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Indinavir

    Brands

    DEA Class; Rx

    Common Brand Names; Crixivan

    • Antiretroviral Agents; 
    • HIV, Protease Inhibitors

    Protease inhibitor (PI)
    Indicated to treat HIV infection in combination with other antiretrovirals
    Potential for nephrolithiasis

    Indicated for the treatment of human immunodeficiency virus (HIV) infection in combination with other antiretroviral agents.

    Hypersensitivity

    Drugs that are contraindicated with indinavir include alpha1-adrenoreptor agonists (eg, alfuzosin), antiarrhythmics (amiodarone, bepridil, flecainide, propafenone, quinidine), rifampin, voriconazole, ergot derivatives (dihydroergotamine, ergonovine, ergotamine, methylergonovine), cisapride, St. John’s wort, lovastatin, simvastatin, lurasidone, pimozide, sildenafil (when used for pulmonary artery hypertension), midazolam, and triazolam

    • Nephrolithiasis/urolithiasis (29%, peds)
    • Hyperbilirubinemia (14%)
    • Nausea (12%)
    • Pain (17%)
    • Nephrolithiasis/urolithiasis (12%, adults)
    • Abdominal pain (9%)
    • Thrombocytopenia (1%)
    • Back pain (8%)
    • Dysuria (2%)
    • Headache (6%)
    • Fever (2%)
    • Dizziness (3%)
    • Diarrhea/vomiting (4-5%)
    • Weakness (4%)
    • Malaise (2%)
    • Insomnia (3%)
    • Fatigue (2%)
    • Taste perversion (3%)
    • Flank pain (3%)
    • Pruritus (4%)
    • Neutropenia (2%)
    • Cough (2%)

    Proper hydration required (1.5 L liquids/day) to counter risk of nephrolithiasis/urolithiasis (much higher in children)

    Risks of fat redistribution, hemolytic anemia, hyperglycemia, hyperbilirubinemia, immune reconstitution syndrome if used in combination w/ other antiretroviral drugs

    Separate from didanosine by 1 hr

    Monitor: LFTs q6-12week

    There are insufficient prospective pregnancy data from Antiretroviral Pregnancy Registry (APR) to adequately assess risk of adverse developmental outcomes

    There is no information available on presence of amprenavir in human milk, the effects of the drug on breastfed infant, or effects of drug on milk production

    NOTE: The following maximum dosage limits apply for typical indinavir use; maximum dosage limits may be altered based on certain individual patient circumstances, such as in the case of specific drug interactions.

    Adults

    2400 mg/day PO.

    Geriatric

    2400 mg/day PO.

    Adolescents

    Dosage not definitively established; 2400 mg/day PO has been recommended.

    Children

    Safety and efficacy have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Indinavir sulfate

    capsules

    • 100mg
    • 200mg
    • 400mg