Indinavir

Indinavir is a prescription medicine used for the treatment of HIV (Human Immunodeficiency Virus), the virus that causes AIDS. Indinavir is in a group of medications called protease inhibitors. It works by blocking protease enzymes that are required for the virus to make DNA and replicate. 

Indinavir is a prescription medication used for the treatment of HIV (Human Immunodeficiency Virus). HIV is the virus that causes AIDS (acquired immune deficiency syndrome). Indinavir is usually prescribed with other anti-HIV drugs such as ZDV (also called AZT), 3TC, ddI, ddC, or d4T.

This medication may be prescribed for other uses. Ask your doctor or pharmacist.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your liver function

The recommended dose of indinavir is 800 mg (usually two 400-mg capsules) orally every 8 hours.

Indinavir does not cure HIV infection or AIDS and you may continue to experience illnesses associated with HIV-1 infection, including opportunistic infections. You should remain under the care of a doctor when using indinavir.

Avoid doing things that can spread HIV-1 infection.

• Do not share needles or other injection equipment.
• Do not share personal items that can have blood or body fluids on them, like toothbrushes and razor blades.
• Do not have any kind of sex without protection. Always practice safe sex by using a latex or polyurethane condom to lower the chance of sexual contact with semen, vaginal secretions, or blood.

Do not take indinavir if you have had a serious allergic reaction to any of its components.

Some patients treated with indinavir developed kidney stones. In some of these patients this led to more severe kidney problems, including kidney failure or inflammation of the kidneys or kidney infection which sometimes spread to the blood. Drinking at least six 8-ounce glasses of liquids (preferably water) each day should help reduce the chances of forming a kidney stone. Call your doctor or other health care provider if you develop kidney pains (middle to lower stomach or back pain) or blood in the urine.

Some patients treated with indinavir have had rapid breakdown of red blood cells (hemolytic anemia) which in some cases was severe or resulted in death.

Some patients treated with indinavir have had liver problems including liver failure and death. Some patients had other illnesses or were taking other drugs. It is uncertain if indinavir caused these liver problems.

Diabetes and high blood sugar (hyperglycemia) have occurred in patients taking protease inhibitors. In some of these patients, this led to ketoacidosis, a serious condition caused by poorly controlled blood sugar. Some patients had diabetes before starting protease inhibitors, others did not. Some patients required adjustments to their diabetes medication. Others needed new diabetes medication.

In some patients with hemophilia, increased bleeding has been reported.

Severe muscle pain and weakness have occurred in patients taking protease inhibitors, including indinavir, together with some of the cholesterol-lowering medicines called "statins". Call your doctor if you develop severe muscle pain or weakness.

Changes in body fat have been seen in some patients taking antiretroviral therapy. These changes may include increased amount of fat in the upper back and neck ("buffalo hump"), breast, and around the trunk. Loss of fat from the legs, arms and face may also happen. The cause and long term health effects of these conditions are not known at this time.

In some patients with advanced HIV infection (AIDS), signs and symptoms of inflammation from opportunistic infections may occur when combination antiretroviral treatment is started.

Increases in bilirubin (one laboratory test of liver function) have been reported in approximately 14% of patients. Usually, this finding has not been associated with liver problems. However, on rare occasions, a person may develop yellowing of the skin and/or eyes.

Side effects occurring in 2% or more of patients included: abdominal pain, fatigue or weakness, low red blood cell count, flank pain, painful urination, feeling unwell, nausea, upset stomach, diarrhea, vomiting, acid regurgitation, increased or decreased appetite, back pain, headache, dizziness, taste changes, rash, itchy skin, yellowing of the skin and/or eyes, upper respiratory infection, dry skin, and sore throat.

Swollen kidneys due to blocked urine flow occurred rarely.

Other side effects reported since indinavir has been marketed include: allergic reactions; severe skin reactions; yellowing of the skin and/or eyes; heart problems including heart attack; stroke; abdominal swelling; indigestion; inflammation of the kidneys; decreased kidney function; inflammation of the pancreas; joint pain; depression; itching; hives; change in skin color; hair loss; ingrown toenails with or without infection; crystals in the urine; painful urination; numbness of the mouth and increased cholesterol.

Tell your doctor promptly about these or any other unusual symptoms. If the condition persists or worsens, seek medical attention.

Tell your doctor about any medicines you are taking or plan to take, including non-prescription medicines, herbal products including St. John's wort (Hypericum perforatum), or dietary supplements.

Especially tell your doctor if you take:

• Versed (midazolam)
• Orap (pimozide)
• Cordarone (amiodarone)
• Halcion (triazolam)
• Xanax (alprazolam)
• Revatio (sildenafil)
• Uroxatral (alfuzosin)
• Ergot medications
• Rifampin
• Statins such as Zocor (simvastatin), Mevacor (lovastatin), Lipitor (atorvastatin), and Crestor (rosuvastatin)
• calcium channel blockers such as amlodipine, felodipine
• antiarrhythmics such as quinidine
• anticonvulsants such as phenobarbital, phenytoin, or carbamazepine
• steroids such as dexamethasone

Taking indinavir with Reyataz (atazanavir) is not recommended because they can both sometimes cause increased levels of bilirubin in the blood.

Taking indinavir with St. John's wort (Hypericum perforatum), an herbal product sold as a dietary supplement, or products containing St. John's wort is not recommended. Taking St. John's wort has been shown to decrease indinavir levels and may lead to increased viral load and possible resistance to indinavir or cross resistance to other antiretroviral drugs.

Tell your doctor if you are pregnant or if you become pregnant while you are taking indinavir. It is not known how indinavir affects pregnant women or their developing babies.

Tell your doctor if you are breastfeeding. Do not breastfeed. It is not known if indinavir can be passed to your baby in your breast milk and whether it could harm your baby. Also, mothers with HIV-1 should not breastfeed because HIV-1 can be passed to the baby in the breast milk.

Take indinavir with water. You can also take indinavir with other beverages such as skim or non-fat milk, juice, coffee, or tea.

Adults should drink at least six 8-ounce glasses of liquids (preferably water) throughout the day, every day.

When your indinavir supply starts to run low, get more from your healthcare provider or pharmacy. It is very important not to run out of this medication. The amount of virus in your blood may increase if the medicine is stopped for even a short time.

Avoid doing things that can spread HIV-1 infection to others.