Leitura clínica
Comentário
A nevirapina é um inibidor da transcriptase reversa não nucleosídico (ITRNN) com atividade contra o HIV-1. É utilizada no tratamento da infecção por HIV e AIDS. Administração oral uma ou duas vezes ao dia. Se excreta no leite materno em quantidade que poderia ser clinicamente significativa. (Aebi 2022, Pressiat 2021, Olagunju 2016 e 2015, Shapiro 2015 e 2005, Palombi 2012, Mirochnick 2009, Rezk 2008, Bennetto 2007, Giuliano 2007, Colebunders 2005, Mirochnick 1998) Alguns lactentes cujas mães a tomavam tiveram exantema e hiperbilirrubinemia. (Minniear 2012) Os níveis em plasma desses lactentes foram entre 20% e 30% dos níveis plasmáticos maternos. (Aebi 2022, Olagunju 2015, Shapiro 2013, Palombi 2012, Mirochnick 2009, Shapiro 2005) Durante a amamentação são preferíveis outros tratamentos contra HIV/AIDS. (Panel 2022, WHO 2016) Pode consultar abaixo a informação deste produto relacionado: HIV-AIDS materno. Infecção materna por HIV (Bastante seguro. Efeitos adversos leves ou pouco prováveis. Compatível em determinadas circunstâncias. Acompanhamento recomendado. Leia o Comentário.)
Encontrabilidade
Outros nomes e marcas
Sinônimos e grafias 6
- νεβιραπίνη άνυδρη
- نيفيرابين
- Невирапин
- 奈韦拉平
- ネビラピン
- J05AG01
Marcas comerciais na fonte 8
- Filide
- Lazinevir
- Muvidina Plus
- Nerapin
- Nevipin
- Protease
- Virainhi
- Viramune
Dados da fonte
Farmacocinética
| Variável | Valor | Unidade |
|---|---|---|
| Biodisp. oral | 93 ± 9 | % |
| Peso Molecular | 266 | daltons |
| Unión proteínas | 60 | % |
| Vd | 1,2 ± 0,1 | l/Kg |
| pKa | 14,98 | - |
| Tmax | 4 | horas |
| T½ | 25 - 45 | horas |
| Índice L/P | 0,8 | - |
| Dosis Teórica | 0,3 - 1,1 | mg/Kg/d |
| Dosis Relativa | 3,4 - 15,3 | % |
Rastreabilidade
Bibliografia
- Aebi-Popp K, Kahlert CR, Crisinel PA, Decosterd L, Saldanha SA, Hoesli I, Martinez De Tejada B, Duppenthaler A, Rauch A, Marzolini C; Swiss Mother and Child HIV Cohort Study (SHCS). Transfer of antiretroviral drugs into breastmilk: a prospective study from the Swiss Mother and Child HIV Cohort Study. J Antimicrob Chemother. 2022 Nov 28;77(12):3436-3442. Resumen Texto completo (enlace a fuente original)
- Pressiat C, Toni TD, Treluyer JM, Yonaba C, Dahourou DL, Malateste K, Seguin-Devaux C, Leroy V, Hirt D; MONOD ANRS Study Group.. High nevirapine levels in breast milk and consequences in HIV-infected child when initiated on antiretroviral therapy. AIDS. 2021 Nov 15;35(14):2409-2410. Resumen
- WHO - World Health Organization Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. Guideline. 2016 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Olagunju A, Khoo S, Owen A. Pharmacogenetics of nevirapine excretion into breast milk and infants' exposure through breast milk versus postexposure prophylaxis. Pharmacogenomics. 2016 Jun;17(8):891-906. Resumen
- CDC - Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV— United States. nPEP Guidelines Update. 2016 Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Olagunju A, Amara A, Waitt C, Else L, Penchala SD, Bolaji O, Soyinka J, Siccardi M, Back D, Owen A, Khoo S. Validation and clinical application of a method to quantify nevirapine in dried blood spots and dried breast-milk spots. J Antimicrob Chemother. 2015 Oct;70(10):2816-22. Resumen
- Pandhi D, Ailawadi P. Initiation of antiretroviral therapy. Indian J Sex Transm Dis. 2014 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Shapiro RL, Rossi S, Ogwu A, Moss M, Leidner J, Moffat C, Lockman S, Moyo S, Makhema J, Essex M, Capparelli E. Therapeutic levels of lopinavir in late pregnancy and abacavir passage into breast milk in the Mma Bana Study, Botswana. Antivir Ther. 2013;18(4):585-90. Resumen Texto completo (enlace a fuente original)
