Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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Protease Inhibitors (PIs)

Nelfinavir

Last Updated: May 22, 2018; Last Reviewed: May 22, 2018

Nelfinavir (NFV, Viracept)
Nelfinavir (NFV, Viracept)
For additional information see Drugs@FDA: http://www.accessdata.fda.gov/scripts/cder/daf/
Formulations
Tablets: 250 mg and 625 mg
Dosing Recommendations Selected Adverse Events

Note: The Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV no longer recommends nelfinavir-based regimens for use in children due to inferior potency compared to other regimens. 

Neonate and Infant Dose:

  • Nelfinavir should not be used for treatment in children aged <2 years.
Pediatric Dose (Aged ≥2 Years):
  • 45–55 mg/kg twice daily
Adolescent and Adult Dose:
  • 1250 mg (five 250-mg tablets or two 625-mg tablets) twice daily
  • Diarrhea
  • Hyperlipidemia
  • Hyperglycemia
  • Fat maldistribution
  • Serum transaminase elevations
Special Instructions
  • Administer nelfinavir with meal or light snack.
  • If co-administered with didanosine, administer nelfinavir 2 hours before or 1 hour after didanosine.
  • Patients unable to swallow nelfinavir tablets can dissolve the tablets in a small amount of water. Once tablets are dissolved, mix the cloudy mixture well and consume it immediately. The glass should be rinsed with water and the rinse swallowed to ensure that the entire dose is consumed. Tablets can also be crushed and administered with pudding or other nonacidic foods.
Metabolism/Elimination
  • Cytochrome P (CYP) 2C19 and 3A4 substrate
  • Metabolized to active M8 metabolite
  • CYP3A4 inhibitor

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