Nelfinavir Brand Name– Viracept
What is Nelfinavir
Nelfinavir is an antiretroviral protease inhibitor (PI) indicated for use with other antiretroviral medications to treat HIV-1 infections in patients 2 years and older.
The drug is available in tablet and oral powder formulations, both of which must be administered with meals.
The oral powder contains phenylalanine (11.2 mg per 1 gram of powder), and therefore should not be used in patients with phenylketonuria.
Like other protease inhibitors, there is a potential for significant drug interactions, as nelfinavir inhibits the hepatic isoenzyme CYP3A4.
Indications
- human immunodeficiency virus (HIV)
- human immunodeficiency virus (HIV) infection
Side Effects
- abdominal pain
- anemia
- anorexia
- anxiety
- arthralgia
- asthenia
- back pain
- bleeding
- bronchospasm
- Cushingoid features
- dehydration
- depression
- diabetes mellitus
- diabetic ketoacidosis
- diarrhea
- dizziness
- drowsiness
- dyspepsia
- dyspnea
- edema
- elevated hepatic enzymes
- emotional lability
- fever
- flatulence
- folliculitis
- GI bleeding
- gynecomastia
- headache
- hematoma
- hepatitis
- hyperamylasemia
- hyperbilirubinemia
- hypercholesterolemia
- hyperglycemia
- hyperhidrosis
- hyperkinesis
- hyperlipidemia
- hypertriglyceridemia
- hyperuricemia
- hypoglycemia
- impotence (erectile dysfunction)
- insomnia
- iritis
- jaundice
- leukopenia
- lipodystrophy
- lymphopenia
- maculopapular rash
- malaise
- metabolic acidosis
- migraine
- muscle cramps
- myalgia
- myasthenia
- myopathy
- nausea
- neutropenia
- oral ulceration
- pancreatitis
- paresthesias
- pharyngitis
- pruritus
- QT prolongation
- rash
- rhinitis
- seizures
- sinusitis
- suicidal ideation
- thrombocytopenia
- torsade de pointes
- urticaria
- vomiting
Adverse events reported in pediatric patients were similar to those noted with adults treated with nelfinavir.
Monitoring Parameters
- blood glucose
- CBC with differential
- CD4+ T cell count
- hepatitis B serology
- LFTs
- plasma hepatitis C RNA
- plasma HIV RNA
- pregnancy testing
- serum bilirubin (total and direct)
- serum cholesterol
- serum lipid profile
- urinalysis
Contraindications
- antimicrobial resistance
- autoimmune disease
- breast-feeding
- children
- diabetes mellitus
- diabetic ketoacidosis
- Graves’ disease
- Guillain-Barre syndrome
- hemophilia
- hepatic disease
- hepatitis B and HIV coinfection
- hepatitis C and HIV coinfection
- hypercholesterolemia
- hyperglycemia
- hyperlipidemia
- hypertriglyceridemia
- immune reconstitution syndrome
- infants
- neonates
- pancreatitis
- phenylketonuria
- pregnancy
Interactions
- Abemaciclib
- Acalabrutinib
- Acarbose
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Adefovir
- Ado-Trastuzumab emtansine
- Afatinib
- Alfentanil
- Alfuzosin
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Almotriptan
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alosetron
- Alpha-glucosidase Inhibitors
- Alprazolam
- Amiodarone
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amobarbital
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Apalutamide
- Apixaban
- Aprepitant, Fosaprepitant
- Aripiprazole
- Artemether; Lumefantrine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Atorvastatin
- Atorvastatin; Ezetimibe
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Avanafil
- Avapritinib
- Axitinib
- Azelastine; Fluticasone
- Azithromycin
- Barbiturates
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzhydrocodone; Acetaminophen
- Bepridil
- Betamethasone
- Betrixaban
- Bicalutamide
- Boceprevir
- Bortezomib
- Bosentan
- Bosutinib
- Brexpiprazole
- Brigatinib
- Bromocriptine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Budesonide
- Budesonide; Formoterol
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Butabarbital
- Cabazitaxel
- Cabozantinib
- Caffeine; Ergotamine
- Calcifediol
- Canagliflozin
- Canagliflozin; Metformin
- Cannabidiol
- Capmatinib
- Carbamazepine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Cariprazine
- Carvedilol
- Ceritinib
- Cevimeline
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Cidofovir
- Cilostazol
- Cisapride
- Citalopram
- Clindamycin
- Clonazepam
- Clorazepate
- Clozapine
- Cobimetinib
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine
- Colchicine; Probenecid
- Conivaptan
- Conjugated Estrogens
- Conjugated Estrogens; Bazedoxifene
- Conjugated Estrogens; Medroxyprogesterone
- Copanlisib
- Crizotinib
- Cyclophosphamide
- Cyclosporine
- Dabigatran
- Daclatasvir
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Darifenacin
- Darolutamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Deflazacort
- Delavirdine
- Dexlansoprazole
- Dextromethorphan; Quinidine
- Diazepam
- Dichlorphenamide
- Didanosine, ddI
- Dienogest; Estradiol valerate
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Dihydroergotamine
- Diltiazem
- Diphenhydramine; Hydrocodone; Phenylephrine
- Disopyramide
- Docetaxel
- Dofetilide
