What is Viracept (Nelfinavir)?
Viracept (nelfinavir mesylate) is a protease inhibitor (PI) drug, used for the treatment of human immunodeficiency virus (HIV-1) infection in combination with other antiretroviral drugs. It works by blocking the active site of the HIV-1 protease. The inhibition of the enzyme results in immature, non-infectious virus production.
Dosing & Administration
Viracept is indicated for the treatment of HIV-1 infection in adults and children age 2 and up. Dosing is based on age and body weight. No dosage adjustments are required in patients with mild liver dysfunction. Viracept is available in oral tablets and an oral powder. Tablets may be dissolved. Dosages and administration instructions are detailed in the package insert.
The coadministration with drugs that have a high dependence on CYP3A for clearance and which elevated concentrations are related to serious and/or life-threatening events.
Viracept Side Effects
The most commonly reported adverse effects include:
- and rash in adult and adolescent patients.
Diarrhea, leukopenia, neutropenia, rash, anorexia, and abdominal pain are the most common adverse reactions in pediatric patients. Further information can be found in the package insert.
There have been reports of new onset or exacerbation of pre-existing diabetes mellitus and hyperglycemia, hemophilia, and immune reconstitution syndrome. There have been observations of fat redistribution with this therapy. Lastly, patients with moderate or severe hepatic impairment should not use this product. Further information can be found in the package insert.
Co-administration of Viracept with CYP3A or CYP2C19 products may alter the concentration of these products and Viracept.
Pregnancy & Lactation
The benefit / risk of the use of this product during pregnancy could be considered to determine if justified. Any exposure to Viracept prior to or during pregnancy should be reported to the Antiretroviral Pregnancy Registry. The registry has been set up to monitor outcomes of the mother and fetus. The registry collects information about the patient’s health and the baby’s health.
It is not known if Viracept can be passed to the baby via breast milk and whether or not it could cause harm. Therefore, mothers with HIV-1 should not breastfeed. The Centers for Disease Control and Prevention recommends that HIV-infected mothers not breast-feed their infants to avoid risking postnatal transmission of HIV.
A specific antidote for overdose with Viracept does not exist. However, unabsorbed drug elimination could be achieved by emesis, gastric lavage, or activated charcoal. There is not a significant amount of drug removed via dialysis.
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