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Herbal preparations containing StJohn’s Wort and Viramune must not be co-administeredsee section 4.3If a patient is already taking StJohn’s Wort check nevirapine and if possible viral levels and stop StJohn’s WortNevirapine levels may increase on stopping StJohn’s WortThe dose of Viramune may need adjustingThe inducing effect may persist for at least 2 weeks after cessation of treatment with StJohn’s Wort.

Oral hormonal contraceptives should not be used as the sole method of contraception in women taking Viramunesee section 4.4Appropriate doses for hormonal contraceptivesoral or other forms of applicationother than DMPA in combination with Viramune have not been established with respect to safety and efficacy.

Skin and appendagesAllergic reactions including anaphylaxisangioedemabullous eruptionsulcerative stomatitis and urticaria have all been reportedhypersensitivity syndrome and hypersensitivity reactions with rash associated with constitutional findingsegfeverblisteringoral lesionsconjunctivitisfacial edemamuscle or joint achesgeneral malaisefatigueor significant hepatic abnormalitiesdrug reaction with eosinophilia and systemic symptomsDRESS

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based on serious and life-threatening hepatotoxicity observed in controlled and uncontrolled trials viramune xr is not recommended to be initiated, unless the benefit outweighs the risk, in .

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