{"id":51086,"date":"2023-09-20T09:17:16","date_gmt":"2023-09-20T09:17:16","guid":{"rendered":"https:\/\/medsname.com\/nevimune\/"},"modified":"2026-05-16T05:24:27","modified_gmt":"2026-05-16T05:24:27","slug":"nevimune","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/nevimune\/","title":{"rendered":"Nevimune"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Nevimune<\/strong> \u2014 Nevirapine 200 mg (Cipla Inc). NNRTI pro HIV. \u00davodn\u00ed d\u00e1vka 200 mg\/den po dobu 14 dn\u016f, pot\u00e9 200 mg dvakr\u00e1t denn\u011b. Varov\u00e1n\u00ed v \u010dern\u00e9m r\u00e1me\u010dku pro z\u00e1va\u017enou hepatotoxicitu a vyr\u00e1\u017eku, zejm\u00e9na u \u017een s CD4 &gt;250 a mu\u017e\u016f s CD4 &gt;400.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/li>\n<li>Diskr\u00e9tn\u00ed balen\u00ed v oby\u010dejn\u00e9 ob\u00e1lce<\/li>\n<li>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/li>\n<li>Hodnoceno v\u00edce ne\u017e 1 400 z\u00e1kazn\u00edky (<a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Z\u00e1ruka op\u011btovn\u00e9ho zasl\u00e1n\u00ed:<\/strong> pokud va\u0161e objedn\u00e1vka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f od odesl\u00e1n\u00ed, za\u0161leme ji znovu bez dal\u0161\u00edch n\u00e1klad\u016f. <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">P\u0159e\u010d\u00edst podm\u00ednky<\/a>.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Nevimune je expedov\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP v neutr\u00e1ln\u00edm balen\u00ed, platba prob\u00edh\u00e1 p\u0159es regulovan\u00e9ho zpracovatele plateb (na v\u00fdpisu z \u00fa\u010dtu se objev\u00ed regulovan\u00fd zpracovatel plateb \u2014 nikdy MedsBase nebo n\u00e1zev l\u00e9ku). Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed 20-pracovn\u00ed-denn\u00ed z\u00e1rukou na p\u0159eposl\u00e1n\u00ed.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>N\u00edzk\u00e1 genetick\u00e1 bari\u00e9ra pro vznik rezistence<\/strong><br \/>NNRTI prvn\u00ed generace (nevirapin, efavirenz) maj\u00ed n\u00edzkou genetickou bari\u00e9ru \u2014 jedin\u00e1 bodov\u00e1 mutace (K103N pro efavirenz; Y181C pro nevirapin) zp\u016fsobuje vysokou \u00farove\u0148 rezistence. Je nutn\u00e1 p\u0159\u00edsn\u00e1 adherence &gt;95%. Rezistence na jeden NNRTI zp\u016fsobuje zk\u0159\u00ed\u017eenou rezistenci v cel\u00e9 t\u0159\u00edd\u011b.<\/div>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Nevirapin \u2014 z\u00e1va\u017en\u00e9 jatern\u00ed a ko\u017en\u00ed reakce<\/strong><br \/>Nevirapin nese varov\u00e1n\u00ed FDA v \u010dern\u00e9m r\u00e1me\u010dku pro z\u00e1va\u017enou hepatotoxicitu (zejm\u00e9na u \u017een s CD4 &gt;250 a mu\u017e\u016f s CD4 &gt;400), z\u00e1va\u017en\u00e9 vyr\u00e1\u017eky, Stevens-Johnson\u016fv syndrom a DRESS. \u00davodn\u00ed d\u00e1vka (200 mg\/den po dobu 14 dn\u016f, pot\u00e9 200 mg dvakr\u00e1t denn\u011b) riziko sni\u017euje, ale neeliminuje. Okam\u017eit\u011b vysa\u010fte p\u0159i vyr\u00e1\u017ece se syst\u00e9mov\u00fdmi p\u0159\u00edznaky nebo p\u0159i hodnot\u00e1ch jatern\u00edch test\u016f &gt;5\u00d7 ULN.<\/div>\n<h2>Jak funguj\u00ed NNRTI<\/h2>\n<p>Nenukleosidov\u00e9 inhibitory reverzn\u00ed transkript\u00e1zy se v\u00e1\u017eou na hydrofobn\u00ed kapsu na reverzn\u00ed transkript\u00e1ze HIV, odli\u0161nou od aktivn\u00edho m\u00edsta NRTI. Alostericky deformuj\u00ed enzym. NNRTI jsou nekompetitivn\u00ed a NEvy\u017eaduj\u00ed intracelul\u00e1rn\u00ed fosforylaci.<\/p>\n<p>Re\u017eimy zalo\u017een\u00e9 na NNRTI (obvykle s dv\u011bma NRTI) byly po mnoho let z\u00e1kladem prvn\u00ed linie ART celosv\u011btov\u011b. Modern\u00ed doporu\u010den\u00ed nyn\u00ed up\u0159ednost\u0148uj\u00ed inhibitory integrasy (INSTI) jako prvn\u00ed linii, s NNRTI jako alternativou v n\u00e1kladov\u011b omezen\u00fdch podm\u00ednk\u00e1ch nebo tam, kde nejsou dostupn\u00e9 INSTI.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Pro\u010d se pou\u017e\u00edv\u00e1n\u00ed NNRTI sn\u00ed\u017eilo?<\/h3>\n<p>Modern\u00ed doporu\u010den\u00ed up\u0159ednost\u0148uj\u00ed inhibitory integr\u00e1zov\u00e9ho p\u0159enosu \u0159et\u011bzce (dolutegravir, raltegravir, bictegravir) jako prvn\u00ed linii ART, proto\u017ee maj\u00ed vy\u0161\u0161\u00ed genetickou bari\u00e9ru v\u016f\u010di rezistenci, lep\u0161\u00ed sn\u00e1\u0161enlivost a m\u00e9n\u011b l\u00e9kov\u00fdch interakc\u00ed. NNRTI z\u016fst\u00e1vaj\u00ed \u0161iroce pou\u017e\u00edv\u00e1ny v prost\u0159ed\u00edch s omezen\u00fdmi zdroji a tam, kde nejsou dostupn\u00e9 INSTI.<\/p>\n<h3>Vedlej\u0161\u00ed \u00fa\u010dinky?<\/h3>\n<p>T\u0159\u00edda: vyr\u00e1\u017eka (10-20 %, \u010dasto m\u00edrn\u00e1, ale m\u016f\u017ee b\u00fdt z\u00e1va\u017en\u00e1), CNS \u00fa\u010dinky (efavirenz), zv\u00fd\u0161en\u00ed jatern\u00edch enzym\u016f, gastrointestin\u00e1ln\u00ed pot\u00ed\u017ee. Specifick\u00e9: efavirenz \u017eiv\u00e9 sny, deprese; nevirapin z\u00e1va\u017en\u00e1 vyr\u00e1\u017eka + hepatotoxicita; rilpivirin dob\u0159e sn\u00e1\u0161en, ale PPI kontraindikov\u00e1ny.<\/p>\n<h3>Co rezistence?<\/h3>\n<p>NNRTI maj\u00ed n\u00edzkou genetickou bari\u00e9ru \u2014 jedin\u00e1 mutace m\u016f\u017ee zp\u016fsobit rezistenci v cel\u00e9 t\u0159\u00edd\u011b. D\u016fsledn\u00e1 adherence je kl\u00ed\u010dov\u00e1.<\/p>\n<h3>Interakce l\u00e9k\u016f?<\/h3>\n<p>V\u011bt\u0161ina NNRTI jsou induktory CYP3A4 (efavirenz, nevirapin) nebo substr\u00e1ty (rilpivirin). Mnoho interakc\u00ed: rifampicin vy\u017eaduje \u00fapravu d\u00e1vkov\u00e1n\u00ed, PPI jsou kontraindikov\u00e1ny s rilpivirinem, metadon vy\u017eaduje zv\u00fd\u0161en\u00ed d\u00e1vky s efavirenzem.<\/p>\n<h3>T\u011bhotenstv\u00ed?<\/h3>\n<p>Efavirenz je obecn\u011b bezpe\u010dn\u00fd v t\u011bhotenstv\u00ed (po letech opatrnosti ohledn\u011b defekt\u016f neur\u00e1ln\u00ed trubice souhrnn\u00e1 data neukazuj\u00ed zv\u00fd\u0161en\u00e9 riziko). Nevirapin je bezpe\u010dn\u00fd, ale v prost\u0159ed\u00edch s dostatkem zdroj\u016f m\u00e1 omezen\u00e9 pou\u017eit\u00ed kv\u016fli riziku z\u00e1va\u017en\u00e9 vyr\u00e1\u017eky\/hepatotoxicity u \u017een s CD4 &gt;250. Rilpivirin m\u00e1 rozumn\u00e1 data pro t\u011bhotenstv\u00ed.<\/p>\n<h3>Adherence?<\/h3>\n<p>&gt;95 % vy\u017eadov\u00e1no. Vynechan\u00e9 d\u00e1vky u NNRTI rychle vedou k rezistenci kv\u016fli n\u00edzk\u00e9 genetick\u00e9 bari\u00e9\u0159e. V\u017edy v\u010das proberte probl\u00e9my s adherenc\u00ed s va\u0161\u00edm HIV t\u00fdmem \u2014 jsou k dispozici alternativn\u00ed re\u017eimy.<\/p>\n<h3>Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>Vezm\u011bte si l\u00e9k, kdy\u017e si vzpomenete, pokud jste pozd\u011b 6 hodin, vynechejte a pokra\u010dujte v b\u011b\u017en\u00e9m sch\u00e9matu \u2014 ned\u00e1vejte dvojn\u00e1sobnou d\u00e1vku.<\/p>\n<h3>HBV koinfekce?<\/h3>\n<p>NNRTI nel\u00e9\u010d\u00ed HBV. Z\u00e1kladn\u00ed NRTI (TDF + FTC nebo 3TC) l\u00e9\u010d\u00ed jak HIV, tak HBV \u2014 tuto kombinaci zachovejte, pokud m\u00e1te koinfekci HBV. N\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee zp\u016fsobit vzplanut\u00ed HBV.<\/p>\n<h3>Do\u017eivotn\u00ed l\u00e9\u010dba?<\/h3>\n<p>Ano. Vysazen\u00ed ART umo\u017e\u0148uje virov\u00fd rebound b\u011bhem t\u00fddn\u016f. D\u016fsledn\u00e1 terapie poskytuje t\u00e9m\u011b\u0159 norm\u00e1ln\u00ed d\u00e9lku \u017eivota a U=U (Nedetekovateln\u00e9 = Nep\u0159enosn\u00e9).