Nelfinavir interactions
Full monograph for NelfinavirCheck it against another medicine
Medicines
456 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Abemaciclib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of abemaciclib and its pharmacologically active… | 4 sources — open the full entry |
| Acalabrutinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of acalabrutinib, which is primarily metabolized by… | 4 sources — open the full entry |
| Alfuzosin Hydrochloride | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of alfuzosin, which is primarily metabolized by the… | 8 sources — open the full entry |
| Amiodarone Hydrochloride | Major | Metabolism | Coadministration with nelfinavir may significantly increase the plasma concentrations of amiodarone and quinidine. The proposed mechanism is nelfinavir… | 7 sources — open the full entry |
| Amlodipine Besilate + Atorvastatin | Major | Metabolism | Protease inhibitors (PIs), particularly ritonavir, may significantly increase the plasma concentrations of atorvastatin. The mechanism is PI inhibition of…2 documented mechanisms | 108 sources — open the full entry |
| Apixaban | Major | Absorption · Metabolism | Coadministration with potent inhibitors of CYP450 3A4 that can also inhibit P-glycoprotein (P-gp) may significantly increase the plasma concentrations of… | 6 sources — open the full entry |
| Artemether + Lumefantrine | Major | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of artemether and lumefantrine, both of which are primarily metabolized…2 documented mechanisms | 9 sources — open the full entry |
| Atorvastatin + Ezetimibe | Major | Metabolism · Unknown | Protease inhibitors (PIs), particularly ritonavir, may significantly increase the plasma concentrations of atorvastatin. The mechanism is PI inhibition of…2 documented mechanisms | 103 sources — open the full entry |
| Atorvastatin Calcium | Major | Metabolism | Protease inhibitors (PIs), particularly ritonavir, may significantly increase the plasma concentrations of atorvastatin. The mechanism is PI inhibition of… | 103 sources — open the full entry |
| Avanafil | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of avanafil, which is primarily metabolized by the… | 10 sources — open the full entry |
| Axitinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of axitinib, which is primarily metabolized by the… | 7 sources — open the full entry |
| Azelastine Hydrochloride + Fluticasone Propionate | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation… | 40 sources — open the full entry |
| Betrixaban | Major | Others | Coadministration with inhibitors of P-glycoprotein (P-gp) may significantly increase the plasma concentrations of betrixaban, which is a substrate of the… | 11 sources — open the full entry |
| Brexpiprazole | Major | Metabolism | Coadministration with inhibitors of CYP450 3A4 and/or 2D6 may significantly increase the plasma concentrations of brexpiprazole, which is metabolized by these… | 5 sources — open the full entry |
| Brigatinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of brigatinib, which is partially metabolized by the… | 4 sources — open the full entry |
| BudesonideInhalerNebuliser SuspensionTablet | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the systemic bioavailability of budesonide, which undergoes extensive… | 19 sources — open the full entry |
| Budesonide + Formoterol Fumarate | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the systemic bioavailability of budesonide, which undergoes extensive… | 19 sources — open the full entry |
| Budesonide + Glycopyrronium Bromide + Formoterol Fumarate | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the systemic bioavailability of budesonide, which undergoes extensive… | 19 sources — open the full entry |
| Cabozantinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of cabozantinib, which is a substrate of the isoenzyme. High… | 7 sources — open the full entry |
| Capmatinib Hydrochloride | Major | Metabolism | Coadministration of capmatinib with strong CYP450 3A4 inhibitors may increase the risk and severity of capmatinib adverse effects, such as interstitial lung… | 3 sources — open the full entry |
| Cariprazine | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of cariprazine and its major active metabolite… | 5 sources — open the full entry |
| Caspofungin Acetate | Major | Metabolism | Coadministration with inducers or mixed inducer/inhibitors of certain metabolic pathways may produce clinically meaningful reductions in the plasma… | 1 sources — open the full entry |
| Ceritinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of ceritinib, which is a substrate of the isoenzyme… | 6 sources — open the full entry |
| Cilostazol | Major | Metabolism | Coadministration with inhibitors of CYP450 3A4 and/or 2C19 may increase the plasma concentrations of cilostazol and or its pharmacologically active… | 12 sources — open the full entry |
| Colchicine | Major | Metabolism | Coadministration with inhibitors of CYP450 3A4 may significantly increase the serum concentrations of colchicine, which is primarily metabolized by the… | 44 sources — open the full entry |
| Crizotinib | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of crizotinib, which is primarily metabolized by the… | 6 sources — open the full entry |
