Monograph Details
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Infections & Infestations
> Viral infections
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VIRACEPT ORAL POWDER |
| Manufacturer |
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Agouron Pharmaceuticals |
| Legal Classification |
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Rx
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| Pharmacological Class |
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HIV-1 protease inhibitor. |
| Generic Name |
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Nelfinavir (as mesylate) 50mg/gram; contains phenylalanine. |
| Also |
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• VIRACEPT
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| Indications |
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HIV infection. |
| Adults and Children |
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Take with food. May dissolve tab and mix in small amount of water; powder may be mixed with a small amount of non-acidic food or beverage. <2yrs: not recommended. 2–13yrs: 20–30mg/kg 3 times daily; max 750mg 3 times daily. >13yrs: 1.25g twice daily or 750mg 3 times daily. Reduce concomitant rifabutin dose by ½ and give nelfinavir 1.25g twice daily. |
| Contraindications |
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CYP3A substrates that may cause serious events if blood levels are elevated (eg, cisapride, pimozide, midazolam, triazolam, lovastatin, simvastatin, ergots, amiodarone, quinidine). |
| Precautions |
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Hepatic impairment. Diabetes. Monitor for hyperglycemia or fat redistribution, hemophiliacs for spontaneous bleeding. Pregnancy (Cat.B). Nursing mothers: not recommended. |
| Interactions |
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See Contraindications. Rifampin, St. John's wort: not recommended. Potentiates CYP3A substrates (eg, dihydropyridine calcium channel blockers, cyclosporine, tacrolimus, sirolimus, rifabutin, atorvastatin), sildenafil (max 25mg in 48 hours), phenytoin (monitor). Nelfinavir levels decreased by CYP3A inducers (eg, phenytoin, rifampin, carbamazepine, phenobarbital) or CYP2C19 inducers. Nelfinavir levels increased by CYP3A or CYP2C19 inhibitors. Antagonizes methadone, oral contraceptives (use additional or alternative contraception). Indinavir, ritonavir, saquinavir increase nelfinavir levels. Concomitant azithromycin: monitor for azithromycin toxicity (eg, elevated liver enzymes). Others: see literature. |
| Adverse Reactions |
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Diarrhea, nausea, flatulence, abdominal pain, rash, redistribution of body fat, diabetes, hyperglycemia. |
| Extra Text |
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Note: Register pregnant patients exposed to nelfinavir by calling (800) 258-4263. |
| How Supplied |
Tabs 250mg—270, 300
625mg—120
Oral Pwd—144g |
| Additional Resources |
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• Related Prescribing Note |
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