Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States

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.

  •   Table of Contents

Download Guidelines

Protease Inhibitors

Nelfinavir (Viracept, NFV)

Last Updated: December 7, 2018; Last Reviewed: December 7, 2018

Excerpt from Table 10a
Generic Name
(Abbreviation)
Trade Name
Formulation Dosing Recommendations Use in Pregnancy
Nelfinavir
(NFV)
Viracept
NFV (Viracept)
Tablets:
  • 250 mg
  • 625 mg (tablets can be dissolved in a small amount of water)
Powder for Oral Suspension:
  • 50 mg/g
Standard Adult Dose:
  • NFV 1250 mg twice daily, or
  • NFV 750 mg 3 times daily with food
PK in Pregnancy:
  • Lower NFV exposure was observed during the third trimester than postpartum in women receiving NFV 1250 mg twice daily; however, adequate drug levels are generally achieved during pregnancy, although levels are variable in late pregnancy.
Dosing in Pregnancy:
  • NFV 750 mg 3 times daily with food is not recommended during pregnancy. No change in standard dose (NFV 1250 mg twice daily with food) indicated.
NFV should not be used during pregnancy.

Minimal to low placental transfer to fetus.b

No evidence of human teratogenicity; can rule out 1.5-fold increase in overall birth defects and 2-fold increase in risk of cardiovascular and genitourinary birth defects.

Contains aspartame; should not be used in individuals with phenylketonuria.
a Individual antiretroviral drug doses may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Guidelines Appendix B, Table 8).
b Placental transfer categories are determined by mean or median cord blood/maternal delivery plasma drug ratio:
          High: >0.6
          Moderate: 0.3–0.6
          Low: <0.3

Key to Acronyms: NFV = nelfinavir; PK = pharmacokinetic

Download Guidelines