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Nelfinavir

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(CAS: 159989-65-8)

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CAS: 159989-65-8

Chemical Name: [3S-(3R,4aR,8aR,2'S)]-2-[2'-hydroxy-3'-phenylthiomethyl-4'-aza-5'-oxo-5'-[2'-methyl-3'-hydroxyphenyl)-pentyl]-3-(N-(tert-butyl)-carboxamide)-decahydro isoquinoline

Structure:

What is the most important information I should know about nelfinavir?
? Some drugs are not recommended to be taken with nelfinavir. Very high levels of these medications, which could occur during therapy with nelfinavir, could be life threatening. Do not take nelfinavir without first talking to your doctor if you are taking any of the following drugs:
, cisapride (Propulsid);
, rifampin (Rifadin, Rimactane) or rifabutin (Mycobutin);
, herbal or natural products containing St. John's wort;
, pimozide (Orap);
, ergotamine (Ergostat, Cafergot, Ercaf, Wigraine) or dihydroergotamine (D.H.E. 45);
, amiodarone (Cordarone), bepridil (Vascor), flecainide (Tambocor), propafenone (Rythmol), or quinidine (Quinaglute, Quinidex, others);
, diazepam (Valium), clorazepate (Librium), estazolam (ProSom), flurazepam (Dalmane), midazolam (Versed), triazolam (Halcion), or zolpidem (Ambien);
, bupropion (Wellbutrin) or clozapine (Clozaril); or
, meperidine (Demerol), piroxicam (Feldene) or propoxyphene (Darvocet, Darvon, Wygesic).
? Take nelfinavir with a meal to increase the absorption of the drug by the body.

What is nelfinavir?
? Nelfinavir is an antiviral medication. It is in a category of HIV medicines called protease inhibitors. Nelfinavir prevents HIV from maturing. This reduces the amount of infectious or active virus in the body.
? Nelfinavir is used to treat human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS).
? Nelfinavir is not a cure for HIV or AIDS.
? Nelfinavir may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking nelfinavir?
? Some drugs are not recommended to be taken with nelfinavir. Very high levels of these medications, which could occur during therapy with nelfinavir, could be life threatening. Do not take nelfinavir without first talking to your doctor if you are taking any of the following drugs:
, cisapride (Propulsid);
, rifampin (Rifadin, Rimactane) or rifabutin (Mycobutin);
, herbal or natural products containing St. John's wort;
, pimozide (Orap);
, ergotamine (Ergostat, Cafergot, Ercaf, Wigraine) or dihydroergotamine (D.H.E. 45);
, amiodarone (Cordarone), bepridil (Vascor), flecainide (Tambocor), propafenone (Rythmol), or quinidine (Quinaglute, Quinidex, others);
, diazepam (Valium), clorazepate (Librium), estazolam (ProSom), flurazepam (Dalmane), midazolam (Versed), triazolam (Halcion), or zolpidem (Ambien);
, bupropion (Wellbutrin) or clozapine (Clozaril); or
, meperidine (Demerol), piroxicam (Feldene) or propoxyphene (Darvocet, Darvon, Wygesic).
? Before taking nelfinavir, tell your doctor if you have any type of liver disease. You may need a dosage adjustment or special monitoring during therapy.
? The Viracept powder contains phenylalanine. Patients with phenylketonuria (PKU) should not take Viracept powder.
? Nelfinavir is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. It is very important to treat HIV/ AIDS during pregnancy to reduce the risk of infecting the unborn baby. Talk to your doctor about treatment options if you are pregnant or could become pregnant during treatment. .
? It is not known whether nelfinavir passes into breast milk and what effect it may have on a nursing baby. To prevent transmission of the virus to uninfected babies, it is recommended that HIV-positive mothers not breast-feed.

