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Viracept
Viracept (generic name: nelfinavir) is an antiretroviral medication used in the treatment of HIV-1 infection. It belongs to the class of drugs known as protease inhibitors (PIs), which work by blocking the HIV protease enzyme, a critical component of the virus’s life cycle. This action prevents the virus from replicating and reduces the viral load in the body, helping improve immune function and reduce the risk of developing AIDS-related complications.
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Frequently Asked Questions
How long does it take for Viracept to start working?
Viracept begins reducing the viral load soon after starting treatment, but it may take several weeks to see a significant reduction. Regular monitoring of viral levels is essential to track progress.
Can I stop taking Viracept once my viral load is undetectable?
No, even if your viral load becomes undetectable, you must continue taking Viracept as prescribed. Stopping treatment can lead to viral rebound and drug resistance.
What should I do if I miss a dose of Viracept?
If you miss a dose, take it as soon as you remember. If it’s close to your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Does Viracept interact with birth control pills?
Yes, Viracept may reduce the effectiveness of hormonal contraceptives. It’s important to use an additional or alternative form of contraception to prevent pregnancy.
Can Viracept cause changes in body fat?
Yes, some patients may experience changes in body fat distribution (lipodystrophy), including increased fat in certain areas of the body or loss of fat in others.
Comprehensive Drug Guide
How Does Viracept Work?
Viracept works by inhibiting the HIV protease enzyme, which is essential for the maturation of the virus. By blocking this enzyme, Viracept prevents the virus from becoming infectious, thereby reducing the viral load in the bloodstream. This helps the immune system function more effectively and slows the progression of HIV infection.
Common Dosages
- 250 mg tablets
- 625 mg tablets
- Oral powder (50 mg/g) The typical adult dose is 1250 mg (two 625 mg tablets) taken twice daily, or 750 mg (three 250 mg tablets) three times daily.
Typical Dosing
- Adults: The usual dose is 1250 mg (two 625 mg tablets) twice daily, or 750 mg three times daily.
- Children: The dose is based on body weight and may vary. The oral powder is commonly used for pediatric patients who cannot swallow tablets.
Typical Dosing
FDA Approved Indications
- Treatment of HIV-1 infection in adults and children aged 2 years and older, in combination with other antiretroviral agents.
Who Shouldn't Take Viracept?
- Known hypersensitivity to nelfinavir or any of the components in the formulation.
- Severe liver impairment.
- Concurrent use of drugs highly dependent on CYP3A4 for clearance (e.g., ergot derivatives, lovastatin).
Advice From The Pharmacist
- Take Viracept with food to improve absorption. Swallow the tablets whole, and avoid crushing or chewing them.
- For the oral powder, mix with water, milk, or formula. Do not mix with acidic foods or juices, as this can reduce its effectiveness.
- Consistency is key for HIV treatment, so do not skip doses. If you miss a dose, take it as soon as possible, but do not double up on doses.
- Regular blood tests are needed to monitor liver function and drug effectiveness.
Side Effects of Viracept
Common Side Effects
- Diarrhea
- Nausea
- Flatulence
- Rash
- Fatigue
Uncommon/Severe Side Effects
- Severe allergic reactions (e.g., rash, swelling, difficulty breathing)
- Liver damage (jaundice, dark urine, fatigue)
- Changes in body fat distribution (lipodystrophy)
Risks and Warnings of Viracept
- Liver Toxicity: Viracept can cause liver damage, particularly in individuals with pre-existing liver conditions. Liver function tests should be performed regularly.
- Diabetes and Insulin Resistance: Protease inhibitors like Viracept may cause or worsen diabetes, leading to increased blood sugar levels. Monitoring for symptoms of high blood sugar is important.
- Drug Interactions: Viracept interacts with many medications, including some that can lead to life-threatening reactions. Inform your healthcare provider of all medications and supplements you are taking.
Interactions with Viracept
Common Drug Interactions
- CYP3A4 substrates: Viracept is metabolized by the liver enzyme CYP3A4 and can interact with other drugs metabolized by this enzyme, including statins, ergot derivatives, and benzodiazepines.
- Oral contraceptives: Viracept may reduce the effectiveness of hormonal contraceptives. Alternative or additional non-hormonal birth control methods should be used.
- Warfarin: Viracept may alter the blood levels of warfarin, increasing the risk of bleeding or clotting.
Alternatives to Viracept
- Kaletra (lopinavir/ritonavir): Another protease inhibitor combination used for HIV treatment.
- Prezista (darunavir): A protease inhibitor used with a boosting agent (ritonavir or cobicistat) for the treatment of HIV.
- Reyataz (atazanavir): A once-daily protease inhibitor often used in combination with other antiretrovirals.
- Isentress (raltegravir): An integrase inhibitor, which is often used as part of combination therapy for HIV.
