US Previously Marketed Source First approved in Source Indinavir is an antiretroviral drug for the treatment of HIV infection. HIV-1 protease is an enzyme required for the proteolytic cleavage of the viral polyprotein precursors into the individual functional proteins found in infectious HIV Protease inhibitors are almost always used in combination with at least two other anti-HIV drugs. Human immunodeficiency virus type 1 protease. AE mg single, oral Overdose.

Patients taking delavirdine mg tid: May decrease the dose to mg 8 hourly. Patients taking itraconazole mg bid: May decrease the dose to mg 8 hourly. Patients taking ketoconazole: May decrease the dose to mg 8 hourly. Patients taking rifabutin: May increase the dose to 1, mg 8 hourly. Concomitant administration with drugs in which inhibition of CYP3A4 can result in elevated serum concentration of these drugs, potentially causing serious adverse reactions; St. Patient with diabetes, haemophilia A or B.

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Indinavir is the only ART known to induce retinoid-like effects, which appear as cutaneous xerosis with asteatotic eczema, acquired ichthyosis, pruritus, and burning sensation, cheilitis, certain nail conditions paronychia, ingrown toenails, hypertrophic granulation tissue deposition, and nail plate dystrophy, hair alterations body and scalp alopecia, and the growth of curly hair, and hyperlipidemia within 2 months after drug administration. Indinavir is not recommended for initial antiretroviral therapy, boosted or unboosted, because of pill burden and the risk of nephrolithiasis. A boosted regimen combines two mg indinavir capsules with 1 to 2 mg ritonavir capsule s, twice daily. Indinavir must be taken with water, either 1 hour before or 2 hours after a meal. Indinavir has low solubility at physiologic pH and can crystallize in the kidney and urine. The main adverse effects seen with indinavir are nephrolithiasis, unconjugated hyperbilirubinemia without jaundice, abdominal pain, nausea, and dry skin and lips. Indinavir has been used in combination regimens with some success but has been largely replaced in recent years by less toxic and more tolerable PI regimens. Minor mutations can occur at positions 10, 20, 24, 32, 36, 54, 71, 73, 76, 77, and

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More than 40 drugs are now available to treat HIV infection. Antiretroviral drugs are used to treat HIV infection. They work by blocking a stage of the virus's life cycle and, by doing so, prevent the virus from replicating. The drugs are organized into six different classes based largely on the stage of the life cycle they inhibit. As of, the Food and Drug Indinavir 800mg has approved 26 individual drug agents and 22 fixed-dosed combination FDC drugs comprised of two or more antiretrovirals. This includes the first antiretroviral drug regimen, Cabenuva, which requires a once-a-month or once-every-two-month injection rather than an oral dose daily.

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Approval Indinavir has not been approved by the Food and Drug Administration for use in the pediatric population. Although indinavir was one of the first protease inhibitors to be studied in children, its use in pediatrics has never been common and is currently very rare. Efficacy and Pharmacokinetics Both unboosted and ritonavir-boosted indinavir have been studied in children with HIV. A significant proportion of children have trough indinavir concentrations less than the 0. Nephrolithiasis Gastrointestinal intolerance, nausea Hepatitis Indirect hyperbilirubinemia Hyperlipidemia Hyperglycemia Fat maldistribution Possible increased bleeding episodes in patients with hemophilia Special Instructions When indinavir is given in combination with ritonavir, meal restrictions are not necessary.

Indinavir is an antiviral medicine that prevents human immunodeficiency virus HIV from multiplying in your body. Tell your doctor about all your current medicines and any you start or stop indinavir 800mg. Many drugs can interact with indinavir, and some drugs should not be used together. Some medicines can cause dangerous or life-threatening side effects when used with indinavir. It is not known whether indinavir will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

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Coadministration of rifabutin with indinavir alone decreased indinavir exposure and increased rifabutin exposure. A dosage reduction of rifabutin to half the standard dose and a dosage increase of indinavir to mg every 8 hours is suggested when rifabutin is co-administered with indinavir alone. In most clinical practice, indinavir will be given in combination with ritonavir. The presence of ritonavir is likely to affect the magnitude of the interaction. Dose reduction of rifabutin and dose increase of indinavir has not been confirmed in clinical studies. Therefore co-administration is not recommended.

Avoid combination if possible; may consider low dose atorvastatin or alternative agents; monitor for myopathy. Start low and titrate bosentan to effect. If patient has been on protease inhibitor other than unboosted atazanavir for more than 10 days, start bosentan at If patient is currently on bosentan and requires a PI other than unboosted atazanavir, stop bosentan for at least 36 hours prior to initiating ART. Wait 10 days and then resume bosentan starting with Avoid combination if possible; consider alternative agents; monitor carbamazepine levels and adjust as indicated.

Pharmacokinetic enhancement involves the use of one drug to inhibit the metabolism of another, leading to improved drug exposure. Ritonavir increases exposure and slows the metabolism of other protease inhibitors leading to potential for using fewer tablets and having less frequent dosing. It also removes the need for food restrictions and at least with saquinavir the need to separate dosing from buffered ddI. Furthermore, the interpatient variability in exposure with PIs is diminished when ritonavir co-dosing is used. Ritonavir is also known to inhibit p-glycoprotein, a cellular efflux pump.

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