How should I take nelfinavir?
? Take nelfinavir exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
? Take each dose with a full glass of water.
? Take nelfinavir with a meal to increase absorption of the drug by the body.
? If you cannot swallow the tablets, dissolve them in a small amount of water. Once dissolved, mix the cloudy liquid well and consume it immediately. The glass should be rinsed with water and the rinse should be swallowed to ensure the entire dose is consumed.
? The pediatric oral powder should be mixed with a small amount of water, milk, formula, soy formula, soy milk, or a dietary supplement. Do not mix the powder with apple, orange, or other acidic juices or foods. Do not add the liquid directly to the bottle of oral powder. The approximate dose should be measured out prior to mixing. The combination will taste very bitter. Consume the mixture immediately after preparation. If the mixture cannot be consumed immediately, it should be stored under refrigeration and used within 6 hours. Do not heat the mixture once it has been prepared.
? Nelfinavir and didanosine (ddI, Videx) should be taken at least 2 and a half hours apart from one another to prevent an interaction.
? It is important to take nelfinavir regularly to get the most benefit.
? Treatment of HIV/ AIDS almost always requires the use of two or more drugs. If you need to stop taking one of the medicines you are taking for HIV, you should stop all of them until you can talk to your doctor.
? Your doctor may want you to have blood tests or other medical evaluations during treatment with nelfinavir to monitor progress and side effects.
? Store nelfinavir at room temperature away from moisture and heat.

What happens if I miss a dose?
? Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and only take the next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor.

What happens if I overdose?
? Seek emergency medical attention if an overdose is suspected.
? Symptoms of a nelfinavir overdose are not known.

What should I avoid while taking nelfinavir?
? Follow your doctor's instructions with respect to high-risk activities such as unprotected sex and the sharing of needles. Nelfinavir is not a cure for HIV or AIDS, and the virus can still be transmitted to others during treatment with this medication.
? Talk to your doctor and pharmacist before taking any other medications, including over-the-counter and herbal products. Many drugs may interact with nelfinavir. Such interactions could cause dangerous side effects or reduce the effectiveness of nelfinavir.

What are the possible side effects of nelfinavir?
? Stop taking nelfinavir and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives).
? The most common side effect from nelfinavir therapy is diarrhea, which can be treated with an antidiarrheal medication. Talk to your doctor if you experience diarrhea.
? Other, less serious side effects may also occur. Continue to take nelfinavir and talk to your doctor if you experience
, nausea or abdominal pain;
, a rash; or
, headache, fever, or discomfort.
? Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect nelfinavir?
? Some drugs are not recommended to be taken with nelfinavir. Very high levels of these medications, which could occur during therapy with nelfinavir, could be life threatening. See the "What should I discuss with my healthcare provider before taking nelfinavir" section for a detailed list.
? Before taking nelfinavir, tell your doctor if you are taking any of the following medicines:
, phenytoin (Dilantin), carbamazepine (Tegretol), or phenobarbital (Luminal, Solfoton);
, sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis);
, a tricyclic antidepressant such as amitriptyline (Elavil), desipramine (Norpramin), nortriptyline (Pamelor), imipramine (Tofranil), and others;
, warfarin (Coumadin);
, cyclosporine (Sandimmune, Neoral), tacrolimus (Prograf), sirolimus (Rapamune);
, methadone (Dolophine, Methadose);
, a stomach or ulcer medication such as cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), ranitidine (Zantac), esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), omeprazole (Prilosec), or rabeprazole (Aciphex);
, dexamethasone (Decadron, Hexadrol, others);
, dapsone;
, disulfiram (Antabuse);
, a cholesterol medicine including atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), and simvastatin (Zocor);
, theophylline (Theo-Dur, Theo-Bid, Theolair, Theochron, others);
, metronidazole (Flagyl), erythromycin (Ery-Tab, E-Mycin, Eryc, E.E.S., PCE, others), clarithromycin (Biaxin) or clindamycin (Cleocin);
, a calcium channel blocker such as diltiazem (Cardizem, Dilacor XR, Tiazac, Diltia XT), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), or nimodipine (Nimotop), verapamil (Calan, Covers-HS ,Isoptin, Verelan), amlodipine (Norvasc, Lotrel); nisoldipine (Sular), isradipine (DynaCirc);
, itraconazole (Sporanox) or ketoconazole (Nizoral); or
, an HIV/ AIDS medicine such as delavirdine (Rescriptor), efavirenz (Sustiva), or nevirapine (Viramune).
? You may not be able to take nelfinavir, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medications listed above.
? Nelfinavir may decrease the effectiveness of birth control pills. Talk to your doctor about other available forms of birth control.
? Drugs other than those listed here may also interact with nelfinavir. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.