Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
GENERIC NAME: nelfinavir
BRAND NAME: Viracept
DRUG CLASS AND MECHANISM: Nelfinavir is an oral medication that is used for treating infections with the human immunodeficiency virus (HIV). It is in a class of drugs called protease inhibitors that also includes indinavir (Crixivan), amprenavir (Agenerase), ritonavir (Norvir) and saquinavir (Invirase, Fortovase). During infection with HIV, the HIV virus multiplies within the body's cells. Viruses are released from the cells and spread throughout the body where they infect other cells. In this manner, HIV infection is perpetuated among new cells that the body continually produces. During the production of the viruses, new proteins are made. Some of the proteins are structural proteins, that, is, proteins that form the body of the virus. Other proteins are enzymes which manufacture DNA and other components for the new viruses. Protease is the enzyme that forms the new structural proteins and enzymes. Nelfinavir blocks the activity of protease and results in the formation of defective viruses that are unable to infect the body's cells. As a result, the number of viruses in the body (the viral load) decreases. Nevertheless, nelfinavir does not prevent the transmission of HIV among individuals, and it does not cure HIV infections or AIDS. Nelfinavir was approved by the FDA in March 1997.
GENERIC AVAILABLE: No
PREPARATIONS: Tablets: 250 and 625 mg; Oral powder: 50 mg/g
STORAGE: Capsules and powder should be stored at room temperature, 15 C to 30 C (59 F to 86 F). The oral powder should be consumed within 6 hours after mixing it with water or other liquids.
PRESCRIBED FOR: Nelfinavir is used in combination with other anti-HIV drugs for the treatment of HIV infection.
DOSING: The recommended dose for adults and adolescents 13 years and older is 1250 mg twice daily or 750 mg three times daily. The recommended dose for children 2-13 years of age is 25-35 mg/kg three times daily or 45 to 55 mg/kg twice daily. Nelfinavir should be administered with food or a light snack. The tablets may be crushed and dissolved in water or mixed with food. Once mixed in water or food, the mixture should be consumed within 6 hours.
DRUG INTERACTIONS: Nelfinavir interacts with many drugs because it reduces the ability of liver enzymes to break down certain drugs. Some of the important interactions are discussed below. Viewers should consult their health care professional before combining any drugs with nelfinavir.
Nelfinavir should not be used together with alfuzosin (Uroxatral), lovastatin (Mevacor), simvastatin (Zocor), pimozide (Orap), sildenafil (Revatio), amiodarone (Cordarone), quinidine (Quinaglute, Cardioquin), ergot derivatives (for example, Ergostat), triazolam (Halcion), and midazolam (Versed), because serious adverse effects could occur due to increased levels of these drug in the body.
Nelfinavir also increases the concentrations in blood of rifabutin (Mycobutin). Therefore, the doses of rifabutin should be reduced.
Rifampin and St. John's wort decrease the concentration of nelfinavir in the body and may reduce the effectiveness of nelfinavir.
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