<\/p>\n<h3>Kdy m\u00e1m nav\u0161t\u00edvit sv\u016fj HIV t\u00fdm?<\/h3>\n<p>Rutinn\u00ed p\u00e9\u010de o HIV: virov\u00e1 n\u00e1lo\u017e + CD4 ka\u017ed\u00e9 3-6 m\u011bs\u00edc\u016f po stabilizaci, ka\u017edoro\u010dn\u00ed screening STI, aktualizace o\u010dkov\u00e1n\u00ed, lipidy\/gluk\u00f3za\/ledviny. D\u0159\u00edve, pokud p\u0159\u00edznaky nazna\u010duj\u00ed selh\u00e1n\u00ed l\u00e9\u010dby nebo ne\u017e\u00e1douc\u00ed \u00fa\u010dinky.<\/p>\n<p class=\"medsbase-link-boost-2026-05-16\" data-marker=\"mb-link-boost-ricovir-em\"><a href=\"https:\/\/medsbase.com\/cs\/what-is-hiv-prep-and-how-does-it-work\/\">Nevimune (nevirapin)<\/a> je NNRTI v druh\u00e9 linii ART podle WHO; z\u00e1kladn\u00ed NRTI, se kter\u00fdm se nej\u010dast\u011bji kombinuje, je <a href=\"https:\/\/medsbase.com\/cs\/ricovir-em\/\">Ricovir-EM (tenofovir DF 300 mg + emtricitabin 200 mg)<\/a> \u2014 stejn\u00e1 fixn\u00ed kombinace tenofovir\/FTC pou\u017e\u00edvan\u00e1 pro HIV PrEP.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed l\u00e9ky na HIV a antivirotika<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/trioday\/\">Trioday<\/a> \u2014 TDF + 3TC + EFV \u2014 jednoduch\u00fd re\u017eim v jedn\u00e9 tablet\u011b od Cipla<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/triomune\/\">Triomune<\/a> \u2014 d4T + 3TC + NVP \u2014 star\u0161\u00ed 3v1 kombinace (na b\u00e1zi stavudinu)<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zepdon\/\">Zepdon<\/a> \u2014 raltegravir 400 mg \u2014 inhibitor integr\u00e1zy<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/abamune-l\/\">Abamune L<\/a> \u2014 abakavir + lamivudin \u2014 alternativn\u00ed z\u00e1klad NRTI<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tenvir-l\/\">Tenvir L<\/a> \u2014 tenofovir + lamivudin \u2014 alternativn\u00ed z\u00e1klad NRTI<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> L\u00e9\u010dba HIV je komplexn\u00ed, celo\u017eivotn\u00ed terapie. V\u00fdb\u011br l\u00e9k\u016f z\u00e1vis\u00ed na genotypu, testech rezistence, p\u0159idru\u017een\u00fdch onemocn\u011bn\u00edch a p\u0159edchoz\u00ed l\u00e9\u010db\u011b. Jakoukoli zm\u011bnu re\u017eimu konzultujte s odborn\u00edkem na HIV. Pro prevenci rezistence je nutn\u00e1 adherence &gt;95%. P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby obsahuj\u00edc\u00ed tenofovir, lamivudin nebo emtricitabin testujte HBV \u2014 vysazen\u00ed m\u016f\u017ee u pacient\u016f s koinfekc\u00ed zp\u016fsobit z\u00e1va\u017en\u00e9 vzplanut\u00ed HBV.<\/div>","protected":false},"excerpt":{"rendered":"<p>Nevimune (Nevirapine 200 mg) \u2014 Cipla NNRTI pro HIV-1. \u00davodn\u00ed d\u00e1vka 200 mg\/den po dobu 14 dn\u016f, pot\u00e9 200 mg dvakr\u00e1t denn\u011b. Varov\u00e1n\u00ed v \u010dern\u00e9m r\u00e1me\u010dku: z\u00e1va\u017en\u00e1 hepatotoxicita a vyr\u00e1\u017eka, zejm\u00e9na p\u0159i vy\u0161\u0161\u00edch hodnot\u00e1ch CD4.<\/p>","protected":false},"featured_media":51087,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3304],"product_tag":[],"class_list":{"0":"post-51086","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-hiv-medication","10":"first","11":"outofstock","12":"shipping-taxable","13":"purchasable","14":"product-type-variable","15":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/51086","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=51086"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51087"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51086"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51086"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51086"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51086"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}