- WHAT IS INDINAVIR?
- WHO SHOULD TAKE IT?
- WHAT ABOUT DRUG RESISTANCE?
- HOW IS IT TAKEN?
- WHAT ARE THE SIDE EFFECTS?
- HOW DOES IT REACT WITH OTHER DRUGS?
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PrintIndinavir is a drug used for antiviral therapy. It is also
called Crixivan®. It is manufactured by Merck & Co. Indinavir
is a protease inhibitor. These drugs prevent the protease enzyme
from working. HIV protease acts like a chemical scissors. It cuts
the raw material for HIV into specific pieces needed to build
a new virus. Protease inhibitors “gum up” these scissors.
INDINAVIR?
Indinavir was approved as an antiviral drug for people with
HIV infection. There are no absolute rules about when to start
antiviral drugs. You and your doctor should consider your T-cell count, your viral
load, any symptoms you are having, and your attitude about
taking HIV medications. Fact Sheet
411 has more information about guidelines
for the use of antiviral medications.
If you take indinavir with other antiviral drugs, you can reduce
your viral load to extremely low levels, and increase your T-cell
counts. This should mean staying healthier longer.
RESISTANCE?
Many new copies of HIV are mutations. They are slightly different
from the original virus. Some mutations can keep multiplying even
when you are taking an antiviral drug. When this happens, the
drug will stop working. This is called “developing resistance”
to the drug. See Fact Sheet 414
for more information on resistance.
Sometimes, if your virus develops resistance to one drug, it
will also have resistance to other antiviral drugs. This is called
“cross-resistance”.
Resistance can develop quickly. It is very important to
take antiviral medications according to instructions, on schedule,
and not to skip or reduce doses.
TAKEN?
The normal dose of Indinavir is 800 milligrams (mg) every 8
hours. The capsules are either 200mg or 400mg. Some people need
to take 1000mg because of drug interactions in some combinations.
A 333mg capsule is available for them to use. Different doses
are used in some combinations. Be sure you know how much indinavir
your doctor has prescribed for you, and when and how to take each
dose.
If indinavir is combined with ritonavir (another protease inhibitor),
you can take it twice a day without food restrictions. If you
take indinavir by itself, you should take it when your stomach
is empty. This means taking indinavir two hours after eating,
or one hour before eating.
If you need to, you can eat dry toast with jelly and drink
skim milk, juice, coffee, tea, or water with Indinavir. Fat, protein,
and high-calorie foods will reduce the absorption of Indinavir.
The American Dietetic Association has a list of foods that
you can safely eat when you take a dose of Indinavir. You can
get this list on the Internet at
Indinavir is sensitive to moisture. Store it in its original
container. Inside the container, there is a desiccant (a material
that helps keep it dry).
SIDE EFFECTS?
The most serious side effect of Indinavir is kidney stones,
including pain in the sides. You can reduce the risk of kidney
stones by drinking at least 8 glasses of water each day. In
rare cases, Indinavir can cause serious anemia, a loss of red
blood cells. This may show up as extreme fatigue, jaundice (yellowing
of the skin), or rust-colored urine.
It can also cause upset stomach, bloating, and skin rash. Indinavir
capsules contain lactose (milk sugar). If you have trouble digesting
dairy products, you may have more stomach problems with Indinavir.
It may cause “frozen shoulder.” Also called adhesive
capsulitis, this is a reduced range of motion and pain in the
shoulder.
HOW
DOES INDINAVIR REACT WITH OTHER DRUGS?
Indinavir is broken down by the liver. It can interact with
other drugs that also use the liver. Combining these drugs
can change the amount of each drug in your bloodstream and cause
an under- or overdose. Drugs to watch out for include Viagra,
several antihistamines, sedatives, drugs to lower cholesterol
and anti-fungal drugs. Make sure that your doctor knows
about ALL drugs you are taking.
If you are taking Indinavir and ddI,
take them an hour apart with your stomach empty.
Some birth control pills may not work if you are taking indinavir.
Talk to your doctor about how to prevent an unwanted pregnancy.
The herb St. John’s Wort (See
Fact Sheet 729) lowers the blood levels of some protease inhibitors.
Tell your doctor about any herbs or other supplements that you
use.
Revised August
16, 2002
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New Mexico AIDS Education and Training Center
and the New Mexico Department of Health