STD Home > Precautions and Warnings With Nelfinavir

Make sure your healthcare provider knows if you have diabetes, phenylketonuria, or any allergies before starting nelfinavir. Warnings and precautions also include not taking the drug if you have moderate to severe liver disease and avoid taking certain other medications that may interact with nelfinavir. Being aware of precautions and warnings with nelfinavir before starting the medication can help minimize risks and ensure safe treatment.

Nelfinavir: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking nelfinavir mesylate (Viracept®) if you have:
  • Phenylketonuria
  • Liver disease, such as liver failure, cirrhosis, or hepatitis
  • Diabetes
  • Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
You should also be sure to tell your healthcare provider about all other medicines you are taking, including prescription and prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings for Nelfinavir

Warnings and precautions to be aware of prior to taking nelfinavir include the following:
  • The manufacturer of nelfinavir has sent letters to healthcare providers warning that ethyl methanesulfonate (EMS) has been found in nelfinavir products. EMS is an impurity caused by the manufacturing process of nelfinavir and may cause cancer. The risk of cancer due to taking nelfinavir appears to be low, and for most people, the benefits of nelfinavir outweigh the possible risks of cancer due to EMS.
  • Nelfinavir powder (but not tablets) contains phenylalanine. This is important for people with phenylketonuria, who must limit their intake of phenylalanine. Each gram of nelfinavir powder contains 11.2 mg of phenylalanine.
  • Nelfinavir can cause high blood sugar (hyperglycemia). This can cause problems for people with diabetes, or can even cause diabetes in individuals who are predisposed to the condition.
  • The liver helps to clear nelfinavir from the body. If you have moderate to severe liver disease, you should not take nelfinavir.
  • There have been reports of bleeding possibly due to protease inhibitors (such as nelfinavir) in people with hemophilia. Be sure your healthcare provider knows if you have hemophilia.
  • Nelfinavir can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.
  • Nelfinavir is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, whether or not you are taking medications. It is important to note that nelfinavir may make oral contraceptives (birth control pills) less effective.
  • As will all HIV medications, it is important that you take nelfinavir exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
  • Nelfinavir can interact with a number of different medications (see Drug Interactions With Nelfinavir for more information).
  • Nelfinavir is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are not known (see Viracept and Pregnancy). However, recent information has shown that nelfinavir contains ethyl methanesulfonate (EMS), a carcinogen. It is currently recommended that pregnant women avoid taking nelfinavir, and pregnant women who are already taking nelfinavir should be switched to a different medication until more information is available.
  • It is not known whether nelfinavir passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Viracept and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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