Nevirapine and Indinavir: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Nevirapine
Indinavir
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Reduced indinavir exposure
Interaction Deep Dive
Concomitant use of nevirapine and indinavir may reduce the exposure of indinavir. Doses for the addition of nevirapine to indinavir therapy is not established12. Indinavir had no significant effect on nevirapine plasma clearance or steady-state trough concentrations 4.
Why it happens (mechanism)
Enhanced indinavir systemic clearance due to metabolic induction by nevirapine; induction of CYP3A-mediated metabolism of indinavir
Literature reports
1 report — tap to read
a) Nineteen HIV-infected subjects who participated in a prospective trial were given indinavir 800 mg every eight hours. After seven days of indinavir therapy, nevirapine was initiated at 200 mg daily for 14 days and then increased to 200 mg twice daily. Nevirapine therapy resulted in an 11% decline in indinavir plasma maximum concentration (Cmax), a 47.5% decrease in indinavir plasma minimum concentration (Cmin), and a 27.7% decrease in the indinavir area under the concentration-time curve (AUC). Indinavir had no significant effect on nevirapine plasma clearance or steady-state trough concentrations. Despite the indinavir pharmacokinetic alterations in the presence of nevirapine, the combination of these drugs was associated with sustained and potent antiviral activity during long-term follow-up 3.
Common questions
Can I take Nevirapine and Indinavir together?
Reduced indinavir exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Nevirapine and Indinavir interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "delayed". Effects tend to build up gradually over days to weeks.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Nevirapine or Indinavir need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (4)
- Product Information: VIRAMUNE(R) oral suspension, nevirapine oral suspension. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2024. DailyMed
- Product Information: VIRAMUNE XR(R) oral extended-release tablets, nevirapine oral extended-release tablets. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2024. DailyMed
- Murphy RL, Sommadossi JP, Lamson M, et al: Antiviral effect and pharmacokinetic interaction between nevirapine and indinavir in persons infected with human immunodeficiency virus type I. J Infect Dis 1999; 179:1116-1123.
- Murphy RL, Sommadossi JP, Lamson M, et al: Antiviral effect and pharmacokinetic interaction between nevirapine and indinavir in persons infected with human immunodeficiency virus type 1. J Infect Dis 1999; 179:1116-1123. PubMed
Keep reading about Nevirapine
Keep reading about Indinavir
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
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