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Viracept

nelfinavir
Used for HIV Treatment

Viracept (nelfinavir) is a protease inhibitor (PI) used to treat human immunodeficiency virus (HIV) in people ages 2 years and older. It works by preventing the HIV virus from making copies of itself and spreading. You take Viracept (nelfinavir) by mouth, typically twice or three times a day with a meal. One of the most common side effects Viracept (nelfinavir) can cause is diarrhea. Your provider might recommend over-the-counter medications, like loperamide (Imodium A-D), to help ease your symptoms.

Reviewed by:
reviewerAllison Gourley, PharmD
reviewerKristianne Hannemann, PharmD
Last reviewed on November 13, 2023
basics-icon

What is Viracept (nelfinavir)?

What is Viracept (nelfinavir) used for?

  • Treatment of HIV

How Viracept (nelfinavir) works

Viracept (nelfinavir) is a protease inhibitor. It works by blocking a protein called protease that helps the HIV virus infect your cells. When protease is blocked by Viracept (nelfinavir), the HIV virus can't make copies of itself and infect healthy cells.

Drug facts

Common BrandsViracept
Drug ClassHIV ARV
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
side-effects-icon

Side effects of Viracept (nelfinavir)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Adults and adolescents ages 13 years and older:

  • Diarrhea (up to 20%)
  • Nausea (up to 7%)

Children ages 2 to 12 years old:

  • Diarrhea (up to 47%)

Less Common Side Effects

  • Rash
  • Passing gas

Source: DailyMed

The following Viracept (nelfinavir) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Anxiety

bleeding gums

bloating

blood in the urine or stools

bloody, black, tarry stools

blurred vision

chest pain

chills

coma

confusion

constipation

cool, pale skin

cough

darkened urine

dehydration

dizziness

dry mouth

fast heartbeat

fever

flushed, dry skin

fruity mouth odor

increased hunger

increased thirst

increased urination

indigestion

joint pain, stiffness, or swelling

loss of appetite

nausea

nervousness

nightmares

painful or difficult urination

pains in the stomach, side, or abdomen, possibly radiating to the back

pinpoint red spots on the skin

seizures

shakiness

slurred speech

sore throat

sores, ulcers, or white spots on the lips or in the mouth

sweating

swelling of the feet or lower legs

swollen glands

trouble breathing

unusual bleeding or bruising

unusual tiredness or weakness

vomiting

vomiting of blood or material that looks like coffee grounds

yellow eyes or skin

weight loss

Incidence not known

Clay-colored stools

difficulty with breathing

drowsiness

fainting

headache

irregular heartbeat

muscle tremors

noisy breathing

rapid, deep breathing

recurrent fainting

restlessness

skin rash

unpleasant breath odor

vomiting of blood

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Diarrhea

Less common

Acid or sour stomach

belching

burning, crawling, itching, numbness, prickling, "pins and needles" , or tingling feelings

difficulty in moving

discouragement

feeling sad or empty

heartburn

increase in body movements

irritability

loss of interest or pleasure

muscle aches, cramps, pain, or stiffness

muscular tenderness, wasting or weakness

passing gas

redistribution or accumulation of body fat

sleepiness or unusual drowsiness

trouble concentrating

trouble sleeping

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Pros and cons of Viracept (nelfinavir)

Pros

  • Tablets can be dissolved in water
  • Can be used in children as young as 2 years old
  • Not a whole lot of side effects

Cons

  • Taken multiple times a day
  • One day's dose can be as many as 10 tablets
  • A lot of medication interactions, including some other HIV ARVs
pharmacist-tips-icon

