The standard dose of nevirapine (Viramune) is two 200mg white tablets per day. They can be taken together, or the dose can be split into two and taken in the morning and evening. Once- and twice-daily dosing are equivalent in terms of anti-viral efficacy and CD4 cell count increases^[1][2]. However, a concern with once daily dosing of nevirapine is that trough levels are well below levels seen with standard dosing. Peak levels may also be much higher than with standard dosing^[3][4].

During the first two weeks on nevirapine, only one tablet should be taken twice a day, to allow the body to get used to the drug, and reduce the risk of developing a serious rash or other side-effects. Nevirapine can be taken with or without food, and at the same time as other anti-HIV drugs.

It is recommended that patients wishing to stop or interrupt nevirapine-based treatment should stop taking the nevirapine component of their regimen five days before the nucleoside reverse transcriptase inhibitor (NRTI) backbone. Since nevirapine has a long half-life and a low genetic barrier to resistance, stopping all the drugs at the same time could cause diminishing effects of nevirapine to persist much longer than those of the NRTIs, leading to the emergence of NNRTI resistance mutations^[5][6][7].

If nevirapine therapy is stopped for any reason for more than seven days, the lead-in dosing of 200mg a day for 14 days should be used.

Patients with hepatitis C co-infection may have elevated levels of nevirapine in the blood^[8].

Nevirapine is also available as an oral suspension at a dose of 10mg/ml, which can be used by children weighing less than 50kg, and patients who cannot take tablets.