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Viracept - nelfinavir

General Information This drug is almost always used as one component of a multidrug combination to suppress the human immunodeficiency (HIV) viral load.
Specifics Nelfinavir is a well-respected and well-tolerated antiviral medication.  It has a long track record of effectiveness and safety.

Nelfinavir works by inhibiting the production of HIV's proteins.  It is classified as a protease inhibitor (PI).

Dosing Generally nelfinavir is taken as two of the 625 mg tablets (or five of the 250 mg tablets) twice a day with food.  It is very important to take this medication with food to aid in its absorption.  If food is not taken, the effectiveness of this medication is decreased.
(this refers to your willingness, ability, and actual performance in taking your medications)
As with any antiviral drug or antibiotic, try not to ever miss a dose.  If you miss a dose and notice that you have done so within a few hours of its scheduled time, you may take the dose as usual and take the next dose at its regular time. 

If you miss more than one dose, look at the reasons why you missed them and come up with a plan to avoid it in the future.  For example, if you fell asleep too early, take the medicine earlier in the evening, with your later meal, set an alarm, or have someone appointed to wake you up for your medicine.  

It is strongly recommended that you consider using weekly pill boxes and arrange all of your doses a week in advance.  Buy a small pill box so that you can carry a dose or two of your medicines with you in case you are away from home.

Possible Side Effects
The package insert for most drugs including nelfinavir is often overwhelming and scary with perhaps an overemphasis on side effects.  We have summarized the important and more common problems here.

Most people take nelfinavir without many side effects. 

Possible side effects include diarrhea, nausea, liver problems, increased fat (cholesterol and triglycerides) in the blood, and possibly diabetes.  Usually you will have blood tests done in the first month to look for the beneficial effects of nelfinavir and any side effects. 

Many minor side effects will either stay constant or get better with time.  It is mainly the side effects that are severe or get worse that may cause significant health risks for you.

Far and away the most common side effect of nelfinavir is some degree of diarrhea or loose stools in up to 50% of persons who take the drug.  Several remedies will treat or improve this diarrhea:

1.  Take a calcium supplement or a Tums tablet twice a day.
2.  Take a psyllium fiber supplement like Metamucil 2-3 times per day (with 8oz or more of fluid each time)
3.  Take Imodium or Lomotil, 1 dose every 4 hours as needed

All drugs of this type can cause or contribute to abnormal fat redistribution characterized by an enlarged belly, thinning of the face, arms, or legs.  In most cases this would be also accompanied by elevated cholesterol levels, elevated triglyceride levels, and perhaps a tendency to develop diabetes. 

Report to you healthcare provider or go to an Emergency Room if you have severe side effects, increasing side effects, shortness of breath, uncontrollable diarrhea, fever, weakness, jaundice (eyes and skin turn yellow,) muscle pain, nausea and vomiting so that you cannot hold down your food and liquids.
You can download this handout in PDF format by clicking HERE.