Nelfinavir
- TRADE NAME: Viracept (ViiV)
- INDICATIONS: HIV infection
- CLASS: Antiretroviral, Covid-19 putative drug, CYP3A4 inhibitor, HIV-1 protease inhibitor
- HALF-LIFE: 3.5–5 hours
Abiraterone, Afatinib, Alfuzosin, Amiodarone, Amprenavir, Aripiprazole, Artemether/Lumefantrine, Atorvastatin, Avanafil, Barbiturates, Benzodiazepines, Brigatinib, Cabazitaxel, Cabozantinib, Calcifediol, Carbamazepine, Chlordiazepoxide, Ciclesonide, Cisapride, Clonazepam, Clorazepate, Copanlisib, Crizotinib, Cyclosporine, Darifenacin, Dasatinib, Delavirdine, Diazepam, Dihydroergotamine, Eletriptan, Eplerenone, Ergot alkaloids, Ergotamine, Erlotinib, Estrogens, Eszopiclone, Etravirine, Eucalyptus, Everolimus, Fentanyl, Fesoterodine, Flibanserin, Flurazepam, Fluticasone Propionate, Indinavir, Ivabradine, Ixabepilone, Lapatinib, Lomitapide, Lopinavir, Lorazepam, Lovastatin, Lumateperone, Maraviroc, Methadone, Methylergonovine, Methysergide, Midazolam, Midostaurin, Mifepristone, Neratinib, Olaparib, Omeprazole, Oral Contraceptives, Oxazepam, Paclitaxel, Palbociclib, Pantoprazole, Pazopanib, Phenytoin, Pimozide, Ponatinib, Primidone, Progestogens, Quazepam, Quinidine, Quinine, Ranolazine, Rifabutin, Rifampin, Rilpivirine, Ritonavir, Rivaroxaban, Romidepsin, Rosuvastatin, Ruxolitinib, Saquinavir, Sildenafil, Simeprevir, Simvastatin, Solifenacin, St John's Wort, Sunitinib, Tacrolimus, Tadalafil, Telithromycin, Temazepam, Temsirolimus, Ticagrelor, Tolterodine, Tolvaptan, Triazolam, Vardenafil, Vemurafenib, Vorapaxar
PREGNANCY CATEGORY: B
See adverse reactions attributed to class:
Protease inhibitors cause dyslipidemia which includes elevated triglycerides and cholesterol and redistribution of body fat centrally to produce the so-called 'protease paunch', breast enlargement, facial atrophy, and 'buffalo hump'
Rash <10%
(2016): Hill EJ+, Clin Cancer Res 22(8), 1922 (grade 3 / 1 case)
(2008): Moura MD+, J Contemp Dent Pract 9 (1), 84
(2001): Abraham PE+, Ann Pharmacother 35(5), 553
(2000): Fortuny C+, AIDS 14, 335
Vasculitis (angiitis) / cutaneous vasculitis (angiitis)
(1998): Bourezane Y+, Clin Infect Dis 27(5), 1321
Diarrhea
(2016): Hill EJ+, Clin Cancer Res 22(8), 1922 (grade 3 / 1 case)
(2014): Alonso-Basanta M+, J Neurooncol 116(2), 365 (with temozolomide and radiotherapy)
(2014): Blumenthal GM+, Oncotarget 5(18), 8161
Hepatotoxicity / liver injury / acute liver injury / drug-induced liver injury (DILI)
(2014): Alonso-Basanta M+, J Neurooncol 116(2), 365 (with temozolomide and radiotherapy)
(2006): Brown LS+, J Subst Abuse Treat 30(4), 331
(2006): Mira JA+, J Antimicrob Chemother 58(1), 140
Urolithiasis
(2014): Izzedine H+, Clin Kidney J 7(2), 121 [REVIEW]
(2002): Engeler DS+, J Urol 167(3), 1384
Leukocytopenia (leukopenia) / leukocytes (white blood cells) decreased
(2012): Rengan R+, J Thorac Oncol 7(4), 709 (grade 4 / 6 cases)
Lymphopenia (lymphocytopenia) / lymphocytes decreased
(2016): Hill EJ+, Clin Cancer Res 22(8), 1922 (grade 3 / 1 case)
(2014): Blumenthal GM+, Oncotarget 5(18), 8161
Adverse effects / adverse reactions
(2016): Smith C+, Infect Dis Obstet Gynecol Apr, Epub [REVIEW]
(in infants following maternal ingestion)
