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The safety and warning information below outlines essential risks and precautions related to the use of Viracept (nelfinavir). Patients are encouraged to carefully read and consult with their healthcare providers if they have any concerns or questions regarding this medication.

• Drug Interactions: Viracept (nelfinavir) may interact with various other medications, potentially requiring dose adjustments. Interactions can lead to either decreased effectiveness or increased side effects. It is crucial to consult your healthcare provider or pharmacist before starting or discontinuing any other medications or supplements.

• Diabetes Risk: Use of Viracept (nelfinavir) and other protease inhibitors can elevate blood sugar levels, which might result in diabetes or exacerbate existing diabetes. Regular blood sugar monitoring and scheduled healthcare appointments are advised.

• Fat Redistribution: Some individuals using HIV antiretrovirals, including Viracept (nelfinavir), may experience changes in body fat distribution, such as increased fat in the abdomen and upper back and decreased fat in the face, arms, and legs. The cause of these changes remains uncertain.

• Immune Reconstitution Syndrome: Initiating treatment with Viracept (nelfinavir) can increase the risk of immune reconstitution inflammatory syndrome (IRIS), where the recovering immune system causes significant inflammation. Seek immediate medical attention if you experience fever, breathing difficulties, or sudden health changes.

• Liver Problems: Patients with moderate to severe liver issues should inform their healthcare provider, as Viracept (nelfinavir) may not be suitable, and alternative treatments may be necessary.

• Phenylketonuria (PKU) Caution – Oral Powder Only: The oral powder form of Viracept (nelfinavir) contains phenylalanine, which can be harmful to individuals with phenylketonuria (PKU). Patients with PKU should alert their healthcare provider to explore safer formulations of the medication.

Contraindications:

• Viracept (nelfinavir) should not be used with certain medications that rely heavily on CYP3A for metabolism, as this can lead to serious health risks. Discuss with your healthcare provider if you are taking such medications.

Diarrhea is a common side effect of this medication, occurring in a significant number of users. Nausea and gas are also frequently reported, though they tend to be mild and manageable. If these symptoms persist or worsen, it is advisable to consult a healthcare provider for potential remedies or adjustments in your treatment plan.

In some cases, as the immune system strengthens, it may trigger symptoms of previous infections or cause new symptoms if it becomes overactive. Immediate consultation with a healthcare provider is crucial if you experience severe symptoms such as unexplained weight loss, persistent muscle aches, severe headaches, or vision changes. Additionally, watch for signs of an overactive thyroid, like irritability or a rapid heartbeat, and report them promptly.

Serious side effects, although rare, demand urgent medical attention. These include persistent nausea or vomiting, symptoms resembling a heart attack such as chest pain or shortness of breath, easy bruising, or signs of liver issues like dark urine and yellowing of the skin or eyes. In rare instances, this medication can elevate blood sugar levels, potentially leading to or worsening diabetes. Symptoms such as increased thirst or urination should be monitored, and blood sugar levels should be checked regularly.

Changes in body fat distribution might occur, with increases in areas like the upper back and stomach, and decreases in the arms and legs. The long-term effects of these changes are not fully understood, so discussing them with a healthcare provider might be beneficial. Although very rare, serious allergic reactions can happen, characterized by rash, severe dizziness, or difficulty breathing, necessitating immediate medical help.

While this overview covers many potential side effects, it is not exhaustive. Always contact your healthcare provider if you notice any unusual symptoms or reactions.

Nelfinavir, also known as Viracept, can interact with a variety of medications. It is important to inform your healthcare provider about all medications and supplements you are currently taking. Some interactions may necessitate changes in your treatment plan.

1. Medications to Avoid with Nelfinavir: Certain drugs should not be used with nelfinavir as they can cause serious interactions. These include alfuzosin, amiodarone, certain benzodiazepines (like midazolam and triazolam), and ergot alkaloids (such as dihydroergotamine and ergotamine), among others.

2. Medications Requiring Caution: Nelfinavir can either increase or decrease the efficacy of certain drugs, necessitating dosage adjustments. These include apalutamide, some anti-seizure medications (such as carbamazepine and phenobarbital), and herbal supplements like St. John's wort.

3. Impact on Hormonal Birth Control: Nelfinavir may reduce the effectiveness of hormonal contraceptives such as pills, patches, and rings, which could result in unintended pregnancy. It is advisable to discuss alternative or additional birth control methods with your healthcare provider.

By understanding these interactions, you can use nelfinavir safely and effectively while minimizing potential risks. Always consult with your doctor or pharmacist for personalized advice.