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Once‐daily nevirapine dosing: a pharmacokinetics, efficacy and safety review
Author(s) -
Cooper CL,
Van Heeswijk RPG
Publication year - 2007
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2007.00426.x
Subject(s) - dosing , nevirapine , medicine , rash , pharmacokinetics , context (archaeology) , pharmacology , toxicity , intensive care medicine , human immunodeficiency virus (hiv) , antiretroviral therapy , viral load , immunology , biology , paleontology
In the context of attempts to simplify treatment regimens and enhance adherence, there is great interest in once‐daily dosing regimens for the treatment of HIV‐1 infection. Nevirapine has a long half‐life and achieves high steady‐state plasma concentrations relative to the concentration required to inhibit 50% viral replication in vitro (IC 50 ) in patients. For this reason, it has been considered as a once‐daily antiretroviral. Pharmacokinetic and efficacy data support the use of this dosing approach, but excess rash and lingering concerns over liver toxicity preclude use of once‐daily dosed nevirapine at this time. Tolerance to high nevirapine concentrations may develop when dose escalation is used during initiation of therapy. It is theoretically possible that the benefits of once‐daily dosing may be achieved without excess toxicity by switching to once‐daily nevirapine following several months of twice‐daily administration. This dosing strategy is currently under evaluation.