{"id":6031,"date":"2012-02-21T17:24:31","date_gmt":"2012-02-21T17:24:31","guid":{"rendered":"http:\/\/i-base.info\/qa\/?p=6031"},"modified":"2012-02-21T17:24:31","modified_gmt":"2012-02-21T17:24:31","slug":"can-i-use-nevirapine-once-daily","status":"publish","type":"post","link":"https:\/\/i-base.info\/qa\/6031","title":{"rendered":"Nevirapine in the UK: nevirapine PR or doubling the old dose?"},"content":{"rendered":"

As background for other people reading this, there are now two formulations of nevirapine.<\/span><\/p>\n

\n
    \n
  1. nevirapine 200 mg (original), and<\/span><\/li>\n
  2. nevirapine PR 400 mg (called nevirapine XR outside Europe)<\/span><\/li>\n<\/ol>\n<\/div>\n

    The original 200 mg formulation is licensed as a twice-daily drug: 200 mg every 12 hours. However, in the last few years many people take both 200 mg tablets together, once a day. This has a benefit if the other meds in your combination are also once-daily.<\/p>\n

    Taking the original nevirapine this way is not<\/strong> as good as twice daily for someone just starting treatment<\/strong>. However, it seems to work well for people who already been undetectable for a while<\/strong> (perhaps a year or more) and who are very adherent<\/strong>.<\/p>\n

    In practice, some people do this by testing their drug levels first, using therapeutic drug monitoring (TDM). Others just switch and check that their viral load stays undetectable with more frequently viral load monitoring. This can be a few weeks after the change and then a month later. In the UK, both options should be easily available.<\/p>\n

    The new formulation, which is called nevirapine prolonged release (PR)<\/strong> in Europe (and nevirapine extended release in the USA) is a once daily single 400 mg tablet.<\/span><\/p>\n

    This is not just the old version compressed more tightly into one pill. It is a different formulation where the drug stays in your body longer so that after 24 hours, you would have higher drug levels compared to those after a double dose of the original formulation.<\/span><\/p>\n

    So although the original formulation is widely used once-daily, the new formulation has been specifically designed to do this. <\/span>Given that your other meds are once-daily, changing to taking all your meds together is likely to improve your quality of life. So you are right to be asking your clinic about this.<\/span><\/p>\n

    The new formulation however is the same price as the old formulation, so I’m not sure why your clinic is not saying that this will become available. It might be that they are using the last of the original and that this will change in the future. Cost should not be a factor in this and there are other advantages of the newer formulation.<\/span>
    \n <\/span><\/p>\n

    Which clinic doe you attend? perhaps take in this Q&A when you see your doctor, and write to your doctor and the head of the clinic to ask why.<\/span>
    \n<\/span> <\/span><\/p>\n

    In summary, your options are <\/span>to ask for a TDM test for your current nevirapine drug levels, and then decide if switching is safe or to<\/span> switch to once-daily with the current formulation, but check your viral load more closely.<\/span><\/p>\n

    Although both these options are technically not approved, they are widely used. Most people find once-daily meds improves their life. <\/span>Or<\/span> (and!) ask your clinic again about the new version.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

    I’m currently taking nevirapine (Viramune) twice a day and Truvada (tenofovir+FTC) once a day. I asked my clinic if they would be getting the new Viramune PR tablets (so i could take this once a day) in but they said it was unlikely as most people take 2 tablets of the standard once a day.<\/p>\n

    I am thinking about taking 2 tabs of nevirapine once a day but i hear that in some people then this means that the levels of nevirapine in the blood might not be enough over a 24 hour period.<\/p>\n

    I’m worried that by changing to taking it once a day i would develop resistance to it if my levels were not high enough at the end of the dose.<\/p>\n

    What do you advise with regards to taking the standard nevirapine once a day. I don’t think the clinic will be getting the long acting ones in so i won’t be able to take them instead.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,7,10],"tags":[],"class_list":["post-6031","post","type-post","status-publish","format-standard","hentry","category-adherence","category-all-topics","category-changing-treatment"],"_links":{"self":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/6031","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/comments?post=6031"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/posts\/6031\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/media?parent=6031"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/categories?post=6031"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/qa\/wp-json\/wp\/v2\/tags?post=6031"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}