Can you answer the following questions about Crixivan®?
What is the generic name? Any abbreviations?
What "class" antiretroviral is it and how does it work?
With food, without food or food doesn't matter?
Any special storage instructions?
Any side effects?
Any possible drug interactions?
What is a typical dose?
Any other significant counseling points?
Crixivan ® (Indinavir) is a protease inhibitor
(PI) that suppresses viral
replication.
The FDA approved dose of Crixivan ®
(Indinavir) is 800 mg every 8 hours. The dose
should be increased to 1000 mg (or 999 mg) every 8 hours when used
concomitantly with efavirenz. Indinavir has also been studied in combination
with ritonavir. Doses of indinavir and ritonavir encountered in practice
include 400 of each bid, or 800 mg of indinavir with 100 or 200 mg of
ritonavir bid. Many other dosage combinations are under investigation.
Crixivan
®
(Indinavir) should be taken 1 hour before or 2 hours after
meals. If GI
intolerance occurs, it may be taken with a low fat snack. When indinavir is
used in combination with ritonavir, it should be taken at the same time as
ritonavir WITH food; do not apply "take on an empty stomach"
auxiliary label.
Store Crixivan
®
(Indinavir) capsules in original container WITH
desiccant. Stability data for indinavir without a
dessicant is very limited.
Counsel patients to drink six 8-ounce glasses of fluids (e.g., water,
juice, etc.) each day to minimize risk of kidney
stones.
Side effects include nephrolithiasis,
nausea, headaches, and
bilirubin elevations.
Hyperglycemia, fat redistribution
(crix-belley), and cholesterol
abnormalities have been associated with the use of PIs.
Potential for drug interactions exists due to inhibition of cytochrome
P450 enzymes.
As with all antiretrovirals, adherence is
crucial. Non-adherence is a
frequent cause of drug failure and viral resistance, not only to indinavir,
but to other PIs as well.
