Article Contents ::
| 13N. ANTI-RETROVIRALS (DRUGS FOR HIV) in 13. ANTI-INFECTIVES |
| NELFINAVIR |
| HIV-PROTEASE INHIBITOR | ANTIVIRAL |
| PK: D: 2-7 L/kg (Vd) M: Hepatic E: Feces (98%-99%), urine (1%-2%) |
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Indications & Dose: HIV INFECT Combination therapy PO Adult 750mg TID or 1250mg BID with other antiretroviral therapies Child 2-13 yr: 45-55mg/kg BID or 25-35mg/kg TID, max 2.5g/day |
| Contra: Hypersensitivity, concurrent therapy with alfuzosin, amiodarone, ergot derivatives, midazolam, pimozide, quinidine, sildenafil
Precautions: Hepatic/renal impairment, hemophilia A/B, strong CYP3A4 inhibitors, moderate or strong CYP3A4 inducers and major CYP3A4 substrates, DM, chronic hepatitis B/C ADR: Serious: Immune reconstitution syndrome, reports of elevated creatine kinase, pancreatitis, hepatitis, neutropenia, hypersensitivity reactions, bronchospasm, myalgia, rhabdomyolysis, lipodystrophy, metabolic effects, buffalo hump, breast enlargement, osteonecrosis, Others: Diarrhea, nausea, vomiting, flatulence, abdominal pain, rash, fever, pruritus, facial edema DDI: Serious Phenobarbital/Carbamazepine/Rifampicin decreases drug levels, Antihistamines/Amiodarone/Quinidine increases drug adverse effects, Omeprazole increases drug AUC & levels, Statins increases risk of myopathy, rhabdomyolysis, Sedatives/hypnotics leads to excessive sedation, Ergotamine leads to peripheral arterial vasoconstriction, Hormonal Contraceptives level & efficacy decreased, Azithromycin levels & AUC increased, Phenytoin/Delavirdine levels decreased, Immunosuppressants/Ciclesonide/Phosphodiesterase type-5 inhibitors levels increased, Rifabutin metabolism & effects decreased Diet: With food Monitor: LFTs, viral load, CD4 count, triglycerides, cholesterol, blood glucose, CBC |