as using abacavir or efavirenz in combination therapies, or by using Nevirapine (Viramune) with Stavudine (d4T) and Didanosine (ddI). Hydroxyurea, a cancer fighting drug, is also gaining support as an HIV treatment, because it inhibits the enzyme that HIV needs to replicate. One study revealed that combining Hydroxyurea, ddI, and Indinavir provided quick and long-lasting reductions in viral load. Conference presentations about mother-to-infant HIV transmission showed reductions in the number of vertical transmissions when Zidovudine preventive therapy was used.
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PMID:New drugs garner interest; but inhibitors lose shine. 1136 95

Sildenafil, a recently approved drug, should not be used by people who are using organic nitrates, blood pressure medications, or certain HIV medications. Some protease inhibitors can increase sildenafil citrate levels in the blood. Drugs such as efavirenz and Nevirapine can reduce sildenafil levels. Other drugs and their effects are discussed.
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PMID:Sildenafil (Viagra) drug interactions. 1136 44

Salvage therapies are treatments that are implemented for people who have been unable to suppress viral loads below the limit of quantification using one or more protease inhibitor- containing regimens. Results of a small study showed that 20 people raised their antiviral activity by adding Nevirapine, a non-nucleoside reverse transcriptase inhibitor, to triple combination therapy. Results of the 20-week study are presented. The effects of switching to a regimen that introduced two potent antiviral drugs were shown to be more significant than changing to a regimen that included two protease inhibitors. Greater decreases in HIV levels were seen in participants who, prior to the start of the study, showed lower phenotypic resistance to the drugs that were going to be used in the study.
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PMID:Salvage therapy studies. 1136 50

At the AIDS Conference in Geneva, reports were presented on new drugs expected to improve treatment of HIV infection, to be useful in combination therapies, and to be less susceptible to viral resistance. Advances in understanding resistance to specific drugs and cross-resistance among drugs were reported. New information was provided for the following treatments: efavirenz (Sustiva), abacavir with AZT/3TC, Nevirapine (Viramune), Hydroxyurea in combination therapy, the use of double protease inhibitors in regimens, and ABT-378 and PNU-140690. Finally, reports showing that resistance testing may predict which drugs may or may not work for a person are discussed.
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PMID:Notes on the International AIDS Conference. 1136 93


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