Comprehensive medication guide to Nevirapine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$20 copay for generic nevirapine on most insurance plans; typically Tier 1–2 on Medicare Part D and commercial plans. Medicare Part D has a $2,100 annual out-of-pocket cap as of 2026. Prior authorization is uncommon for established patients.
Estimated Cash Pricing
$19–$35 retail for generic nevirapine 200 mg (60 tablets) with GoodRx or SingleCare coupons for a 30-day supply; extended-release 400 mg runs $62–$90 with discount cards. Retail price without coupons can exceed $1,300.
Medfinder Findability Score
82/100
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Nevirapine is an FDA-approved antiretroviral medication used to treat HIV-1 (human immunodeficiency virus type 1) infection. It belongs to the non-nucleoside reverse transcriptase inhibitor (NNRTI) drug class. First approved in 1996, nevirapine was one of the first NNRTI medications available and played a pivotal role in expanding HIV treatment options worldwide.
Originally sold as Viramune (immediate-release) and Viramune XR (extended-release) by Boehringer Ingelheim, both brand-name products have been discontinued. Generic nevirapine from multiple manufacturers — including Aurobindo Pharma, Camber Pharmaceuticals, Macleods Pharmaceuticals, and Mylan — is available in three forms: 200 mg immediate-release tablets, 400 mg extended-release tablets, and 10 mg/mL oral suspension.
Nevirapine must always be used in combination with other antiretroviral drugs — never as monotherapy. It is used in adults and children as young as 15 days old (suspension) or 6 years old (extended-release tablets). It is also used to prevent mother-to-child transmission of HIV during childbirth.
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Nevirapine works by blocking a critical viral enzyme called reverse transcriptase. HIV needs this enzyme to convert its genetic material (RNA) into DNA — a necessary step for replication inside human immune cells. Nevirapine binds to a specific allosteric pocket on reverse transcriptase (the NNRTI binding pocket), located approximately 10 angstroms from the active site.
When nevirapine occupies this pocket, it causes a conformational change in the enzyme — distorting its shape and preventing it from copying HIV's genetic code. Without functional reverse transcriptase, HIV cannot create the DNA it needs to insert into host cell chromosomes and reproduce. Viral replication is halted, and HIV levels in the blood (viral load) decline.
Nevirapine is effective only against HIV-1. HIV-2 has a differently structured NNRTI binding pocket that nevirapine cannot effectively block. Nevirapine has a half-life of 25–30 hours and is extensively metabolized by the liver through CYP2B6 and CYP3A4 enzyme pathways, which it also induces — creating a complex drug interaction profile.
200 mg — immediate-release tablet
Standard starting and maintenance dose for adults; taken once daily for 14-day lead-in, then twice daily
400 mg — extended-release tablet
Once-daily maintenance dose for adults and children ≥6 years old with BSA ≥1.17m²; swallow whole
10 mg/mL (50 mg/5 mL) — oral suspension
For infants ≥15 days old, children, and adults who cannot swallow tablets; shake well before use
Nevirapine is not on the FDA's drug shortage list, and the national generic supply from multiple manufacturers is stable. However, finding it at a retail pharmacy can be inconsistent. Because nevirapine is no longer a preferred first-line HIV treatment in U.S. guidelines, demand has declined and some retail pharmacies — particularly smaller locations — do not stock it routinely.
The oral suspension (10 mg/mL) is the hardest to find at retail and may require specialty pharmacy ordering. The 200 mg immediate-release tablet is the most widely available. Major chain pharmacies (CVS, Walgreens, Walmart) may carry it, but it is classified as a specialty medication and availability varies by location.
If you can't find nevirapine at your usual pharmacy, medfinder calls pharmacies in your area to identify which ones have it in stock, then texts you the results. This is especially helpful for specialty medications like nevirapine. Specialty pharmacies affiliated with HIV clinics are the most reliable long-term supply source.
Nevirapine is not a controlled substance and does not require any DEA special registration to prescribe. Any licensed healthcare provider with prescriptive authority can write a nevirapine prescription. However, because of its serious safety profile (boxed warnings for hepatotoxicity and severe skin reactions) and the complexity of HIV drug regimens, it is almost always managed by HIV-experienced providers.
Prescriber types commonly managing nevirapine:
Infectious disease (ID) physicians and HIV specialists
Primary care physicians (PCPs) with HIV-experienced patient panels
Nurse practitioners (NPs) and physician assistants (PAs) in HIV clinics
OB/GYNs and maternal-fetal medicine specialists (for PMTCT use in pregnant patients)
Pediatric HIV specialists (for infants and children)
Telehealth HIV care is available in many states for stable patients already on antiretroviral therapy. Services like specialty HIV telehealth platforms and health system telemedicine programs can manage ongoing nevirapine prescriptions remotely. Some states may require an in-person visit before establishing a telehealth prescribing relationship.
