Indications: HIV infection in combination with other antiretroviral drugs.

Cautions: elderly; history of mental illness or seizures; monitor liver function if receiving other hepatotoxic drugs. Rash. Rash, usually in the first 2 weeks, is the most common side-effect; discontinue if severe rash with blistering, desquamation, mucosal involvement or fever; if rash mild or moderate, may continue without interruption—usually resolves within 1 month. Psychiatric disorders Patients or their carers should be advised to seek immediate medical attention if symptoms such as severe depression, psychosis or suicidal ideation occur.

Contra-indications: acute porphyria.

Hepatic impairment: in mild liver disease, monitor for dose related Side Effects: (e.g. CNS effects) and monitor liver function (avoid in moderate to severe impairment) greater risk of hepatic Side Effects: in chronic hepatitis B or C.

Renal impairment: manufacturer advises caution in severe renal failure (no information available).

Pregnancy: reports of neural tube defects when used in first trimester Pregnancies in HIV-positive women and babies born to them should be reported prospectively to the National Study of HIV in pregnancy and Childhood and to the Anti-retroviral pregnancy Registry.

Side Effects: MOST COMMON : rash including Stevens-Johnson syndrome (see Rash above); abdominal pain, diarrhoea, nausea, vomiting; anxiety, depression, sleep disturbances, abnormal dreams, dizziness, headache, fatigue, impaired concentration (administration at bedtime especially in first 2–4 weeks reduces CNS effects); pruritus. less commonly pancreatitis, hepatitis, flushing, psychosis, mania, suicidal ideation, amnesia, ataxia, tremor, convulsions, gynaecomastia, blurred vision, tinnitus. rarely hepatic failure, suicide, photosensitivity. also reported raised serum cholesterol.

Dose: 600 mg once daily