- Hirnschall G, Harries AD, Easterbrook PJ, Doherty MC, Ball A. The next generation of the World Health Organization's global antiretroviral guidance. J Int AIDS Soc. 2013 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Palombi L, Pirillo MF, Andreotti M, Liotta G, Erba F, Sagno JB, Maulidi M, Ceffa S, Jere H, Marchei E, Pichini S, Galluzzo CM, Marazzi MC, Vella S, Giuliano M. Antiretroviral prophylaxis for breastfeeding transmission in Malawi: drug concentrations, virological efficacy and safety. Antivir Ther. 2012;17(8):1511-9. Resumen Texto completo (enlace a fuente original)
- Minniear TD, Zeh C, Polle N, Masaba R, Peters PJ, Oyaro B, Akoth B, Ndivo R, Angira F, Mills LA, Thomas TK. Rash, hepatotoxicity and hyperbilirubinemia among Kenyan infants born to HIV-infected women receiving triple-antiretroviral drugs for the prevention of mother-to-child HIV transmission. Pediatr Infect Dis J. 2012 Nov;31(11):1155-7. Resumen
- Mirochnick M, Thomas T, Capparelli E, Zeh C, Holland D, Masaba R, Odhiambo P, Fowler MG, Weidle PJ, Thigpen MC. Antiretroviral concentrations in breast-feeding infants of mothers receiving highly active antiretroviral therapy. Antimicrob Agents Chemother. 2009 Mar;53(3):1170-6. Resumen Texto completo (enlace a fuente original)
- Rezk NL, White N, Bridges AS, Abdel-Megeed MF, Mohamed TM, Moselhy SS, Kashuba AD. Studies on antiretroviral drug concentrations in breast milk: validation of a liquid chromatography-tandem mass spectrometric method for the determination of 7 anti-human immunodeficiency virus medications. Ther Drug Monit. 2008 Oct;30(5):611-9. Resumen Texto completo (enlace a fuente original)
- Bennetto-Hood C, Aldrovandi GM, King JR, Woodman K, Ashouri N, Acosta EP. Persistence of nevirapine in breast milk after discontinuation of treatment. Clin Infect Dis. 2007 Aug 1;45(3):391-4. Epub 2007 Jun 18. Resumen Texto completo (enlace a fuente original)
- Giuliano M, Guidotti G, Andreotti M, Pirillo MF, Villani P, Liotta G, Marazzi MC, Mancini MG, Cusato M, Germano P, Loureiro S, Ceffa S, Regazzi M, Vella S, Palombi L. Triple antiretroviral prophylaxis administered during pregnancy and after delivery significantly reduces breast milk viral load: a study within the Drug Resource Enhancement Against AIDS and Malnutrition Program. J Acquir Immune Defic Syndr. 2007 Mar 1;44(3):286-91. Resumen Texto completo (enlace a fuente original)
- Shapiro RL, Holland DT, Capparelli E, Lockman S, Thior I, Wester C, Stevens L, Peter T, Essex M, Connor JD, Mirochnick M. Antiretroviral concentrations in breast-feeding infants of women in Botswana receiving antiretroviral treatment. J Infect Dis. 2005 Sep 1;192(5):720-7. Epub 2005 Jul 27. Resumen Texto completo (enlace a fuente original)
- Colebunders R, Hodossy B, Burger D, Daems T, Roelens K, Coppens M, Van Bulck B, Jacquemyn Y, Van Wijngaerden E, Fransen K. The effect of highly active antiretroviral treatment on viral load and antiretroviral drug levels in breast milk. AIDS. 2005 Nov 4;19(16):1912-5. Resumen Texto completo (enlace a fuente original)
- WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Resumen Texto completo (enlace a fuente original) Texto completo (en nuestros servidores)
- Mirochnick M, Fenton T, Gagnier P, Pav J, Gwynne M, Siminski S, Sperling RS, Beckerman K, Jimenez E, Yogev R, Spector SA, Sullivan JL. Pharmacokinetics of nevirapine in human immunodeficiency virus type 1-infected pregnant women and their neonates. Pediatric AIDS Clinical Trials Group Protocol 250 Team. J Infect Dis. 1998 Aug;178(2):368-74. Resumen Texto completo (enlace a fuente original)