Tìm theo
Nelfinavir
Các tên gọi khác (1) :
  • Viracept
Thuốc trị ký sinh trùng, chống nhiễm khuẩn
Thuốc Gốc
Small Molecule
CAS: 159989-64-7
ATC: J05AE04
ĐG : Agouron Pharmaceuticals Inc.
CTHH: C32H45N3O4S
PTK: 567.782
A potent HIV-1 protease inhibitor. It is used in combination with other antiviral drugs in the treatment of HIV in both adults and children. [PubChem]
Nhận Dạng Quốc Tế & Đặc Tính Hóa Học
Công thức hóa học
Phân tử khối
567.782
Monoisotopic mass
567.313077633
InChI
InChI=1S/C32H45N3O4S/c1-21-25(15-10-16-28(21)36)30(38)33-26(20-40-24-13-6-5-7-14-24)29(37)19-35-18-23-12-9-8-11-22(23)17-27(35)31(39)34-32(2,3)4/h5-7,10,13-16,22-23,26-27,29,36-37H,8-9,11-12,17-20H2,1-4H3,(H,33,38)(H,34,39)/t22-,23+,26-,27-,29+/m0/s1
InChI Key
InChIKey=QAGYKUNXZHXKMR-HKWSIXNMSA-N
IUPAC Name
(3S,4aS,8aS)-N-tert-butyl-2-[(2R,3R)-2-hydroxy-3-[(3-hydroxy-2-methylphenyl)formamido]-4-(phenylsulfanyl)butyl]-decahydroisoquinoline-3-carboxamide
Traditional IUPAC Name
nelfinavir
SMILES
[H][C@@]12CCCC[C@]1([H])CN(C[C@@H](O)[C@H](CSC1=CC=CC=C1)NC(=O)C1=C(C)C(O)=CC=C1)[C@@H](C2)C(=O)NC(C)(C)C
Độ tan chảy
349.84 °C
Độ hòa tan
Slightly soluble
logP
6
logS
-5.5
pKa (strongest acidic)
9.32
pKa (Strongest Basic)
8.18
PSA
101.9 Å2
Refractivity
162.67 m3·mol-1
Polarizability
63.8 Å3
Rotatable Bond Count
10
H Bond Acceptor Count
5
H Bond Donor Count
4
Physiological Charge
1
Number of Rings
4
Bioavailability
1
MDDR-Like Rule
true
Dược Lực Học : Nelfinavir is a protease inhibitor with activity against Human Immunodeficiency Virus Type 1 (HIV-1). Protease inhibitors block the part of HIV called protease. HIV-1 protease is an enzyme required for the proteolytic cleavage of the viral polyprotein precursors into the individual functional proteins found in infectious HIV-1. Nelfinavir binds to the protease active site and inhibits the activity of the enzyme. This inhibition prevents cleavage of the viral polyproteins resulting in the formation of immature non-infectious viral particles. Protease inhibitors are almost always used in combination with at least two other anti-HIV drugs.
Cơ Chế Tác Dụng : A potent HIV-1 protease inhibitor. It is used in combination with other antiviral drugs in the treatment of HIV in both adults and children. [PubChem] Nelfinavir inhibits the HIV viral proteinase enzyme which prevents cleavage of the gag-pol polyprotein, resulting in noninfectious, immature viral particles.
Dược Động Học :
▧ Absorption :
Well absorbed following oral administration.
▧ Volume of Distribution :
* 2 to 7 L/kg
▧ Protein binding :
>98%
▧ Metabolism :
Primarily hepatic via cytochrome P450 (CYP450) enzymes. CYP3A and CYP2C19 appear to be the predominant enzymes that metabolize nelfinavir in humans. One major and several minor metabolites are found in plasma; the major oxidative metabolite has in vitro antiviral activity comparable to that of the parent drug.
▧ Route of Elimination :
The terminal half-life in plasma was typically 3.5 to 5 hours. The majority (87%) of an oral 750 mg dose containing 14C-nelfinavir was recovered in the feces; fecal radioactivity consisted of numerous oxidative metabolites (78%) and unchanged nelfinavir (22%). Only 1–2% of the dose was recovered in urine, of which unchanged nelfinavir was the major component.
▧ Half Life :
3.5 - 5 hours
Độc Tính : Oral LD50 is over 5g/kg in rats. Side effects include thirst and hunger, unexplained weight loss, increased urination, fatigue, and dry, itchy skin.
Chỉ Định : Used in combination with other antiviral drugs in the treatment of HIV in both adults and children.
Tương Tác Thuốc :
  • Abacavir The serum concentration of Abacavir may be decreased by protease inhibitors such as Nelfinavir. The antiviral response should be closely monitored.
  • Abiraterone Strong CYP3A4 inhibitors may increase levels of abiraterone. Monitor concomitant therapy closely.
  • Acenocoumarol The protease inhibitor, nelfinavir, may increase the anticoagulant effect of acenocoumarol.
  • Alprazolam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, alprazolam.
  • Amiodarone Nelfinavir may increase the effect and toxicity of amiodarone.