No. Nevirapine is not a controlled substance and is not scheduled by the U.S. Drug Enforcement Administration (DEA). It does not have abuse potential, physical dependence risk, or other characteristics that trigger DEA scheduling.
Because nevirapine is not scheduled, any licensed prescriber — including primary care physicians, nurse practitioners, and physician assistants — can prescribe it without special DEA registration. Prescriptions can be refilled without restrictions related to controlled substance rules. However, it is a prescription-only medication and requires a valid prescription from a licensed healthcare provider. Telehealth providers can prescribe nevirapine in states that allow telehealth prescribing for HIV medications.
Nevirapine carries two FDA boxed warnings for potentially fatal reactions. Most patients tolerate it when the 14-day lead-in dosing is followed correctly.
Common side effects:
Rash (very common, especially in first 6 weeks; report immediately to provider)
Headache
Nausea
Fatigue
Elevated liver enzymes (ALT/AST)
Fat redistribution (lipodystrophy)
Serious side effects requiring immediate medical attention:
Severe hepatotoxicity (jaundice, dark urine, upper abdominal pain, fatigue) — potentially fatal; boxed warning
Stevens-Johnson syndrome / toxic epidermal necrolysis (blistering rash, skin peeling) — potentially fatal; boxed warning
Severe hypersensitivity reactions (fever, rash, organ involvement)
Immune reconstitution inflammatory syndrome (IRIS)
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Efavirenz (Sustiva)
First-generation NNRTI; once-daily; similar resistance profile to nevirapine; neuropsychiatric side effects common; generic available and widely stocked
Rilpivirine (Edurant)
Second-generation NNRTI; better tolerated; requires baseline viral load <100,000 copies/mL; must be taken with a full meal; available in combo pills Complera, Odefsey, Juluca
Doravirine (Pifeltro)
Newest NNRTI (FDA-approved 2018); fewest drug interactions in the NNRTI class; no food requirements; active against some nevirapine/efavirenz-resistant strains; also in Delstrigo combination
Etravirine (Intelence)
Second-generation NNRTI for treatment-experienced patients with NNRTI resistance; taken twice daily; not for treatment-naive patients
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St. John's Wort
majorPotent CYP3A4 inducer; dramatically reduces nevirapine blood levels, causing virologic failure. Contraindicated.
Rifampin
majorTB antibiotic; strong CYP inducer that significantly reduces nevirapine levels. Co-administration generally avoided.
Atazanavir
majorHIV protease inhibitor; contraindicated with nevirapine — nevirapine reduces atazanavir levels and combination increases hepatotoxicity risk.
Cobicistat-boosted regimens
majorNevirapine substantially reduces cobicistat levels. Avoid with elvitegravir/cobicistat-containing regimens.
Oral contraceptives
majorNevirapine reduces blood levels of hormonal contraceptives, potentially causing contraceptive failure. Use non-hormonal backup method.
Methadone
moderateNevirapine induces CYP3A4, reducing methadone levels. May precipitate opioid withdrawal in patients on methadone maintenance.
Warfarin
moderateNevirapine alters warfarin anticoagulant effect; INR should be monitored closely when starting or stopping nevirapine.
Itraconazole / Ketoconazole
moderateNevirapine reduces azole antifungal blood levels through CYP3A4 induction. Alternative antifungals may be preferred.
Clarithromycin
moderateIncreases nevirapine levels while reducing clarithromycin levels. Azithromycin preferred as alternative macrolide.
Orlistat
moderateReduces GI absorption of nevirapine. Monitor HIV viral load closely; discontinue orlistat if viral load increases.
Nevirapine has a 30-year track record as an HIV antiretroviral. While newer NNRTIs and integrase inhibitors have largely supplanted it in first-line HIV treatment guidelines due to better tolerability and simpler drug interaction profiles, nevirapine remains clinically relevant — particularly for patients who are virologically suppressed on it and tolerating it well, for pediatric HIV care, for mother-to-child transmission prevention, and in resource-limited global health settings where its low cost remains decisive.
If you are on nevirapine and doing well, there is generally no urgency to switch. Regular monitoring, consistent adherence, and awareness of drug interactions are the keys to long-term success. If you are having trouble filling your prescription at your pharmacy, reach out to your HIV care provider and consider transitioning to a specialty pharmacy or mail-order service for more reliable access.
When you can't find nevirapine at your pharmacy, medfinder can help. Simply provide your medication name, dosage, and location, and medfinder will call pharmacies near you to identify which ones have it in stock — and text you the results.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
Real-time availability
Medfinder is actively checking pharmacy inventory for Nevirapine. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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