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nelfinavir mesylate
Viracept

Pregnancy Risk Category B

How supplied
Tablets:
250 mg
Powder:
50 mg/g powder in 144-g bottle

Action
An HIV-1 protease inhibitor, thereby preventing cleavage of the viral polyprotein, resulting in the production of immature, noninfectious virus.

Indications & dosage
HIV infection when antiretroviral therapy is warranted-

Adults:
1,250 mg b.i.d. or 750 mg P.O. t.i.d. with meals or light snack.
Children ages 2 to 13:
20 to 30 mg/kg/
dose P.O. t.i.d. with meals or light snack; don't exceed 750 mg t.i.d.
Recommended children's dose given t.i.d. is as follows:
If the child's weight is from 7 up to 8.5 kg, give 4 level, 1-g scoops or 1 level teaspoon. If the child's weight is from 8.5 up to 10.5 kg, give 5 level, 1-g scoops or 1.25 level teaspoons. If the child's weight is from 10.5 up to 12 kg, give 6 level, 1-g scoops or 1.5 level teaspoons. If the child's weight is from 12 up to 14 kg, give 7 level, 1-g scoops or 1.75 level teaspoons. If the child's is from 14 up to 16 kg, give 8 level, 1-g scoops or 2 level teaspoons. If the child's weight is from 16 up to 18 kg, give 9 level, 1-g scoops or 2.25 level teaspoons. If the child's weight is from 18 up to 23 kg, give 10 level, 1-g scoops, 2. 5 level teaspoons, or 2 tablets. If the child's weight is 23 kg, give 15 level, 1-g scoops, 3.75 level teaspoons, or 3 tablets.

Adverse reactions
CNS:
anxiety, depression, dizziness, emotional lability, hyperkinesia, insomnia, migraine, headache, paresthesia, seizures, sleep disorders, malaise, somnolence, suicidal ideation.
EENT:
iritis, eye disorder, pharyngitis, rhinitis, sinusitis.
GI:
nausea, diarrhea, flatulence, anorexia, dyspepsia, epigastric pain, GI bleeding, pancreatitis, mouth ulceration, vomiting.
GU:
sexual dysfunction, renal calculus, urine abnormality.
Hematologic:
anemia, leukopenia, thrombocytopenia.
Hepatic:
hepatitis, elevated liver function test results, jaundice, bilirubinemia.
Metabolic:
dehydration, hyperglycemia, hyperlipidemia, hyperuricemia, hypoglycemia, increased amylase and creatinine phosphokinase levels, metabolic acidosis.
Musculoskeletal:
back pain, arthralgia, arthritis, cramps, myalgia, myasthenia, myopathy.
Respiratory:
dyspnea.
Skin:
rash, dermatitis, folliculitis, fungal dermatitis, pruritus, sweating, urticaria.
Other:
allergic reactions, fever, hypersensitivity reactions, including bronchospasm, moderate to severe rash, edema.

Interactions
Drug-drug.
Amiodarone, ergot derivatives, midazolam, quinidine, triazolam: nelfinavir may produce large increases in plasma levels of these drugs, which may increase risk for serious or life-threatening adverse effects. Don't administer concurrently.
Carbamazepine, phenobarbital, phenytoin:
may reduce the effectiveness of nelfinavir by decreasing nelfinavir plasma levels. Monitor closely.
HIV protease inhibitors
(indinavir, ritonavir): may increase nelfinavir plasma levels. Use together cautiously.
Oral contraceptives
(ethinyl estradiol, norethindrone): nelfinavir may decrease plasma levels. Suggest alternative or additional contraceptive measures during nelfinavir therapy.
Rifabutin
: nelfinavir dramatically increases rifabutin plasma levels. Therefore, reduce dose of rifabutin to one-half the usual dose.
Rifampin:
decreased nelfinavir plasma levels. Don't use together.

Effects on diagnostic tests
None reported.

Contraindications
Contraindicated in patients with hypersensitivity to drug or its components.

Nursing considerations

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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