title: Hyperhidrosis related to nevirapine therapy.
abstract: A 70-year-old white man presented to the internal medicine outpatient clinic with symptoms of significant hyperhidrosis. He had been started on antiretroviral therapy (ART) with tenofovir, lamivudine and nevirapine. The patient complained of excessive sweating following severe asthenia after taking nevirapine. Based on these findings, we suspected that the causative agent was nevirapine and a diagnosis of hyperhidrosis due to nevirapine was made. Nevirapine treatment was stopped and was substituted with efavirenz: the patient continued on therapy with tenofovir and lamivudine. The hyperhidrosis symptoms resolved in 2-3 days. No relapse was observed with the new ART regimen. Drugs that induce hyperhidrosis can cause patient discomfort and embarrassment. In our patient, this adverse drug reaction also caused severe asthenia that decreased the patient's physical and emotional quality of life. There was a temporal relationship between the developments of symptoms and starting nevirapine therapy. Once nevirapine was suspended and switched to efavirenz, excessive sweating resolved. An objective causality assessment revealed that the adverse effect was probable. Until further data are available, clinicians should consider discontinuation of nevirapine therapy in patients who develop severe hyperhidrosis.
authors.affiliation: Internal Medicine Service, Hospital de Sagunto, Valencia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Belda
authors.forename: J
authors.initials: J
authors.lastname: Borrás-Blasco
authors.forename: D
authors.initials: D
authors.lastname: Rosique-Robles
authors.forename: I
authors.initials: I
authors.lastname: Jiménez
authors.forename: L
authors.initials: L
authors.lastname: López-Montes
authors.forename: E
authors.initials: E
authors.lastname: Casterá
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003875:Drug Eruptions / Q000209:etiology*; D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D006945:Hyperhidrosis / Q000139:chemically induced*; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D019829:Nevirapine / Q000009:adverse effects* / Q000627:therapeutic use; D063065:Organophosphonates / Q000627:therapeutic use; D000068698:Tenofovir
chemical_list: D019380:Anti-HIV Agents; D063065:Organophosphonates; D019259:Lamivudine; D019829:Nevirapine; D000068698:Tenofovir; D000225:Adenine