Pharmacist tips for Viracept (nelfinavir)

pharmacist
  • Consider using a weekly pill box or smartphone app to help you remember to take Viracept (nelfinavir) and other HIV medications. Each dose of Viracept (nelfinavir) is made up of multiple tablets and you need to take a dose 2 to 3 times a day, which can be hard to keep track of.
  • Always take Viracept (nelfinavir) with food. This will help with how your body absorbs the medication. Tell your healthcare provider if you're concerned about consistent, reliable access to food. There might be resources they can help you with, or they might choose to have you on a medication that doesn't need to be taken with food.
  • If you have a hard time swallowing the Viracept (nelfinavir) tablets, try making a mixture to drink. Put the tablet in a small amount of water. Once it dissolves, mix the liquid until it's cloudy, then drink the mixture right away. Rinse the glass with water and drink the rinse so that you make sure you're getting the whole dose.
  • If you're taking the oral powder version of Viracept (nelfinavir), you can mix it with water, milk, formula, soy milk or dietary supplements. If you don't take your full dose right away, it can be stored in the refrigerator for up to 6 hours. After this amount of time, you must throw the mixture away.
  • Talk to your healthcare provider or pharmacist before starting any new medications. Viracept (nelfinavir) interacts with a lot of medications, and can make the levels in your body too high and cause more side effects. Also make sure to tell your providers if you stop taking Viracept (nelfinavir). Your providers might need to lower the dose of other medications to adjust for the interaction.
  • If you take hormonal birth control pills, you should also use another form of contraception. The birth control pills might not work as well while you're taking Viracept (nelfinavir).
faq-icon

Common questions about Viracept (nelfinavir)

Viracept (nelfinavir) needs to be taken with food, so it's best that you take it around times when you typically eat meals. For example, if your provider instructed you to take Viracept (nelfinavir) twice a day, you can take your medication with breakfast and dinner every day.

You should take your dose of Viracept (nelfinavir) as soon as you realize you missed it. But if the timing is too close to your next scheduled dose, skip the missed dose and just take the next dose at the next scheduled time. Never double up on doses. If you find yourself missing several doses of your HIV medications, have a discussion with your provider. Missing too many doses of Viracept (nelfinavir) can cause the infection to become more difficult to treat (resistance)

Get medical help right away if you think you took too much Viracept (nelfinavir). There's no antidote for Viracept (nelfinavir) and there's limited information about how taking too much of this medication might affect your body. If needed, a provider might help you empty your stomach, or they might give you activated charcoal to absorb some of the medication (but this only works well if you get medical help right away).

You're recommended to avoid mixing Viracept (nelfinavir) with acidic drink or food (e.g., orange juice, apple juice, or applesauce). Doing so can cause the mixture to have a really bitter taste. If you need to dissolve the Viracept (nelfinavir) tablets, do so in a small amount of water. If you're taking the Viracept (nelfinavir) oral powder, dissolve it in a small amount of water, milk or formula (including soy-based products), or liquid dietary supplements.

If you're pregnant, talk with your provider before starting Viracept (nelfinavir). Limited reports suggest that Viracept (nelfinavir) can raise the risk for birth defects in babies and liver problems in mothers. But you might be able to take Viracept (nelfinavir) during pregnancy if you and your provider determine the benefit outweighs its risk of harm to you and your unborn baby. If you decide to take this medication during pregnancy, you're encouraged to enroll in a Pregnancy Registry that monitors the health of mothers and babies by calling 1-800-258-4263.

Viracept (nelfinavir) is known to interact with many commonly prescribed medications. For example, Viracept (nelfinavir) can raise the risk of side effects from certain medications (e.g., trazodone, colchicine (Colcrys), tacrolimus) because it raises their levels in the body. Alternatively, there's also a chance that certain medications can lower the levels of Viracept (nelfinavir) and cause it to not work as well to treat your HIV (e.g., omeprazole (Prilosec)). If you're not sure if Viracept (nelfinavir) will interact with your other medications, ask your provider or pharmacist to check.

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Risks and warnings for Viracept (nelfinavir)

Viracept (nelfinavir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Drug interactions

  • Risk factors: Taking other medications or supplements

Viracept (nelfinavir) can interact with many other medications. Depending on what other medications you're taking, your provider might need to adjust the dose of Viracept (nelfinavir) or those other medications. Otherwise, the interactions can either cause the levels of Viracept (nelfinavir) to drop too low and not work well to fight HIV; or the levels of Viracept (nelfinavir) might be too high and cause more unwanted side effects. Talk to your healthcare provider or pharmacist before starting or stopping any medication.

