Taking it

The recommended dose of nelfinavir (Viracept) is 1250mg twice a day or 750mg three times daily. These two dosing schedules have similar efficacy.1 2 3 In Europe and Australia, nelfinavir is available in 250mg tablets. However, it is available in a 625mg tablet in the United States and Canada, where it is manufactured by Pfizer. This formulation produces similar levels of nelfinavir to the 250mg tablets when taken with food, and allows patients to take fewer tablets every day and is less likely to cause diarrhoea.4 5 6 However, it is no longer being developed by Roche, who hold the licence for the product in Europe and Australia.

Nelfinavir should be taken with a meal or snack, and a glass of water.7 This increases the amount of the drug that gets into the blood. The minimum amount of food advised is a snack like a large sandwich or a baked potato with filling.

The original nelfinavir tablets caused some people to complain of a strange taste in the mouth after taking them with particular liquids, especially fruit juice. Taking the tablets with milk or water seems to reduce the risk of this. However, the currently available tablets are coated, reducing the problems of strange tastes and crumbling of the tablets.

Unlike other protease inhibitors, nelfinavir cannot be boosted with low-dose ritonavir (Norvir).

Patients with moderate to severe liver damage may have altered blood levels of nelfinavir.8 9 These patients may benefit from drug level monitoring to ensure that drug levels are appropriate.

References

  1. Petersen A et al. A comparison of the long-term antiviral efficacy of bid and tid dosing of nelfinavir in combination with stavudine (d4) and lamivudine (3TC) beyond 48 weeks. Seventh European Conference on Clinical Aspects and Treatment of HIV Infection, Lisbon, abstract 205, 1999
  2. Squires KE et al. Efficacy and safety of BID and TID regimens of nelfinavir (NFV) + saquinavir (SQV) + stavudine (d4T) + lamivudine (3TC) in HIV-infected women: 48 week results of the Women First study. 39th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, abstract 1988, 1999
  3. Marzolini C et al. Nelfinavir plasma levels under twice-daily and three-times-daily regimens: high interpatient and low intrapatient variability. Ther Drug Monit 23: 394-398, 2001
  4. Kaeser B et al. Assessment of the bioequivalence of two nelfinavir tablet formulations under fed and fasted conditions in healthy subjects. Int J Clin Pharmacol Ther 43: 154-162, 2005
  5. Johnson M et al. Comparison of gastrointestinal tolerability and patient preference for treatment with the 625 mg and 250 mg nelfinavir tablet formulations. HIV Med 6: 107-113, 2005
  6. Nieto-Cisneros L et al. Roche Viracept 625mg film-coated tablets: investigation of safety and gastrointestinal tolerability of this new formulation in comparison with 250mg film-coated tablets in HIV patients. Antivir Ther 8: S331, 2003
  7. Petersen C et al. Pharmacokinetics of nelfinavir (Viracept 250 mg tablet): effect of food intake on single-dose PK parameters. Tenth Conference on Retroviruses and Opportunistic Infections, Boston, abstract 544, 2003
  8. Khaliq Y et al. Single and multiple dose pharmacokinetics of nelfinavir and CYP2C19 activity in human immunodeficiency virus-infected patients with chronic liver disease. Br J Clin Pharmacol 50: 108-115, 2000
  9. Regazzi M et al. Clinical pharmacokinetics of nelfinavir and its metabolite M8 in human immunodeficiency virus (HIV)-positive and HIV-hepatitis C virus-coinfected subjects. Antimicrob Agents Chemother 49: 643-649, 2005
Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.