Drug Evaluations Anti-infectives: Nevirapine: A review of its development, pharmacological profile and potential for clinical use

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Abstract
Nevirapine, a dipyridodiazepinone, is the prototypic member of a class of antiretroviral compounds referred to as nonnucleoside reverse transcriptase inhibitors. Nevirapine is a potent and selective noncompetitive inhibitor of the reverse transcriptase enzyme, an important therapeutic target for the treatment of HIV-1 infection. The activity of nevirapine does not compete with template or nucleoside triphosphates, nor does it inhibit HIV-2 reverse transcriptase or any of the human DNA polymerases. In completed clinical studies, nevirapine has demonstrated antiretroviral activity both as monotherapy and in combination with nucleoside analogues. When administered with zidovudine or the combination zidovudine/didanosine, the antiviral effect has been profound and sustained. A favourable antiviral effect and CD4+ lymphocyte response has been demonstrated in both adults and children, in patients experienced and naive to antiretroviral therapy as well as in those with baseline resistance to zidovudine. Nevirapi...