indinavir, Crixivan (cont.)

Pharmacy Author:

Omudhome Ogbru, PharmD

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Indinavir also may inhibit the break-down of the cholesterol-lowering drugs lovastatin (Mevacor), simvastatin (Zocor), and atorvastatin (Lipitor). This may increase the risk of muscle breakdown (rhabdomyolysis) that may be seen when these drugs accumulate in the body.

Ketoconazole (Nizoral), itraconazole (Sporanox), delavirdine (Rescriptor) and clarithromycin (Claritin) can increase blood levels of indinavir and result in more frequent or severe side effects from indinavir.

Rifampin (Rifadin), rifabutin (Mycobutin), St. John's Wort and efavirenz (Sustiva) decrease the blood levels of indinavir and thus can reduce the effect of indinavir.

Indinavir increases blood levels of sildenafil (Revatio) and the risk of side effects such as low blood pressure, prolonged erection, and fainting.

PREGNANCY: Use of indinavir during pregnancy has not been adequately evaluated.

NURSING MOTHERS: It is not known whether indinavir is excreted in breast milk. Nevertheless, HIV-infected mothers should not breastfeed because of the potential risk of transmitting HIV to an infant that is not infected.

SIDE EFFECTS: The most common side effects of indinavir are abdominal pain, weakness, nausea, diarrhea, vomiting, headache, insomnia and abnormal taste sensation. Indinavir may cause hemolytic anemia (break-down of red blood cells), liver failure and kidney stones. Kidney stones may be prevented by adequate fluid intake. Adequate fluid intake can be achieved by consuming at least 48 ounces of fluid daily. Like other protease inhibitors, use of indinavir may be associated with redistribution or accumulation of body fat, increased blood cholesterol and worsening of diabetes. Immune reconstitution syndrome which is an inflammatory response to infection may occur in patients treated with combination antiretroviral therapy.

Reference: FDA Prescribing Information

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