Other Names/Brands

Crixivan

Mechanism of Action

Indinavir is an antiretroviral drug belonging to the protease inhibitor class and used to treat HIV infection. This drug works by inhibiting the HIV protease enzyme, which is essential for the virus to process viral proteins into mature, infectious forms.

By inhibiting protease, the virus cannot form new, functional particles, thus reducing the viral load in the body and giving the immune system a chance to fight the infection.

Indications

Indinavir is used primarily to treat HIV-1 infection in adults and children as part of combination antiretroviral therapy. It is prescribed to reduce the amount of virus in the blood, improve immune system function, and prevent the development of AIDS and HIV-related complications.

Contraindications

Indinavir is contraindicated in patients with known hypersensitivity to indinavir or any component of the formulation. It should be avoided in patients with severe liver impairment or certain medical conditions that may be exacerbated by indinavir's side effects. It should also not be used concomitantly with drugs that have serious interactions with CYP3A metabolism, as this may increase the risk of toxicity or decrease therapeutic efficacy.

Side Effects

Indinavir can cause several side effects, the most common of which are nausea, diarrhea, headache, and fatigue. Furthermore, this drug can cause kidney problems such as the formation of urine crystals or kidney stones, changes in liver function, and lipodystrophy and increased blood lipid levels with long-term use.

Preparations

Indinavir is generally available in hard capsules for oral administration, with an active ingredient typically of 200 mg per capsule. Some formulations may also be available as an oral suspension, although this is less common and is more common in research or pediatric use.

Dosage

The typical adult dose of indinavir is 800 mg every 8 hours as part of combination antiretroviral therapy. This medication should be taken on an empty stomach and accompanied by adequate fluid intake to prevent kidney complications.

In children, the dose is adjusted based on body weight or body surface area with close clinical and laboratory monitoring.

Safety of Drugs

Indinavir is classified as pregnancy category B by the FDA, meaning animal studies have not demonstrated a risk to the fetus, but there are no adequately controlled studies in pregnant women. Use of this drug during pregnancy is recommended only if the expected benefit outweighs the potential risk to the fetus.

Drug Interactions

Indinavir interacts with drugs metabolized by the CYP3A enzyme. Concomitant use with CYP3A inhibitors or inducers may increase toxicity or decrease the effectiveness of indinavir.

Several medications, such as rifampin, certain statins, and antiarrhythmic drugs, require avoidance or dose adjustment due to the risk of serious side effects or impaired drug metabolism.

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