Viracept

— THERAPEUTIC CATEGORIES —
  • Viral infections

Viracept Generic Name & Formulations

General Description

Nelfinavir (as mesylate) 250mg, 625mg; tabs.

Pharmacological Class

HIV-1 protease inhibitor.

How Supplied

Tabs 250mg—300; 625mg—120

Manufacturer

Viracept Indications

Indications

HIV infection.

Viracept Dosage and Administration

Adults and Children

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: 45–55mg/kg twice daily or 25–35mg/kg 3 times daily; max 2.5g/day. ≥13yrs: 1.25g twice daily or 750mg 3 times daily. Reduce concomitant rifabutin dose by ½ and give nelfinavir 1.25g twice daily.

Viracept Contraindications

Contraindications

CYP3A substrates that may cause serious events if blood levels are elevated (eg, alfuzosin, amiodarone, quinidine, cisapride, lurasidone, pimozide, ergots, oral midazolam, triazolam, lovastatin, simvastatin, rifampin, St. John's wort, sildenafil [Revatio; when used to treat PAH]).

Viracept Boxed Warnings

Not Applicable

Viracept Warnings/Precautions

Warnings/Precautions

Moderate or severe hepatic impairment. Diabetes. Monitor for hyperglycemia, fat redistribution, immune reconstitution syndrome, hemophiliacs for spontaneous bleeding. Pregnancy: monitor. Nursing mothers: not recommended.

Viracept Pharmacokinetics

See Literature

Viracept Interactions

Interactions

See Contraindications. Salmeterol: not recommended. Potentiates CYP3A substrates (eg, dihydropyridine calcium channel blockers, cyclosporine, tacrolimus, sirolimus, rifabutin, rosuvastatin, atorvastatin [use lowest dose necessary; max atorvastatin dose is 40mg/day]), PDE5 inhibitors (adjust dose: see full labeling), phenytoin (monitor). Potentiates fluticasone (caution and consider alternatives w. long-term use), trazodone (use lower dose), bosentan, colchicine (adjust dose: see full labeling). Nelfinavir levels decreased by CYP3A inducers (eg, phenytoin, carbamazepine, phenobarbital), omeprazole 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). Administer didanosine 1hr before or 2hrs after nelfinavir. Monitor INR with warfarin. Others: see full labeling.

Viracept Adverse Reactions

Adverse Reactions

Diarrhea, nausea, flatulence, abdominal pain, rash, redistribution of body fat; diabetes, hyperglycemia.

Viracept Clinical Trials

See Literature

Viracept Note

Notes

Register pregnant patients exposed to nelfinavir by calling (800) 258-4263.

Viracept Patient Counseling

See Literature