Drug General Information (ID: DDI9WZXF2S)
Drug Name			Pantoprazole		Drug Info		Nelfinavir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiulcer Agents				Protease Inhibitors
Structure

Mechanism of Pantoprazole-Nelfinavir Interaction (Severity Level: Major)
Altered gastric pH Click to Show/Hide Mechanism Graph
Drug Name		Pantoprazole				Nelfinavir
Mechanism		Gastric alkalinizer				Gastric pH sensitive
Key Mechanism Factor 1
		Factor Name		Gastric pH
		Factor Description		The normal pH range of gastric acid is between 1.5 and 3.5 and is highly acidic, consisting mainly of hydrochloric acid. Changes in the pH of the stomach can alter the absorption of drugs.
Mechanism Description		Decreased absorption of Nelfinavir due to altered gastric pH caused by Pantoprazole

Recommended Action
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.

References
1	Product Information. Viracept (nelfinavir). Agouron Pharma Inc, La Jolla, CA.
2	Durant J, Clevenbergh P, Garraffo R, Halfon P, Icard S, DelGiudice P, Montagne N, Schapiro JM, Dellamonica P "Importance of protease inhibitor plasma levels in HIV-infected patients treated with genotypic-guided therapy: pharmacological data from the Viradapt Study." Aids 14 (2000): 1333-9. [PMID: 10930147]