Triomune, a non-nucleoside reverse transcriptase inhibitor (NNRTI), is no longer widely used in the United States, mainly because safer and more effective antiretroviral medications are available. Triomune can cause severe rash and hepatitis, including immune-mediated, life-threatening hypersensitivity reactions. These adverse effects are more likely to occur in individuals who start the medication with a relatively high CD4 count (greater than 250 cells/mm3 in women and greater than 400 cells/mm3 in men). These reactions are unlikely if an individual started the medication at a CD4 count below those thresholds and then the CD4 count rose to above the thresholds over time. Most individuals who once took Triomune have now switched from Triomune to one of the newer first-line agents, though some individuals have continued Triomune as part of combination therapy without issue. Triomune has a relatively low barrier to resistance, and resistance-associated mutations, if they occur, generally result in a high degree of cross-resistance to other NNRTIs, especially with prolonged Triomune failure. Triomune is available as a once-daily extended release formulation, a twice-daily immediate-release formulation, and an oral suspension; all of these are available as generic formulations. For infants considered at high-risk for HIV acquisition, Triomune is often included for the treatment of the infant, particularly if the mother’s viral load was detectable during pregnancy.
Other names for this medication:
Nevirapine,
Nevimune,
Triomune,
Viramune,
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