Nelfinavir
- Atc Codes:J05AE04
- CAS Codes:159989-65-8#159989-64-7
- PHARMGKB ID:159989-65-8#159989-64-7
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Induces
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Viracept; Belgium: Viracept; Bulgaria: Viracept; Cyprus: Viracept; Czech Republic: Viracept; Denmark: Viracept; Estonia: Viracept; Finland: Viracept; France: Viracept; Germany: Viracept; Greece: Viracept; Hungary: Viracept; Ireland: Viracept; Italy: Viracept; Latvia: Viracept; Lithuania: Viracept; Luxembourg: Viracept; Malta: Viracept; Netherlands: Viracept; Poland: Viracept; Portugal: Viracept; Romania: Viracept; Slovakia: Viracept; Slovenia: Viracept; Spain: Viracept; Sweden: Viracept; UK: Viracept.
North America
Canada: Viracept; USA: Viracept.
Latin America
Argentina: Nalvir, Nemacina, Retroinhi; Brazil: Viracept.
Asia
Japan: Viracept.
Drug combinations
Chemistry
Nelfinavir Mesylate: C~32~H~45~N~3~O~4~S CH~4~O~3~S. Mw: 663.89. (1) 3-Isoquinolinecarboxamide, N-(1,1-dimethylethyl)decahydro-2-[2-hydroxy-3-[(3-hydroxy-2-methylbenzoyl)amino]-4-(phenylthio)butyl]-, [3S-[2(2S*,3S*),3α,4aβ,8aβ]]-;monomethanesulfonate; (2)(3S,4aS,8aS)-N-tert-Butyl-2-[(2R,3R)-3-(3,2-cresotamido)-2-hydroxy-4-(phenylthio)butyl]decahydro-3-isoquinolinecarboxamide monomethanesulfonate. CAS-159989-65-8; CAS-159989-64-7 (nelfinavir)(1996).
Pharmacologic Category
Antiretrovirals; HIV Protease Inhibitors. (ATC-Code: J05AE04).
Mechanism of action
Inhibits HIV-1 protease, thus preventing cleavage of gag-pol polyprotein resulting in production of immature, noninfectious virus.
Therapeutic use
In combination with other antiretroviral therapy in treatment of HIV infection.
Pregnancy and lactiation implications
Adverse events not observed in animal studies and no increased risk of overall birth defects observed following 1^st^ trimester exposure in humans. Nelfinavir crosses placenta. Pregnancy and protease inhibitors both associated with increased risk of hyperglycemia. Contraindicated in nursing women.
Unlabeled use
Contraindications
Hypersensitivity to nelfinavir or any component of the formulation. Concurrent therapy with amiodarone, ergot derivatives, midazolam, pimozide, quinidine, triazolam.
Warnings and precautions
May cause fat redistribution. Patients may develop immune reconstitution syndrome resulting in occurrence of inflammatory response to indolent or residual opportunistic infection. Changes in glucose tolerance, hyperglycemia, exacerbation of diabetes, DKA, and new-onset diabetes mellitus reported in patients receiving protease inhibitors. Use with caution in hemophilia A or B (increased bleeding during protease inhibitor therapy reported). May cause hepatitis and/or exacerbate pre-existing hepatic dysfunction (use with caution in underlying hepatic disease, such as hepatitis B or C or cirrhosis; use not recommended with moderate-to-severe impairment). Use with caution in patients taking strong CYP3A4 inhibitors, moderate or strong CYP3A4 inducers and major CYP3A4 substrates. Not recommended for use with rifampin, St. John’s wort, lovastatin, simvastatin, phosphodiesterase-5 inhibitors, or proton pump inhibitors (based on omeprazole data). Formulation contains phenylalanine.