MEDICATION GUIDE

Nevirapine Oral Suspension, USP

(ne vir' a peen)

What is the most important information I should know about nevirapine oral suspension?

Nevirapine oral suspension can cause severe liver and skin problems that may lead to death. These problems can happen at any time during treatment, but your risk is higher during the first 18 weeks of treatment.

Nevirapine oral suspension can cause serious side effects, including:

•   Severe liver problems. Some people taking nevirapine oral suspension may develop severe liver problems that can lead to liver failure and the need for a liver transplant, or death. If you have liver problems, you may get a rash. 

        • Women have a higher risk of developing liver problems during treatment with nevirapine oral suspension than men.
        • People who have abnormal liver test results before starting nevirapine oral suspension and people with hepatitis B or C also have a greater risk of getting liver problems. 

      People who have higher CD4+ cell counts when they begin nevirapine oral suspension have a higher risk of liver problems, especially: 

        • Women with CD4+ counts higher than 250 cells/mm3. This group has the highest risk.
        •  Men with CD4+ counts higher than 400 cells/mm3.  

     Stop taking nevirapine oral suspension and call your doctor right away if you have any of the following symptoms of liver problems with or without a skin rash:  

        • dark (tea colored) urine
        • yellowing of your skin or whites of your eyes
        • light-colored bowel movements (stools)
        • fever
        • feeling sick to your stomach (nausea)
        • feel unwell or like you have the flu
        • pain or tenderness on your right side below your ribs
        • tiredness
        • loss of appetite 

• Severe skin reactions and rash. Some skin reactions and rashes may be severe, life-threatening, and in some people, may lead to death. Most severe skin reactions and rashes happen in the first 6 weeks of treatment with nevirapine oral suspension.

    • Women have a higher risk of developing a rash during treatment with nevirapine oral suspension than men. 

       Stop taking nevirapine oral suspension and call your doctor right away if you get a rash with any of the following symptoms:

            • blisters
            • red or inflamed eyes, like “pink eye” (conjunctivitis)
            • swelling of your face
            • feel unwell or like you have the flu
            • muscle or joint aches
            • mouth sores
            • fever
            • tiredness 

• Your doctor should do blood tests often to check your liver function and check for severe skin reactions during the first 18 weeks of treatment with nevirapine oral suspension. You should continue to see your doctor and have your liver checked regularly during your treatment with nevirapine oral suspension. It is important for you to keep all of your doctor appointments.
• If your doctor tells you to stop treatment with nevirapine oral suspension because you have had any of the severe liver or skin symptoms listed above, you should never take nevirapine oral suspension again.  

See “What are the possible side effects of nevirapine oral suspension?”  for more information about side effects.

What is nevirapine oral suspension?  

Nevirapine oral suspension is prescription HIV-1 medicines used with other HIV-1 medicines to treat HIV-1 (Human Immunodeficiency Virus 1) in adults and in children 15 days of age or older. HIV-1 is the virus that causes AIDS (Acquired Immune Deficiency Syndrome).  

• If you are a woman with CD4+ counts higher than 250 cells/mm3 or a man with CD4+ counts higher than 400 cells/mm3, you and your doctor will decide if starting nevirapine oral suspension is right for you. 

Do not take nevirapine oral suspension:  

• if you have liver problems.
• as part of occupational and non-occupational post-exposure prophylaxis (PEP) regimens. nevirapine oral suspension is only for people diagnosed with HIV-1. If you have not been diagnosed as HIV positive, then do not take nevirapine oral suspension. 

Before taking nevirapine oral suspension, tell your doctor about all your or your child’s medical conditions, including if you or your child: 

• have or have had hepatitis (inflammation of your liver) or problems with your liver. See “What is the most important information I should know about nevirapine oral suspension?”
• receive dialysis
• have trouble swallowing pills
• are pregnant or plan to become pregnant. It is not known if nevirapine oral suspension will harm your unborn baby.

Pregnancy Registry: There is a pregnancy registry for women who take nevirapine oral suspension during pregnancy. The purpose of the registry is to collect information about the health of you and your baby. Talk to your doctor about how you can take part in this registry.

• are breastfeeding or plan to breastfeed. Nevirapine can pass into your breast milk and may harm your baby. You should not breastfeed if you have HIV-1 because of the risk of passing HIV-1 to your baby. Do not breastfeed during treatment with nevirapine oral suspension. Talk to your doctor about the best way to feed your baby. 

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Especially tell your doctor if you take St. John’s wort. 

• Some medicines interact with nevirapine oral suspension. Keep a list of your medicines to show your doctor or pharmacist.
• You can ask your doctor or pharmacist for a list of medicines that interact with nevirapine oral suspension.
• Do not start taking a new medicine without telling your doctor. Your doctor can tell you if it is safe to take nevirapine oral suspension with other medicines. 