Adverse reactions attributed to entire drug class Antiretroviral
Hematological adverse effect
(2019): Oumar AA+, Int J Basic Clin Pharmacol 8(5), 83115%
Optic neuropathy
(2013): Wang MY+, J Neuroophthalmol 33(2), 172 [REVIEW]
Adverse effects / adverse reactions
(2019): Oumar AA+, Int J Basic Clin Pharmacol 8(5), 83142%
(2014): Lorio M+, J Int Assoc Provid AIDS Care 13(5), 4666%
Adverse reactions attributed to entire drug class Covid-19 putative drug
Cutaneous adverse reaction (includes severe cutaneous adverse drug reaction (SCAR))
(2020): Tursen U+, Dermatol Ther May, Epub ahead of print [REVIEW]
Cardiovascular adverse effect
(2020): Carpenter A+, Front Cardiovasc Med 7, 85 [REVIEW]
(2020): Giudicessi JR+, Mayo Clin Proc May, Online ahead of print [REVIEW]
(2020): Naksuk N+, Eur Heart J Acute Cardiovasc Care May, Epub ahead of print [REVIEW]
(2020): Sarayani A+, Res Social Adm Pharm Apr, Epub ahead of print [REVIEW]
(2020): Zhang D+, Zhongguo Zhong Yao Za Zhi (Chinese) 45(10), 2275-2286 [REVIEW]
Neuropsychiatric / neuropsychological adverse effect
(2021): Borah P+, Front Mol Biosci 8, 627723
(2020): García CAC+, Gen Hosp Psychiatry Jun, Online ahead of print [REVIEW]
Gastrointestinal disorder / discomfort
(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print23%
Hepatic (liver) disorder / hepatobiliary disorder / hepatic (liver) dysfunction
(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print14%
Thrombocytopenia
(2020): Nham E+, Infect Chemother Apr, Epub ahead of print
Adverse effects / adverse reactions
(2022): Aguilera C+, Diagnostics (Basel) 12(7), 1612
(2022): Chiu MN+, Eur J Clin Pharmacol Jan, Online ahead of print [REVIEW]
(2021): Bérard A+, PLoS One 16(5), e0251746 [REVIEW] (in pregnancy)
(2021): Cheng Q+, Aging (Albany NY) Sep, Online ahead of print [REVIEW]
(2021): Cruciani F+, Recenti Prog Med 112(3), 195-206 [REVIEW]
(2021): Drożdżal S+, Drug Resist Updat Dec, eCollection [REVIEW]
(2021): Ommati MM+, J Biochem Mol Toxicol May, Online ahead of print [REVIEW]
(2021): Qiu R+, Medicine (Baltimore) 100(16), e25532 [REVIEW]
(2021): Wu SS+, Chin Med J (Engl) Jul, Online ahead of print [REVIEW]
(2020): Favilli A+, J Matern Fetal Neonatal Med Jun, Online ahead of print [REVIEW]
(2020): Griffiths G+, Trials 21(1), 544
(2020): Patil VM+, Life Sci May, Epub ahead of print [REVIEW]
(2020): Rhodes NJ+, medRxiv Jun, Preprint
(2020): Sun J+, Clin Pharmacol Ther Apr, Epub ahead of print38%
(2020): Svensson M, Lakartidningen (Swedish) Apr, 117
(2020): Wen CY+, Zhonghua Nei Ke Za Zhi (Chinese) May, Epub ahead of print
(2020): Zekarias A+, Drug Saf Sep, Online ahead of print [REVIEW]
(2020): Zhong H+, Pharmacol Res Apr, Epub ahead of print [REVIEW]
Adverse reactions attributed to entire drug class HIV-1 protease inhibitor
Eczema / eczematous reaction / eczematous eruption
(2015): Descamps V+, Br J Dermatol 173(1), 311
Xerosis
(2015): Descamps V+, Br J Dermatol 173(1), 311
Page last updated 08/03/2022
Symbol key
Incidence 
- <1%
- 1-5%
- 5-10%
- 10-15%
- 15-20%
- 20-30%
- >30%
Seriousness
- Hospitalization possible
- Life threatening
- Fatal
Warnings in other populations
- Breast feeding
- Geriatric
- Pediatric
