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Viracept

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Viracept

Viracept

OVERDOSE

Human experience of acute overdose with VIRACEPT is limited. There is no specific antidote for overdose with VIRACEPT. If indicated, elimination of unabsorbed drug should be achieved by emesis or gastric lavage. Administration of activated charcoal may also be used to aid removal of unabsorbed drug. Since nelfinavir is highly protein bound, dialysis is unlikely to significantly remove drug from blood.

CONTRAINDICATIONS

Coadministration of VIRACEPT is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening events. These drugs and other contraindicated drugs (which may lead to reduced efficacy of nelfinavir) are listed in Table 3 [also see DRUG INTERACTIONS, Table 6].

Table 3: Drugs That Are Contraindicated With VIRACEPT

Drug Class Drugs Within Class That Are Contraindicated With VIRACEPT Clinical Comment
Alpha 1-adrenoreceptor antagonist Alfuzosin Potentially increased alfuzosin concentrations can result in hypotension.
Antiarrhythmics Amiodarone, quinidine Potential for serious and/or life-threatening cardiac arrhythmia.
Antimycobacterial Agents Rifampin Plasma concentrations of nelfinavir can be reduced by concomitant use of rifampin. This may lead to loss of therapeutic effect and possible development of resistance to VIRACEPT or other coadministered antiretroviral agents.
Ergot Derivatives Dihydroergotamine, ergotamine, methylergonovine Potential for serious and/or life threatening reactions such as ergot toxicity characterized by peripheral vasospasm and ischemia of the extremities and other tissues.
GI Motility Agent Cisapride Potential for serious and/or life threatening reactions such as cardiac arrhythmias.
Herbal products St. John's wort (Hypericum perforation) Plasma concentrations of nelfinavir can be reduced by concomitant use of the herbal preparation St. John's wort. This may lead to loss of therapeutic effect and possible development of resistance to VIRACEPT or other coadministered antiretroviral agents.
HMG-CoA Reductase Inhibitors Lovastatin, Simvastatin Potential for serious reactions such as myopathy including rhabdomyolysis.
Neuroleptics Pimozide Potential for serious and/or life threatening reactions such as cardiac arrhythmias.
PDE5 Inhibitors Sildenafil (Revatio®) [for treatment of pulmonary arterial hypertension]a A safe and effective dose has not been established when used with nelfinavir. There is increased potential for sildenafil-associated adverse events (which include visual disturbances, hypotension, prolonged erection, and syncope).
Sedative/Hypnotics Triazolam, oral midazolam Potential for serious and/or life threatening reactions such as prolonged or increased sedation or respiratory depression.
a See DRUG INTERACTIONS Table 6 for coadministration of sildenafil and tadalafil when dosed for erectile dysfunction.

Last reviewed on RxList: 4/20/2012
This monograph has been modified to include the generic and brand name in many instances.

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