Nefivir

Indications

Nelfinavir is an antiretroviral medicine used together with other HIV medicines to treat HIV-1 infection in adults and children. It is part of combination therapy and is not used alone. It does not cure HIV but helps control the virus so the immune system can recover.

How It Works

Nelfinavir is a protease inhibitor. HIV needs an enzyme called protease to cut long viral proteins into the working parts it needs to build new virus particles. Nelfinavir blocks this enzyme, so the new virus particles made are faulty and cannot infect more cells. This lowers the amount of virus in the blood (viral load).

Dosage and Administration

Take exactly as prescribed by your HIV specialist. The usual adult dose is 1,250 mg twice a day or 750 mg three times a day, taken with a meal to improve absorption. Children's doses are based on body weight and are set by the doctor. Take it every day at the same times and do not miss doses, as missed doses can allow the virus to become resistant.

Interactions

Nelfinavir has many serious interactions. It must not be taken with Rifampicin, St John's Wort, Simvastatin, Lovastatin, Amiodarone, Quinidine, Ergotamine and related ergot medicines, oral Midazolam, Triazolam, Pimozide, Alfuzosin, Sildenafil for lung blood pressure, Omeprazole or other proton pump inhibitors. It can change the levels of hormonal contraceptives, Methadone, some anti-seizure medicines and Warfarin. Always tell your doctor and pharmacist about every medicine and herbal product you use.

Contraindications

Do not take if you are allergic to Nelfinavir, or with any of the medicines listed above that must not be combined with it.

Side Effects

Diarrhoea is very common. Other side effects include nausea, wind, abdominal pain, rash and tiredness. Long-term use may raise blood sugar, blood fats and cause changes in body fat. People with haemophilia may bleed more easily.

Get urgent medical help if you have severe or bloody diarrhoea, signs of a serious allergic reaction or skin reaction (blistering rash, swelling of face or throat, difficulty breathing), very high thirst and passing a lot of urine, or yellowing of the skin or eyes.

Pregnancy and Lactation

HIV treatment in pregnancy helps protect the baby from infection. Your doctor will choose the most suitable medicines; Nelfinavir is now rarely the first choice. Breastfeeding advice for mothers living with HIV depends on local guidance; discuss this with your HIV doctor.

Precautions and Warnings

Use with caution in liver disease, diabetes, haemophilia and high blood fats. Regular blood tests are needed. When the immune system starts to recover, old hidden infections may flare up; report any new symptoms. Use condoms, as HIV can still be passed on if the viral load is not suppressed.

Overdose

Experience with overdose is limited. Contact a doctor or emergency service if too much is taken; treatment is supportive.

Therapeutic Class

Antiretroviral (HIV protease inhibitor).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.