Drug Interaction Report

Nevirapine and Rilpivirine: Interaction Details

A pharmacist-reviewed analysis of the Nevirapine and Rilpivirine interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Nevirapine

Viramune Viramune® Viramune® XR
+

Rilpivirine

Edurant Edurant® Juluca® (as a combination product containing dolutegravir, rilpivirine)
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 163 documented Nevirapine interactions, 132 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Reduced rilpivirine exposure and altered nevirapine exposure

Interaction Deep Dive

Do not coadminister nevirapine with another NNRTI, such as rilpivirine as this combination has not been shown to be beneficial and may alter nevirapine exposure12. Although pharmacokinetic studies have not been conducted, concomitant use of rilpivirine with other NNRTI, such as nevirapine, may lead to decreased rilpivirine plasma concentrations. Therefore, concomitant use of nevirapine and rilpivirine is not recommended 34.

Why it happens (mechanism)

Induction of CYP3A-mediated metabolism of rilpivirine

Common questions

Can I take Nevirapine and Rilpivirine together?

Reduced rilpivirine exposure and altered nevirapine exposure Always confirm with your pharmacist or prescriber before making any change.

How serious is the Nevirapine and Rilpivirine interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Nevirapine or Rilpivirine 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 a safer alternative to one of these medications for me?

References (4)

  1. Product Information: VIRAMUNE(R) oral suspension, nevirapine oral suspension. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2024. DailyMed
  2. Product Information: VIRAMUNE XR(R) oral extended-release tablets, nevirapine oral extended-release tablets. Boehringer Ingelheim Pharmaceuticals Inc (per FDA), Ridgefield, CT, 2024. DailyMed
  3. Product Information: EDURANT(R) oral tablets, rilpivirine oral tablets. Janssen Therapeutics (per FDA), Horsham, Pa, 2024. DailyMed
  4. Product Information: EDURANT(R) PED oral tablets for suspension, rilpivirine oral tablets for suspension. Janssen Therapeutics (per FDA), Horsham, Pa, 2024. DailyMed
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Nevirapine

Keep reading about Nevirapine

All Nevirapine interactions (163) Nevirapine drug information
Also serious with: Atazanavir Cobicistat Dasabuvir Ensitrelvir
Rilpivirine

Keep reading about Rilpivirine

All Rilpivirine interactions (73) Rilpivirine drug information
Also serious with: Dexlansoprazole Omeprazole Ketoconazole Topical Esomeprazole
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Nevirapine + Activated Charcoal Beer Grapefruit Siberian Cocklebur St. John's Wort Wine Acacia Rigidula Adrafinil + 172 more
Rilpivirine + Activated Charcoal American Hellebore Arsenic Beer Cesium Ephedra Grapefruit Siberian Cocklebur + 167 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.