Viracept (nelfinavir)

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

- Diarrhoea.
- Nausea.
- Rash.
- Excess gas in the stomach and intestines (flatulence).
- Abdominal pain.
- Fever.
- Itching.
- Vomiting.
- Inflammation of the pancreas (pancreatitis).
- Inflammation of the liver (hepatitis).
- Raised cholesterol levels.
- Raised blood sugar level (hyperglycaemia).
- Pain in the muscles (myalgia).
- Inflammation of the muscles (myositis).
- Muscle breakdown (rhabdomyolysis).
- Decrease in the number of a type of white blood cell (neutrophil) in the blood (neutropenia).
- Redistribution of body fat, eg decreased fat under the skin, increased fat on the abdomen, 'buffalo humps' and breast enlargement.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

The following medicines must not be used in combination with nelfinavir, as nelfinavir may increase their blood levels and subsequently increase the risk of serious side effects:

- astemizole
- amiodarone
- cisapride
- dihydroergotamine
- ergotamine
- midazolam
- pimozide
- quinidine
- terfenadine
- triazolam.

You should not take the herbal remedy St John's wort (Hypericum perforatum) with this medicine, as it may decrease the blood level of nelfinavir and make it less effective.

The following medicines may also decrease the blood level and effect of nelfinavir:

- barbiturates, eg phenobarbital
- carbamazepine
- omeprazole
- rifampicin (must not be used with nelfinavir)
- rifabutin.

Nelfinavir increases the blood level of the antibiotic rifabutin. If you need to take rifabutin in combination with nelfinavir, your doctor will prescribe you a lower than normal dose of rifabutin.

Nelfinavir may increase the blood level of cholesterol-lowering medicines known as statins. Simvastatin and lovastatin are not recommended for use in combination with nelfinavir, as the increased levels of these statins may lead to side effects on the muscles. Atorvastatin should be used with caution and only at a low dose. If cholesterol-lowering treatment is needed, fluvastatin or pravastatin are preferred, as these are not affected by nelfinavir.

Nelfinavir may increase the blood level of sildenafil (Viagra), which increases the risk of side effects such as fainting, visual disturbances and prolonged erection.

Nelfinavir may also increase the blood levels of the following medicines, which could increase the risk of their side effects:

- aripiprazole
- calcium channel blockers such as bepridil
- ciclosporin
- eletriptan
- ivabradine
- tacrolimus.

Nelfinavir may decrease the blood level of the following medicines. If you are taking these with nelfinavir your doctor may therefore need to increase their dose:

- methadone
- phenytoin.

Nelfinavir may reduce the effectiveness of hormonal contraceptives containing ethinylestradiol. For this reason, a higher dose of these contraceptives may be needed to prevent pregnancy. Alternatively, other methods of contraception should be used. A barrier method of contraception, such as condoms, will prevent pregnancy as well as preventing transmission of the HIV virus. Discuss this with your doctor.

Your doctor may need to adjust the doses of other anti-HIV medicines you are already taking when this medicine is added to your treatment.

If you are taking didanosine as part of your anti-HIV therapy, it is recommended that you take this medicine with food an hour after, or at least two hours before taking your didanosine. This is because didanosine must be taken on an empty stomach.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain nelfinavir as the active ingredient.

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