  • Anisindione The protease inhibitor, nelfinavir, may increase the anticoagulant effect of anisindione.
  • Aprepitant This CYP3A4 inhibitor increases the effect and toxicity of aprepitant
  • Astemizole Increased risk of cardiotoxicity and arrhythmias
  • Atorvastatin Nelfinavir, a strong CYP3A4 inhibitor, may increase the serum concentration of atorvastatin by decreasing its metabolism. Monitor for changes in the therapeutic and adverse effects of atorvastatin if nelfinavir is initiated, discontinued or dose changed.
  • Bromazepam Nelfinavir, a strong CYP3A4 inhibitor, may increase the serum concentration of bromazepam by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of bromazepam if nelfinavir is initiated, discontinued or dose changed. Dosage adjustments may be required.
  • Cabazitaxel Concomitant therapy with a strong CYP3A4 inhibitor may increase concentrations of cabazitaxel. Avoid concomitant therapy.
  • Chlordiazepoxide The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, chlordiazepoxide.
  • Ciclesonide Increased effects/toxicity of ciclesonide
  • Cisapride Increased risk of cardiotoxicity and arrhythmias
  • Clonazepam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, clonazepam.
  • Clorazepate The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, clorazepate.
  • Cyclosporine The protease inhibitor, nelfinavir, may increase the effect of cyclosporine.
  • Dantrolene Nelfinavir may increase the serum concentration of dantrolene by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of dantrolene if nelfinavir is initiated, discontinued or dose changed.
  • Darifenacin Nelfinavir, a strong CYP3A4 inhibitor, may decrease the metabolism of darifenacin/solifenacin. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of darifenacin if nelfinavir is initiated, discontinued or dose changed.
  • Diazepam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, diazepam.
  • Dicoumarol The protease inhibitor, nelfinavir, may increase the anticoagulant effect of dicumarol.
  • Dihydroergotamine Nelfinavir increases the effect and toxicity of ergot derivative
  • Dihydroquinidine barbiturate Nelfinavir increases the effect and toxicity of quindine
  • Eletriptan The protease inhibitor, nelfinavir, may increase the effect and toxicity of eletriptan.
  • Eplerenone The protease inhibitor, nelfinavir, may increase the effect and toxicity of eplerenone.
  • Ergotamine Nelfinavir increases the effect and toxicity of ergot derivative
  • Erlotinib This CYP3A4 inhibitor increases levels/toxicity of erlotinib
  • Estazolam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, estazolam.
  • Ethinyl Estradiol Ritonavir could decrease the contraceptive efficacy
  • Felodipine Nelfinavir increases the effect and toxicity of felodipine
  • Fentanyl The protease inhibitor, nelfinavir, may increase the effect and toxicity of fentanyl.
  • Flurazepam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, flurazepam.
  • Fusidic Acid The protease inhibitor, nelfinavir, may increase the effect and toxicity of fusidic acid.
  • Halazepam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, halazepam.
  • Lovastatin Nelfinavir may increase the effect and toxicity of lovastatin. Concomitant therapy is contraindicated.
  • Mestranol Ritonavir could decrease the contraceptive efficacy
  • Methadone Nelfinavir decreases the effect of methadone
  • Midazolam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, midazolam.
  • Nevirapine Nevirapine may decrease the effect of nelfinavir.
  • Pimozide Nelfinavir increases the effect and toxicity of pimozide
  • Ponatinib Strong CYP3A4 inhibitors may increase levels of ponatinib. Monitor concomitant therapy closely.
  • Prazepam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, prazepam.
  • Quazepam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, quazepam.
  • Quinidine Nelfinavir increases the effect and toxicity of quinidine
  • Quinidine barbiturate Nelfinavir increases the effect and toxicity of quinidine
  • Ranolazine Increased levels of ranolazine - risk of toxicity
  • Rifampicin Rifampin decreases the effect of nelfinavir
  • Saxagliptin Nelfinavir is an inhibitor of CYP3A4 which increases exposure of saxagliptin. Decrease dose of saxagliptin to 2.5 mg per day.
  • Sildenafil The protease inhibitor, nelfinavir, may increase the effect and toxicity of sildenafil.
  • Simvastatin Nelfinavir may increase the effect and toxicity of simvastatin. Concomitant therapy should be avoided.
  • Solifenacin This potent CYP3A4 inhibitor slows darifenacin / solifenacin metabolism
  • St. John's Wort St. John's Wort decreases the effect of indinavir
  • Sunitinib Possible increase in sunitinib levels
  • Tacrolimus The protease inhibitor, Nelfinavir, may increase the blood concentration of Tacrolimus. Monitor for changes in the therapeutic/toxic effects of Tacrolimus if Nelfinavir therapy is initiated, discontinued or altered.
  • Tadalafil Nelfinavir may reduce the metabolism of Tadalafil. Concomitant therapy should be avoided if possible due to high risk of Tadalafil toxicity.
  • Tamoxifen Nelfinavir may increase the serum concentration of Tamoxifen by decreasing its metabolism. Monitor for increased adverse/toxic effects of Tamoxifen.
