Nevirapine: fluconazole and TB treatment

Pharmacokinetics of nevirapine (200 mg twice daily) and fluconazole ( 200 mg three times weekly) were determined in 27 HIV+ patients and compared to data from 22 HIV+ subjects receiving nevirapine (200 mg twice daily) and placebo. [1]

Fluconazole increased nevirapine AUC by 33 % (from 34297 ng.h/ml to 45685 ng.h/ml); increases were also observed in median Cmax (5028 vs 6354 ng/ml) and Cmin (3709 vs 5116 ng/ml). Despite the increase in nevirapine exposure, there was no evidence of increased hepatotoxicity.

Nevirapine trough concentrations were determined in 20 Ugandan children (age 1.2-11.3 years), seven of whom were receiving concomitant anti-TB therapy which included rifampicin. [2]

Median concentrations in the non-rifampicin group were 4204 ng/ml (range 834 to 15976 ng/ml). Concentrations in the rifampicin group were lower (2920 ng/ml, range 1668 to 9978 ng/ml), with 57% of the children in this group having subtherapeutic concentrations.


  1. Wakeham K, et al. Coadministration of fluconazole increases nevirapine concentrations in HIV-infected Ugandans. 16th CROI, Montreal, 2009. Abstract 703. Abstract 700.
  2. Barlow-Mosha L, et al. Nevirapine concentrations in HIV-infected Ugandan children on adult fixed-dose combination tablet ART, with and without rifampicin-based treatment for active M. tuberculosis infection. 16th CROI, Montreal, 2009. Abstract 909.

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