II. Indications
- HIV Infection (part of combination therapy)
III. Contraindications
- Moderate to severe hepatic Impairment (Child-Pugh Class B, C)
- May use without dose adjustment in mild hepatic Impairment (Child-Pugh Class A)
IV. Mechanism
V. Efficacy
VI. Dosing
- Take with a meal or light snack (>500 calories, >11 g fat) for best absorption
- Tablets may be dissolved in a small amount of liquid
- Adult
- Take 750 mg orally three times daily OR
- Take 1250 mg orally twice daily
- Child (age >=2 years old)
- Other Protease Inhibitors with better potency in children are recommended instead
- Give 20-30 mg/kg orally three times daily OR
- Give 45-55 mg/kg orally twice daily
VII. Adverse Effects
- Well tolerated
- Diarrhea (one third of patients)
VIII. Safety
- Pregnancy Category B
- Avoid in Lactation
IX. Drug Interactions
-
Statins
- Use lowest effective dose for Rosuvastatin
- Limit Atorvastatin to 40 mg max dose
- Pravastatin and Fluvastatin do not significantly interact with Nelfinavir
-
Oral Contraceptives
- Decreased efficacy
-
Antacids
- Avoid with Proton Pump Inhibitor
- Buffered Didanosine should be taken at least 1 hour before or 2 hours after Nelfinavir