Diabetes

  • Risk factors: Use of protease inhibitors

Viracept (nelfinavir) and other protease inhibitors can raise your blood sugar levels and lead to diabetes. If you already have diabetes, it can make it worse. Be sure to keep your regularly scheduled appointments and check your blood sugar at home if your provider tells you to.

Fat redistribution

  • Risk factors: Taking HIV ARVs

Some people taking HIV ARVs, including Viracept (nelfinavir), have noticed changes to the way fat is located in the body. This might cause more fat in the abdomen and upper back, and less fat in the face, arms, and legs. Scientists and health care providers don't really know why this happens.

Immune reconstitution syndrome

  • Risk factors: Weakened immune system | Current untreated infection

Taking Viracept (nelfinavir) and other HIV medications can raise your risk of immune reconstitution inflammatory syndrome (IRIS). This can happen after your immune system starts to recover with the help of HIV treatment. Once your immune system is strong enough to fight off infections, this can result in a lot of inflammation. Too much inflammation can lead to symptoms of IRIS. Call your provider if you experience fever, difficulty breathing, or sudden changes to your health after starting Viracept (nelfinavir).

Not for people with liver problems

If you have moderate or severe liver problems, let your provider know. You likely won't be able to take Viracept (nelfinavir) and they'll talk with you about other options.

Caution in people with phenylketonuria (PKU) - Oral powder only

Viracept (nelfinavir) contains phenylalanine, a component of the artificial sweetener aspartame. If you have a genetic condition called phenylketonuria (PKU), taking this medication can be dangerous for you. Let your provider know if you have PKU so they can prescribe a different formulation of Viracept (nelfinavir) that might be safer for you.

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Viracept (nelfinavir) dosage

The average cost for 360 tablets of 625mg of Viracept (nelfinavir) is $3,502.57 with a free GoodRx coupon. This is 12.60% off the average retail price of $4,007.67.
tabletTablet
DosageQuantityPrice as low asPrice per unit
250mg30 tablets$122.79$4.09
625mg360 tablets$3,502.57$9.73

Typical dosage for Viracept (nelfinavir)

Viracept (nelfinavir) is available as 250 mg tablets and 625 mg tablets that can be swallowed or dissolved in a small amount of water. For people or children who can't swallow the tables, there's also an oral powder version that can be mixed with milk, formula, soy formula, soy milk, or dietary supplements.

  • Adults and adolescents (ages 13 years and older): The typical dose is 1,250 mg by mouth twice a day with meals, or 750 mg by mouth three times a day with meals.

  • Children (ages 2 to 12 years old): Your child's provider will calculate the dose based on the child's weight. The typical dose ranges from 45 mg/kg to 55 mg/kg by mouth twice a day with meals, or 25 mg/kg to 35 mg/kg three times a day with meals.

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Interactions between Viracept (nelfinavir) and other drugs

Viracept (nelfinavir) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Viracept (nelfinavir). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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Viracept (nelfinavir) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Viracept (nelfinavir) will not be safe for you to take.

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What are alternatives to Viracept (nelfinavir)?

There are a number of medications that your doctor can prescribe in place of Viracept (nelfinavir). Compare a few possible alternatives below.
Viracept (nelfinavir)
Used for:
  • Treatment of HIV
$122.79Lowest GoodRx priceView prices
Used for:
  • Treatment of HIV infection in people aged 3 years and older
$69.85Lowest GoodRx priceView prices
Used for:
$120.74Lowest GoodRx priceView prices
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Viracept (nelfinavir) images

White Oval V And 625 - VIRACEPT 625mg Tablet
This medicine is White, Oval Tablet Imprinted With "625" And "V".White Oval V And 625 - VIRACEPT 625mg Tablet

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References

Best studies we found

AGOURON. (2023). Viracept- nelfinavir mesylate tablet, film coated [package insert]. DailyMed.

Clinical Info HIV.gov. (n.d.). Immune reconstitution inflammatory syndrome (IRIS).

Clinical Info HIV.gov. (n.d.). Protease inhibitor (PI).

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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