  • Tamsulosin Nelfinavir, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Nelfinavir is initiated, discontinued, or dose changed.
  • Telaprevir Telaprevir increases levels by affecting CYP3A4 metabolism. Concomitant therapy is contraindicated.
  • Telithromycin Nelfinavir may increase the plasma concentration of Telithromycin. Consider alternate therapy or monitor therapeutic/adverse effects.
  • Temsirolimus Nelfinavir may inhibit the metabolism and clearance of Temsirolimus. Concomitant therapy should be avoided.
  • Teniposide The strong CYP3A4 inhibitor, Nelfinavir, may decrease the metabolism and clearance of Teniposide, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Teniposide if Nelfinavir is initiated, discontinued or dose changed.
  • Terfenadine Increased risk of cardiotoxicity and arrhythmias
  • Tiagabine The strong CYP3A4 inhibitor, Nelfinavir, may decrease the metabolism and clearance of Tiagabine, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Tiagabine if Nelfinavir is initiated, discontinued or dose changed.
  • Tolterodine Nelfinavir may decrease the metabolism and clearance of Tolterodine. Adjust Tolterodine dose and monitor for efficacy and toxicity.
  • Topotecan The p-glycoprotein inhibitor, Nelfinavir, may increase the bioavailability of oral Topotecan. A clinically significant effect is also expected with IV Topotecan. Concomitant therapy should be avoided.
  • Tramadol Nelfinavir may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.
  • Trazodone The protease inhibitor, Nelfinavir, may increase the efficacy/toxicity of Trazodone by inhibiting Trazodone metabolism and clearance. Monitor for changes in Trazodone efficacy/toxicity if Nelfinavir is initiated, discontinued or dose changed.
  • Triazolam The protease inhibitor, nelfinavir, may increase the effect of the benzodiazepine, triazolam.
  • Trimipramine The strong CYP3A4 inhibitor, Nelfinavir, may decrease the metabolism and clearance of Trimipramine, a CYP3A4 substrate. Consider alternate therapy or monitor for changes in therapeutic and adverse effects of Trimipramine if Nelfinavir is initiated, discontinued or dose changed.
  • Vardenafil Nelfinavir, a strong CYP3A4 inhibitor, may reduce the metabolism and clearance of Vardenafil. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of Vardenafil.
  • Vemurafenib Strong CYP3A4 inhibitors may increase levels of vemurafenib. Monitor concomitant therapy closely.
  • Venlafaxine Nelfinavir, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Venlafaxine, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Venlafaxine if Nelfinavir is initiated, discontinued, or dose changed.
  • Verapamil Nelfinavir, a strong CYP3A4 inhibitor, may increase the serum concentration of Veramapil, a CYP3A4 substrate, by decreasing its metabolism and clearance. Consider alternate therapy or monitor for changes in the therapeutic/adverse effects of Verapamil if Nelfinavir is initiated, discontinued or dose changed.
  • Vinblastine Nelfinavir, a strong CYP3A4 inhibitor, may decrease the metabolism of Vinblastine. Consider alternate therapy to avoid Vinblastine toxicity. Monitor for changes in the therapeutic/adverse effects of Vinblastine if Nelfinavir is initiated, discontinued or dose changed.
  • Vincristine Nelfinavir, a strong CYP3A4 inhibitor, may increase the serum concentration of Vincristine by decreasing its metabolism. Consider alternate therapy to avoid Vincristine toxicity. Monitor for changes in the therapeutic and adverse effects of Vincristine if Nelfinavir is initiated, discontinued or dose changed.
  • Vinorelbine Nelfinavir, a strong CYP3A4 inhibitor, may increase the serum concentration of Vinorelbine by decreasing its metabolism. Consider alternate therapy to avoid Vinorelbine toxicity. Monitor for changes in the therapeutic and adverse effects of Vinorelbine if Nelfinavir is initiated, discontinued or dose changed.
  • Voriconazole Nelfinavir may decrease the serum concentration of voriconazole likely by increasing its metabolism. Voriconazole may increase the serum concentration of nelfinavir by decreasing its metabolism. Consider alternate therapy or adjust doses and monitor for reduced voriconazole efficacy and increased nelfinavir adverse effects during concomitant therapy.
  • Warfarin The protease inhibitor, nelfinavir, may increase the anticoagulant effect of warfarin.
  • Zolpidem Nelfinavir, a strong CYP3A4 inhibitor, may increase the serum concentration of zolpidem by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zolpidem if nelfinavir is initiated, discontinued or dose changed.
  • Zonisamide Nelfinavir, a strong CYP3A4 inhibitor, may increase the serum concentration of zonisamide by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zonisamide if nelfinavir is initiated, discontinued or dose changed.
  • Zopiclone Nelfinavir, a strong CYP3A4 inhibitor, may increase the serum concentration of zopiclone by decreasing its metabolism. Consider alternate therapy or monitor for changes in the therapeutic and adverse effects of zopiclone if nelfinavir is initiated, discontinued or dose changed.
Liều Lượng & Cách Dùng : Powder - Oral
Tablet - Oral
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