nelfinavir

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.

The most common side effects are

• nausea,
• diarrhea,
• flatulence,
• allergic reactions, and
• rash.

Other important side effects Nelfinavir include:

• jaundice,
• metabolic disturbance,
• liver failure and
• failure of the pancreas (pancreatitis).

Nelfinavir oral powder contains phenylalanine and should be avoided by individuals with phenylketonuria. Like other protease inhibitors, use of nelfinavir may be associated with redistribution or accumulation of body fat, increased cholesterol and worsening of diabetes.

Immune reconstitution syndrome, an inflammatory response to infection, may occur in patients treated with combinations of drugs for the treatment of HIV infection. There have been reports of spontaneous bleeding in patients with hemophilia treated with protease inhibitors.

• 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.

• It is not known whether nelfinavir is secreted in breast milk. Nevertheless, HIV-infected mothers should not breastfeed because of the potential risk of transmitting HIV to an infant that is not infected.

Do I need a prescription for nelfinavir?

• Yes

What preparations of nelfinavir are available?

• Tablets: 250 and 625 mg; Oral powder: 50 mg/g

How should I keep nelfinavir stored?

• 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.