Introduction: The pharmacokinetics of nevirapine in paediatric populations are important to\nconsider for those receiving anti-retroviral treatment in resource limited settings. High rate of\nadherence is required to achieve therapeutic success with good record keeping system for\nmonitoring and follow-ups.\nDiscussion: Children up to 2 years old have a higher rate of elimination for nevirapine compared\nto adult population and older children. Elimination rate in children less than 8 years are about twice\nthose in adults. Prescriptions for the drug based on body surface area have been found to be too\ncomplex for use in resource limited settings and calculations based on weight bands are used.\nThough weight bands make drug administration easier the lower weight bands are likely to receive\nsub therapeutic doses when drug is administered especially when adult fixed dose combinations\nare used. Chewable paediatric tablets offer better pharmacokinetic profile compared to liquids or\noral tablets, however availability of such dosage forms remains low. Solid dosage forms tend to\ngive better nevirapine exposure when taken whole and not broken into halves or quarters as is the case in resource limited settings. Absorption and bioavailability of nevirapine may be affected by\nnutritional status when they is changes in fat/lean body mass ratio and physiological function due\nto malnutrition.\nConclusion: Effective antiretroviral treatment is limited by low availability of formulations for\nnevirapine only or fixed dose combinations for use in paediatric populations. Paediatric\nformulations are more accurate in achieving trough concentrations and sufficient nevirapine\nexposure. Adult tablets usually have to be broken in halves or quarters and this can affect the\nbioavailability of nevirapine and lead to sub therapeutic concentrations.
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