indinavir, Crixivan

  • Pharmacy Author:
    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.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    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.

What is the dosage for indinavir?

The recommended dose for adults is 800 mg every eight hours. Food reduces the absorption of indinavir. Therefore, for optimal absorption, indinavir should be taken with water one hour before or two hours after a meal; however, it may administered with skim milk, juice, coffee, tea or with a light meal such as dry toast or corn flakes.

The dose of indinavir should be reduced to 600 mg every 8 hours when it is combined with delaviridine (Rescriptor), itraconazole (Sporanox), ketoconazole (Nizoral), or in patients with liver failure. The dose of indinavir should be increased to 1000 mg every 8 hours when it is combined with rifabutin (Mycobutin).

Which drugs or supplements interact with indinavir?

Indinavir interacts with many drugs. Some of the important interactions are mentioned below. Patients should consult their health care professional before combining any drugs with indinavir.

Triazolam (Halcion), midazolam (Versed), alprazolam (Xanax), pimozide, lovastatin (Mevacor), simvastatin (Zocor), ergot derivatives (for example, ergotamine, dihydroergotamine), and amiodarone (Cordarone) should not be combined with indinavir due to the risk of serious adverse effects resulting from indinavir increasing the blood levels of these drugs.

Indinavir increases blood concentrations of stavudine (Zerit), alfuzosin (Uroxatral), oral contraceptives, and clarithromycin (Claritin). Increased blood levels may result in more frequent side effects.

Indinavir decreases the blood concentration of didanosine (Videx) in the body and can thereby reduce the effectiveness of didanosine. Therefore, when didanosine and indinavir are both being used for treatment, their ingestion should be separated by one hour.

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.

Medically Reviewed by a Doctor on 7/9/2015

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