| Cyclosporine (Oral) | Major | Absorption · Metabolism | Coadministration with protease inhibitors (PIs), especially ritonavir, may significantly increase the blood concentrations of cyclosporine. The risk of nephro-… | 29 sources — open the full entry |
| Daclatasvir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of daclatasvir, which is primarily metabolized by… | 4 sources — open the full entry |
| Daclatasvir + Sofosbuvir | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of daclatasvir, which is primarily metabolized by… | 4 sources — open the full entry |
| Darifenacin | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of darifenacin, which is partially metabolized by… | 7 sources — open the full entry |
| Dasatinib | Major | Metabolism | Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations and pharmacologic effects of dasatinib, which is primarily metabolized by… | 8 sources — open the full entry |
| Deflazacort | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Dexlansoprazole | Major | Absorption | Concurrent use of proton pump inhibitors may decrease the oral bioavailability of nelfinavir and reduce its concentrations in plasma. Nelfinavir solubility may… | 2 sources — open the full entry |
| Docetaxel Trihydrate | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 or dual CYP450 3A4 and P-glycoprotein (P-gp) inhibitors may significantly increase the plasma… | 21 sources — open the full entry |
| Drospirenone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of drospirenone which is primarily metabolized by… | 9 sources — open the full entry |
| Drospirenone + Estetrol | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of drospirenone which is primarily metabolized by… | 9 sources — open the full entry |
| Drospirenone + Estradiol | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of drospirenone which is primarily metabolized by…2 documented mechanisms | 17 sources — open the full entry |
| Drospirenone + Ethinyl Estradiol0.02 mg0.03 mg | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of drospirenone which is primarily metabolized by…2 documented mechanisms | 45 sources — open the full entry |
| Drospirenone + Ethinyl Estradiol + Levomefolate | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of drospirenone which is primarily metabolized by…2 documented mechanisms | 45 sources — open the full entry |
| Econazole Nitrate + Triamcinolone Acetonide | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of triamcinolone. | 14 sources — open the full entry |
| Elacestrant | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of elacestrant, which is primarily… | 1 sources — open the full entry |
| Elagolix Sodium | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of elagolix, which is a substrate of the isoenzyme… | 3 sources — open the full entry |
| Eplerenone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may significantly increase the plasma concentrations and risk of adverse reactions of eplerenone, which… | 3 sources — open the full entry |
| Erdafitinib | Major | Metabolism | Coadministration of erdafitinib with potent inhibitors of CYP450 2C9 or 3A4 may increase the plasma concentrations and risk of toxicity of erdafitinib, which… | 1 sources — open the full entry |
| Ergometrine Maleate | Major | Metabolism | Coadministration with protease inhibitors (PIs), particularly ritonavir, may significantly increase the plasma concentrations of ergot derivatives. The… | 62 sources — open the full entry |
| ErythromycinLotionOral | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of erythromycin, which is primarily metabolized by the isoenzyme… | 11 sources — open the full entry |
| EsomeprazolebaseMUPS preparation | Major | Absorption | Concurrent use of proton pump inhibitors may decrease the oral bioavailability of nelfinavir and reduce its concentrations in plasma. Nelfinavir solubility may… | 2 sources — open the full entry |
| Esomeprazole + Amoxicillin + Clarithromycin | Major | Absorption · Metabolism | Concurrent use of proton pump inhibitors may decrease the oral bioavailability of nelfinavir and reduce its concentrations in plasma. Nelfinavir solubility may…2 documented mechanisms | 3 sources — open the full entry |
| Eszopiclone | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 may increase the plasma concentrations of both zopiclone and its pharmacologically active S(-)… | 7 sources — open the full entry |
| Everolimus | Major | Metabolism | Coadministration with potent inhibitors of CYP450 3A4 and P-glycoprotein may significantly increase the plasma concentrations of everolimus following oral… | 5 sources — open the full entry |
Conditions
Conditions in which Nelfinavir needs care, as documented in this source.
Hemophilia A
MajorThere have been postmarketing reports of increased bleeding, including spontaneous skin hematomas and hemarthrosis, in types A and B hemophiliac patients treated with protease inhibitors. However, a causal relationship has not been established. In some patients, additional Factor VIII was given. In more than half of the reported cases, protease inhibitor therapy was continued or reintroduced following an interruption. Hemophiliacs and patients with other coagulation defects should be monitored closely for bleeding during protease inhibitor therapy.
11 sources
- "Product Information. Invirase (saquinavir)." Roche Laboratories (2001):
- "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical (2001):
- "Product Information. Crixivan (indinavir)." Merck & Co., Inc (2001):
- "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc (2001):
- "Product Information. Agenerase (amprenavir)." Glaxo Wellcome (2001):
- "Product Information. Kaletra (lopinavir-ritonavir)." Abbott Pharmaceutical (2001):
- "Product Information. Fortovase (saquinavir)." Roche Laboratories (2001):
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb (2003):
Show all 11 sourcesShow fewer sources
- "Product Information. Lexiva (fosamprenavir)." GlaxoSmithKline (2003):
- "Product Information. Aptivus (tipranavir)." Boehringer-Ingelheim (2005):
- "Product Information. Prezista (darunavir)." Ortho Biotech Inc (2006):
Hyperglycemia
ModerateNew onset diabetes mellitus, exacerbation of preexisting diabetes mellitus, glucose intolerance, hyperglycemia, and some cases of diabetic ketoacidosis have been reported during postmarketing surveillance in HIV-infected patients treated with protease inhibitors (PIs). In some cases, glucose abnormalities/hyperglycemia persisted despite discontinuation of PI therapy. Frequently, insulin resistance may accompany fat redistribution and serum lipid elevations in what is collectively termed the HIV-associated lipodystrophy syndrome. Although a causal relationship has not been established, these metabolic disturbances have most often occurred in HIV-infected patients during treatment with potent antiretroviral regimens containing PIs. Monitoring patients for hyperglycemia, new onset diabetes mellitus, or exacerbation of diabetes mellitus should be considered during PI therapy. Dosage adjustments in insulin or oral hypoglycemic medications may be necessary in patients with diabetes.
23 sources
- "Product Information. Invirase (saquinavir)." Roche Laboratories (2001):
- "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical (2001):
- "Product Information. Crixivan (indinavir)." Merck & Co., Inc (2001):
- "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc (2001):
- Dube MP, Johnson DL, Currier JS, Leedom JM "Protease inhibitor-associated hyperglycaemia." Lancet 350 (1997): 713-4
- Walli R, Demant T "Impaired glucose tolerance and protease inhibitors." Ann Intern Med 129 (1998): 837-8
- "Product Information. Agenerase (amprenavir)." Glaxo Wellcome (2001):
- Mauss S, Wolf E, Jaeger H "Impaired glucose tolerance in HIV-positive patients receiving and those not receiving protease inhibitors." Ann Intern Med 130 (1999): 162-3
Show all 23 sourcesShow fewer sources
- Kaufman MB, Simionatto C "A review of protease inhibitor-induced hyperglycemia." Pharmacotherapy 19 (1999): 114-7
- Struble K, Piscitelli SC "Syndromes of abnormal fat redistribution and metabolic complications in HIV-infected patients." Am J Health Syst Pharm 56 (1999): 2343-8
- Qaqish RB, Fisher E, Rublein J, Wohl DA "HIV-associated lipodystrophy syndrome." Pharmacotherapy 20 (2000): 13-22
- Pujol RM, Domingo P, XavierMatiasGuiu, Francia E, Sanbeat MA, Alomar A, Vazquez G "HIV-1 protease inhibitor-associated partial lipodystrophy: Clinicopathologic review of 14 cases." J Am Acad Dermatol 42 (2000): 193-8
- Tsiodras S, Mantzoros C, Hammer S, Samore M "Effects of protease inhibitors on hyperglycemia, hyperlipidemia, and lipodystrophy - A 5-year cohort study." Arch Intern Med 160 (2000): 2050-6
- Carr A "HIV protease inhibitor-related lipodystrophy syndrome." Clin Infect Dis 30 (2000): s135-42
- "Product Information. Kaletra (lopinavir-ritonavir)." Abbott Pharmaceutical (2001):
- "Product Information. Fortovase (saquinavir)." Roche Laboratories (2001):
- Hardy H, Esch LD, Morse GD "Glucose disorders associated with HIV and its drug therapy." Ann Pharmacother 35 (2001): 343-51
- Noor MA, Lo JC, Mulligan K, Schwarz JM, Halvorsen RA, Schambelan M, Grunfeld C "Metabolic effects of indinavir in healthy HIV-seronegative men." Aids 15 (2001): f11-8
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb (2003):
- Brambilla AM, Novati R, Calori G, et al. "Stavudine or indinavir-containing regimens are associated with an increased risk of diabetes mellitus in HIV-infected individuals." AIDS 17 (2003): 1993-5
- "Product Information. Lexiva (fosamprenavir)." GlaxoSmithKline (2003):
- "Product Information. Aptivus (tipranavir)." Boehringer-Ingelheim (2005):
- "Product Information. Prezista (darunavir)." Ortho Biotech Inc (2006):
Hyperlipidemias
ModerateHyperlipidemia has been observed in 10% of patients receiving ritonavir during clinical trials. Increases of 30% to 40% from baseline have been reported for total cholesterol and 200% to 300% or more for triglycerides. These effects have also been reported during postmarketing experience with other protease inhibitors (PIs) but may be the most dramatic with ritonavir. The clinical significance of these elevations is unclear. Severe hyperlipidemia is known to sometimes cause pancreatitis. In addition, some patients have reportedly developed symptomatic atherosclerosis and coronary artery disease after initiating PI treatment. Patients with preexisting hyperlipidemia may require closer monitoring during PI therapy, and adjustments made accordingly in their lipid-lowering regimen. PI therapy should be administered cautiously in patients with coronary artery disease or a history of ischemic heart disease.
