What severe side effect can occur with the use of nevirapine?

Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) used in the treatment of HIV/AIDS. One of the most significant adverse effects associated with its use is hepatotoxicity, which can progress to liver failure. This adverse event is particularly concerning in patients with pre-existing liver disease or in those who are co-infected with hepatitis. The liver toxicity associated with nevirapine may present as elevated liver enzymes, and in severe cases can lead to symptoms of acute liver failure, including jaundice, fatigue, and coagulopathy.

The risk of hepatotoxicity primarily occurs within the first few months of treatment, making it essential for clinicians to monitor liver function tests closely during this period. If hepatotoxicity is suspected, discontinuation of nevirapine is recommended, as ongoing use can lead to severe liver damage and acute liver failure, which may be life-threatening.

This recognition of nevirapine-induced liver toxicity is crucial for safe management in patients requiring antiretroviral therapy, emphasizing why it can be categorized as a severe adverse effect of this medication.