Indinavir


Concise Prescribing Info
Indications/Uses
HIV infection.
Dosage/Direction for Use
Adult : PO 800 mg 8 hrly.
Dosage Details
Oral
HIV infection
Adult: 800 mg every 8 hr. Dose reduction may be required when used with delavirdine, itraconazole, ketoconazole and rifabutin.
Child: >4 yr: 500 mg/m2 every 8 hr without exceeding adult dose.
Hepatic Impairment
Mild-moderate (due to cirrhosis): 600 mg every 8 hr.
Contraindications
Hypersensitivity. Severe hepatic impairment.
Special Precautions
Increased risk of urolithiasis/nephrolithiasis. Ensure adequate hydration. Hyperbilirubinaemia may be exacerbated. Diabetes; haemophilia. Monitor for signs of lipodystrophy. Pregnancy and lactation.
Adverse Reactions
Flank pain, abdominal pain, nephrolithiasis, malaise, nausea, vomiting, diarrhoea, elevated liver enzymes, hyperbilirubinaemia, raised creatinine phosphokinase and blood lipids, back pain, lipodystrophy, alopecia, acid regurgitation, dyspepsia, dry mouth, dysuria, dry skin, hyperpigmentation, headache, dizziness, somnolence, cough, dyspnoea.
Potentially Fatal: Acute haemolytic anemia; acute hepatitis.
Overdosage
Symptoms: Renal and GI disturbances (doses >2400 mg). Management: Supportive and symptomatic.
Drug Interactions
Reduced absorption with antacids. Increased concentrations with ketoconazole, delavirdine, nelfinavir and ritonavir. Reduced efficacy with nevirapine, efavirenz or rifampicin. Increased risk of myopathy with statins. Increased concentrations of phosphodiesterase-5 inhibitors.
Potentially Fatal: Increased risk of cardiac arrhythmias with amiodarone, pimozide or cisapride. Increased sedation and respiratory depression with midazolam, alprazolam and triazolam. Increased risk of ergotism with ergot derivatives. Increased toxicity of drugs with narrow therapeutic index.
Food Interaction
Reduced concentrations with grapefruit juice. Reduced antiviral response with St. John's wort.
Action
Description: Indinavir binds reversibly to HIV-protease which prevents cleavage of the viral precursor polyproteins. As a result, immature viral particles incapable of infecting other cells are formed.
Pharmacokinetics:
Absorption: Absorbed rapidly from the GIT (oral); peak plasma concentrations after 0.8 hr. May be reduced by intake of high-calorie meals.
Distribution: Protein-binding: 60%
Metabolism: Oxidation by CYP3A4 and glucuronidation.
Excretion: Via urine (<20%, half as unchanged drug), via faeces (remaining dose); 1.8 hr (elimination half-life).
Storage
Store at 15-30°C (59-86°F).
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Indinavir from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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