NELFINAVIR MESYLATE

Indications & Dose:

Combination therapy for HIV-1 

• BY MOUTH

Adult and Child>14 yr

PO: 750mg tid with food

Child 2-13yr

• P0: 20-30 mg per dose, taken tid with food

• Adjust dose when used with indinavir, rifabutin, ritonavir 

Contraindications:

Concurrent use of rifampin 

Side Effects:

CNS: Dizziness, headache

EENT: Iritis, rhinitis

GI: Diarrhea (20%), dyspepsia, nausea

GU: Nephrolithiasis, sexual dysfunction 

HEME: Anemia, leukopenia, thrombocytopenia

METAB: Hyperlipidemia, hyperuricemia, increased alkaline phosphatase, transaminases, CPK, LDH

MS: Arthralgia, myalgia, myopathy

RESP: Dyspnea SKIN. Folliculitis, pruritus, rash

MISC: Weakness 

Cautions:

Precautions:

Phenylketonuria, hepatic insufficiency, hemophilia; do not administer concurrently with cisapride; avoid coadministration with rifampin, midazolam, or trazolam

Interaction:

Drugs

Barbiturates: Increased clearance of nelfinavir; reduced clearance of barbiturates

Carbamazepine: Increased clearance of nelfinavir; reduced clearance of carbamazepine

Cisapride: Increased plasma levels of cisapride

Ergot alkaloids: Increased plasma levels of ergot alkaloids

Erythromycin: Reduced clearance of nelfinavir; nelfinavir reduces clearance of erythromycin

Lovastatin: Nelfinavir reduces. clearance of lovastatin

Midazolam: Increased plasma levels of midazolam and prolonged effect

Nevirapine: Reduces plasma nelfinavir levels; increase nelfinavir dose to 1000mg tid

Oral contraceptives: Nelfinavir may reduce efficacy

Phenytoin: Increased clearance of nelfinavir; reduced clearance of phenytoin

Rifabutin: Increased clearance of nelfinavir; reduced clearance of rifabutin reduce rifabutin dose to 150 mg qd and increase nelfinavir dose to 1000mg tid

Rifarnpin: Increased clearance of nelfinavir

Ritonavir: Decreased clearance of nelfinavir; decrease nelfinavir dose to 750mg bid

Saquinavir: Decreased clearance of saquinavir; reduce dose of Fortovase (saquinavir soft gel capsule) to 800mg tid

Simvastatin: Nelfinavir reduces clearance of simvastatin

Triazolam: Increased plasma levels of triazolam and prolonged effect

Warnings:

Adverse Effects:

Lactations:

Pregnancy category B; excreted in breast milk; breast feeding not recommended for HIV-infected women 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: