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Nelfinavir Mesylate and Viekira XR

Determining the interaction of Nelfinavir Mesylate and Viekira XR and the possibility of their joint administration.

Check result:

Nelfinavir Mesylate <> Viekira XR

Relevance: 09.08.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using nelfinavir together with ritonavir may increase the effects of nelfinavir. Contact your doctor if you experience increased urination or extreme thirst, easy bruising or bleeding, or signs of a new infection, such as fever or chills, cough, or flu symptoms. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

ADJUST DOSE: Coadministration with ritonavir may significantly increase the plasma concentrations of nelfinavir. The mechanism is ritonavir inhibition of CYP450 3A4 metabolism of nelfinavir. According to the nelfinavir product labeling, ritonavir (500 mg orally every 12 hours for 3 doses) increased the peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of nelfinavir (750 mg single dose) by 44% and 152%, respectively, in 10 subjects (HIV status not stated). In a study involving 18 healthy volunteers, simultaneous administration of ritonavir (400 mg single oral dose) decreased the clearance of nelfinavir (750 mg single dose) 2-fold compared to when nelfinavir was administered alone. Nelfinavir had negligible effect on the pharmacokinetics of ritonavir.

MANAGEMENT: Alteration in dosages or regimen is recommended by the manufacturer of nelfinavir during concomitant therapy with ritonavir. However, appropriate dosages for the combination, with respect to safety and efficacy, have not been established. Patients receiving the combination should be closely monitored for toxicity such as elevations in liver function tests and undue gastrointestinal disturbances, and the dosage(s) adjusted as necessary.

References

Kempf DJ, Marsh KC, Kumar G, et al "Pharmacokinetic enhancement of inhibitors of the human immunodeficiency virus protease by coadministration with ritonavir." Antimicrob Agents Chemother 41 (1997): 654-60
Lu JF, Blaschke TF, Flexner C, Rosenkranz SL, Sheiner LB "Model-based Analysis of the Pharmacokinetic Interactions Between Ritonavir, Nelfinavir, and Saquinavir after Simultaneous and Staggered Oral Administration." Drug Metab Dispos 30 (2002): 1455-61
"Product Information. Viracept (nelfinavir)." Agouron Pharma Inc, La Jolla, CA.
Kempf D, Marsh K, Denissen J, Kumar G, Rodrigues D, McDonald E, Flentge C, Green B, Chen X, Leonard J, Norbeck D "Coadministration with ritonavir enhances the plasma levels of HIV protease inhibitors by inhibition of cytochrome P450." 3rd Conf Retro and Opportun Infect (1996): 79

Nelfinavir Mesylate

Generic Name: nelfinavir

Brand name: Viracept

Synonyms: Nelfinavir

What is Nelfinavir Mesylate?

Viekira XR

Generic Name: dasabuvir / ombitasvir / paritaprevir / ritonavir

Brand name: Viekira Pak, Viekira XR

Synonyms: n.a.

What is Viekira XR?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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