19 sources
- "Product Information. Invirase (saquinavir)." Roche Laboratories (2001):
- "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical (2001):
- "Product Information. Crixivan (indinavir)." Merck & Co., Inc (2001):
- "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc (2001):
- Sullivan AK, Feher MD, Nelson MR, Gazzard BG "Marked hypertriglyceridaemia associated with ritonavir therapy." AIDS 12 (1998): 1393-4
- Karmochkine M, Raguin G "Severe coronary artery disease in a young HIV-infected man with no cardiovascular risk factor who was treated with indinavir." AIDS 12 (1998): 2499
- "Product Information. Agenerase (amprenavir)." Glaxo Wellcome (2001):
- Segerer S, Bogner JR, Walli R, Loch O, Goebel FD "Hyperlipidemia under treatment with proteinase inhibitors." Infection 27 (1999): 77-81
Show all 19 sourcesShow fewer sources
- Echevarria KL, Hardin TC, Smith JA "Hyperlipidemia associated with protease inhibitor therapy." Ann Pharmacother 33 (1999): 859-63
- Flynn TE, Bricker LA "Myocardial infarction in HIV-infected men receiving protease inhibitors." Ann Intern Med 131 (1999): 548
- Struble K, Piscitelli SC "Syndromes of abnormal fat redistribution and metabolic complications in HIV-infected patients." Am J Health Syst Pharm 56 (1999): 2343-8
- Tsiodras S, Mantzoros C, Hammer S, Samore M "Effects of protease inhibitors on hyperglycemia, hyperlipidemia, and lipodystrophy - A 5-year cohort study." Arch Intern Med 160 (2000): 2050-6
- "Product Information. Kaletra (lopinavir-ritonavir)." Abbott Pharmaceutical (2001):
- "Product Information. Fortovase (saquinavir)." Roche Laboratories (2001):
- Noor MA, Lo JC, Mulligan K, Schwarz JM, Halvorsen RA, Schambelan M, Grunfeld C "Metabolic effects of indinavir in healthy HIV-seronegative men." Aids 15 (2001): f11-8
- Costa A, Pulido F, Rubio R, Cepeda C, Torralba M, Costa JR "Lipid changes in HIV-infected patients who started rescue therapy with an amprenavir/ritonavir-based highly active antiretroviral therapy." AIDS 16 (2002): 1983-4
- "Product Information. Reyataz (atazanavir)." Bristol-Myers Squibb (2003):
- "Product Information. Lexiva (fosamprenavir)." GlaxoSmithKline (2003):
- "Product Information. Aptivus (tipranavir)." Boehringer-Ingelheim (2005):
Liver Diseases
ModerateNelfinavir is primarily metabolized by the liver. Patients with liver disease may be at greater risk for adverse effects from nelfinavir due to decreased drug clearance. Therapy with nelfinavir should be administered cautiously in patients with liver disease.
2 sources
- "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc (2001):
- Sommadossi JP "HIV protease inhibitors: pharmacologic and metabolic distinctions." AIDS 13 (1999): s29-40
Phenylketonurias
ModerateViracept (brand of nelfinavir) oral powder contains 11.2 mg of phenylalanine per each gram of powder. The phenylalanine content should be considered when this product is used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).
1 source
- "Product Information. Viracept (nelfinavir)." Agouron Pharma Inc (2001):
Therapeutic duplication
Drug classes that overlap with Nelfinavir, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.
protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'protease inhibitors' category.
Example product in the source data (US market): Emtricitabine/lopinavir/ritonavir/tenofovir
protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'protease inhibitors' category.
Example product in the source data (US market): Nirmatrelvir/ritonavir
protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'protease inhibitors' category.
Example product in the source data (US market): Ombitasvir/paritaprevir/ritonavir
protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'protease inhibitors' category.
Example product in the source data (US market): Prezcobix
protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'protease inhibitors' category.
Example product in the source data (US market): Evotaz
protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'protease inhibitors' category.
Example product in the source data (US market): Symtuza
protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'protease inhibitors' category.
Example product in the source data (US market): Zepatier
protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'protease inhibitors' category.
Example product in the source data (US market): Dasabuvir/ombitasvir/paritaprevir/ritonavir
protease inhibitors
The recommended maximum number of medicines in the 'protease inhibitors' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'protease inhibitors' category.
Example product in the source data (US market): Lopinavir/ritonavir