How should I take nevirapine oral suspension?   

• Take nevirapine oral suspension exactly as your doctor tells you to take it. Do not change your dose unless your doctor tells you to.
• Nevirapine oral suspension is always taken in combination with other antiretroviral medicines.
• You should not take more than one form of nevirapine at the same time. Talk to your doctor if you have any questions.
• If your child is prescribed nevirapine oral suspension, your child’s doctor will tell you exactly how nevirapine oral suspension should be taken.
• Nevirapine oral suspension can be taken with or without food.
• Do not miss a dose of nevirapine oral suspension. If you miss a dose of nevirapine oral suspension, take the missed dose as soon as you remember. If it is almost time for your next dose, do not take the missed dose. You should take the next dose at your regular time. Do not take 2 doses at the same time.
• If you stop taking nevirapine oral suspension for more than 7 days, ask your doctor how much to take before you start taking it again. You may need to begin taking the nevirapine oral suspension starting dose again, which is taken 1 time each day for 14 days. 

Your doctor should start you with 1 dose each day to lower your chance of getting a serious rash. It is important that you only take 1 dose of nevirapine oral suspension each day for the first 14 days.

• Call your doctor right away if you get a skin rash during the first 14 days of nevirapine oral suspension treatment.
• Do not increase your dose to 2 times a day if you have a rash.
• You should never take your starting dose for longer than 28 days. If after 28 days you are still receiving this starting dose because you have a rash, you and your doctor should talk about prescribing another HIV-1 medicine for you instead of nevirapine oral suspension. 

Switching from nevirapine oral suspension to nevirapine extended-release tablets: 

• Take nevirapine extended-release tablets 1 time a day as prescribed by your doctor. 
• You may sometimes pass a soft mass in your stools (bowel movement) that looks like your nevirapine extended-release tablets. This will not affect the way your medicine works. 

If you take nevirapine oral suspension:

• If you or your child takes nevirapine oral suspension (liquid), shake it gently before each use. Use an oral dosing syringe or dosing cup to measure the right dose. The oral dosing syringe and dosing cup are not provided with nevirapine oral suspension. Ask your pharmacist for a syringe or cup if you do not have one.
• After drinking the medicine, fill the dosing cup with water and drink it to make sure you get all the medicine.
• If the dose is less than 1 teaspoon (5 mL), use the syringe instead of the dosing cup. 

What are the possible side effects of nevirapine oral suspension?

Nevirapine oral suspension may cause serious side effects, including:

See “What is the most important information I should know about nevirapine oral suspension?”

• Changes in your immune system (Immune Reconstitution Syndrome) can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your doctor right away if you start having new symptoms after starting your HIV-1 medicine.
• Changes in body fat can happen in people who take HIV-1 medicines. These changes may include increased amount of fat in the upper back and neck (“buffalo hump”), breast, and around the middle of your body (trunk). Loss of fat from your legs, arms, and face may also happen. The exact cause and long-term health effects of these conditions are not known. 

The most common side effect of nevirapine oral suspension is rash. 

Nevirapine oral suspension may cause decreased fertility in females. Talk to your doctor if you have concerns about fertility. 

These are not all the possible side effects of nevirapine oral suspension. For more information, ask your doctor or pharmacist. 

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I store nevirapine oral suspension?  

• Nevirapine oral suspension should be stored at 20° to 25°C (68° to 77°F) excursions permitted to 15° to 30°C (59° to 86°F).

Keep nevirapine oral suspension and all medicines out of the reach of children.

General information about the safe and effective use of nevirapine oral suspension.

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use nevirapine oral suspension for a condition for which it was not prescribed. Do not give nevirapine oral suspension to other people, even if they have the same condition you have. It may harm them. You can ask your pharmacist or doctor for information about nevirapine oral suspension that is written for health professionals. 

What are the ingredients in nevirapine oral suspension?  

Active ingredient: nevirapine

Inactive ingredients: carbopol 974PNF, methylparaben, propylparaben, non crystallizing sorbitol solution, sucrose, propylene glycol, polysorbate 80, sodium hydroxide, and purified water.

For more information, call Aurobindo Pharma USA, Inc. at 1-866-850-2876.

This Medication Guide has been approved by the U.S. Food and Drug Administration.

Dispense with Medication Guide available at: www.aurobindousa.com/medication-guides  

Distributed by:
Aurobindo Pharma USA, Inc.
279 Princeton-Hightstown Road
East Windsor, NJ 08520

Manufactured by:
Aurobindo Pharma Limited
Hyderabad-500 032, India

Revised: 07/2022