Interactions between nexium-i-v(esomeprazole) and Nelfinavir (nelfinavir)
nelfinavir and esomeprazole (Major Drug-Drug)
GENERALLY AVOID: Concurrent use of proton pump inhibitors may decrease the oral bioavailability of nelfinavir and reduce its concentrations in plasma. Nelfinavir solubility may decrease with increasing pH, thus inhibition of gastric acid secretion may interfere with dissolution of the drug. In one study, administration of omeprazole (40 mg once daily) 30 minutes before nelfinavir (1250 mg twice a day) for 4 days reduced the peak plasma concentration, trough plasma concentration, and systemic exposure (AUC) of nelfinavir by a little over one-third.
MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, use of proton pump inhibitors is not recommended in patients treated with nelfinavir.