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doravirine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxazosin
- Doxercalciferol
- Doxorubicin
- Dronabinol
- Dronedarone
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Dutasteride
- Dutasteride; Tamsulosin
- Duvelisib
- Echinacea
- Edoxaban
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Elbasvir; Grazoprevir
- Eletriptan
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Enalapril; Felodipine
- Encorafenib
- Enfortumab vedotin
- Entrectinib
- Enzalutamide
- Eplerenone
- Erdafitinib
- Ergoloid Mesylates
- Ergonovine
- Ergot alkaloids
- Ergotamine
- Erlotinib
- Ertugliflozin; Metformin
- Esomeprazole
- Esomeprazole; Naproxen
- Estazolam
- Esterified Estrogens
- Esterified Estrogens; Methyltestosterone
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Estradiol; Progesterone
- Estropipate
- Eszopiclone
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Ethosuximide
- Ethotoin
- Etonogestrel
- Etravirine
- Everolimus
- Ezetimibe; Simvastatin
- Fedratinib
- Felodipine
- Fenofibric Acid
- Fentanyl
- Fesoterodine
- Flibanserin
- Flurazepam
- Fluticasone
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvastatin
- food
- Formoterol; Mometasone
- Fosphenytoin
- Fostamatinib
- Gefitinib
- Gilteritinib
- Glasdegib
- Glecaprevir; Pibrentasvir
- Glipizide; Metformin
- Glyburide; Metformin
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanfacine
- Halofantrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydantoins
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Ibrutinib
- Ibuprofen; Oxycodone
- Idelalisib
- Ifosfamide
- Iloperidone
- Imatinib
- Incretin Mimetics
- Indinavir
- Insulins
- Interferon Alfa-2b; Ribavirin
- Interferons
- Irinotecan
- Irinotecan Liposomal
- Isavuconazonium
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Isradipine
- Istradefylline
- Ivabradine
- Ivacaftor
- Ivosidenib
- Ixabepilone
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lansoprazole
- Lansoprazole; Naproxen
- Lanthanum Carbonate
- Lapatinib
- Larotrectinib
- Lefamulin
- Lemborexant
- Letermovir
- Leuprolide; Norethindrone
- Levobupivacaine
- Levomethadyl
- Levonorgestrel
- Lidocaine
- Lidocaine; Prilocaine
- Linagliptin
- Linagliptin; Metformin
- Lomitapide
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorlatinib
- Lovastatin
- Lovastatin; Niacin
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
- Lurasidone
- Lurbinectedin
- Maraviroc
- Medroxyprogesterone
- Mefloquine
- Mephobarbital
- Mestranol; Norethindrone
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methadone
- Methohexital
- Methylergonovine
- Methysergide
- Midazolam
- Midostaurin
- Mifepristone
- Miglitol
- Mirtazapine
- Mitotane
- Mometasone
- Naldemedine
- Naloxegol
- Nanoparticle Albumin-Bound Paclitaxel
- Nateglinide
- Nefazodone
- Neratinib
- Netupitant, Fosnetupitant; Palonosetron
- Nevirapine
- Niacin; Simvastatin
- Nicardipine
- Nifedipine
- Nilotinib
- Nimodipine
- Nintedanib
- Nisoldipine
- Norethindrone
- Norgestrel
- Olaparib
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Oritavancin
- Orlistat
- Osilodrostat
- Osimertinib
- Oxybutynin
- Oxycodone
- Paclitaxel
- Palbociclib
- Panobinostat
- Pantoprazole
- Paricalcitol
- Pazopanib
- Pemigatinib
- Pentobarbital
- Perampanel
- Pergolide
- Perindopril; Amlodipine
- Pexidartinib
- Phenobarbital
- Phenytoin
- Pimavanserin
- Pimozide
- Polatuzumab Vedotin
- Ponatinib
- Posaconazole
- Pramlintide
- Primidone
- Progesterone
- Propafenone
- Proton pump inhibitors
- Quazepam
- Quetiapine
- Quinidine
- Quinine
- Rabeprazole
- Ramelteon
- Ranolazine
- Red Yeast Rice
- Regorafenib
- Repaglinide
- Retapamulin
- Ribavirin
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Rifaximin
- Rilpivirine
- Rimegepant
- Ripretinib
- Ritonavir
- Rivaroxaban
- Romidepsin
- Rucaparib
- Ruxolitinib
- Salmeterol
- Sapropterin
- Saquinavir
- Saxagliptin
- Secobarbital
- Segesterone Acetate; Ethinyl Estradiol
- Selpercatinib
- Selumetinib
- Sibutramine
- Sildenafil
- Silodosin
- Simeprevir
- Simvastatin
- Simvastatin; Sitagliptin
- Siponimod
- Sirolimus
- Sitagliptin
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Solifenacin
- Somatropin, rh-GH
- Sonidegib
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Sulfonylureas
- Sunitinib
- Suvorexant
- Tacrolimus
- Tadalafil
- Talazoparib
- Tamsulosin
- Tasimelteon
- Tazemetostat
- Telaprevir
- Telithromycin
- Telotristat Ethyl
- Temsirolimus
- Tenofovir, PMPA
- Terbinafine
- Terfenadine
- Tezacaftor; Ivacaftor
- Thiazolidinediones
- Thiopental
- Thiotepa
- Ticagrelor
- Tofacitinib
- Tolterodine
- Tolvaptan
- Topotecan
- Toremifene
- Trabectedin
- Trazodone
- Triamcinolone
- Triazolam
- Trimetrexate
- Tucatinib
- Ubrogepant
- Ulipristal
- Umeclidinium; Vilanterol
- Upadacitinib
- Valbenazine
- Vardenafil
- Vemurafenib
- Venetoclax
- Vilazodone
- Vinblastine
- Vincristine
- Vincristine Liposomal
- Vinorelbine
- Vorapaxar
- Voriconazole
- Voxelotor
- Warfarin
- Zaleplon
- Zanubrutinib
- Zileuton
- Ziprasidone
- Zolpidem
- Zonisamide
