Generic name: Indinavir sulfateBrand names: Crixivan
Crixivan is used in the treatment of human immunodeficiency virus (HIV) infection. HIV causes the immune system to break down so that it can no longer fight off other infections. This leads to the fatal disease known as acquired immune deficiency syndrome (AIDS).
HIV thrives by taking over the immune system's vital CD4 cells (white blood cells) and using their inner workings to make additional copies of itself. Crixivan belongs to a class of HIV drugs called protease inhibitors, which work by interfering with an important step in the virus's reproductive cycle. Although Crixivan cannot eliminate HIV already present in the body, it can reduce the amount of virus available to infect other cells.
Crixivan can be taken alone or in combination with other HIV drugs such as zidovudine. Because Crixivan and zidovudine attack the virus in different ways, the combination is likely to be more effective than either drug alone.
It is important that you drink at least six 8-ounce glasses of liquid (preferably water) daily while taking Crixivan. If you do not get enough liquid, you may develop kidney stones and have to temporarily stop taking Crixivan or even discontinue it altogether.
Take Crixivan exactly as prescribed by your doctor. Do not share Crixivan with anyone and do not take more than your recommended dosage.
To ensure maximum absorption, do not take Crixivan with food. Instead, take it with water 1 hour before or 2 hours after a meal. (Crixivan may also be taken with liquids such as skim milk, juice, coffee, or tea, or even with a light meal such as dry toast with jelly, juice, and coffee with skim milk and sugar, or corn flakes with skim milk and sugar.)
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Crixivan.
Certain drugs, when combined with Crixivan may cause serious, even life-threatening reactions. The following drugs should not be taken if you are taking Crixivan:
AmiodaroneCisaprideErgot-based drugs such as ergotamine tartrate, methylergonovine maleate, anddihydroergotamine mesylateMidazolamPimozideTriazolam
If you suffer a severe allergic reaction to Crixivan or any of its ingredients, you should not take Crixivan.
Although Crixivan reduces the amount of HIV in the blood and increases the white blood cell count, its long-term effect on survival is still unknown. The virus remains in the body, and you will continue to face the possibility of complications, including opportunistic infections (rare infections that develop when the immune system falters) such as certain types of pneumonia, tuberculosis, and fungal infection. Therefore, it is important that you remain under the care of a doctor and keep all your follow-up appointments.
Crixivan is not a cure for HIV infection, and it does not reduce the risk of transmission of HIV to others through sexual contact or blood contamination. Therefore, you should continue to avoid practices that could spread HIV.
Protease inhibitors such as Crixivan have been known to trigger diabetes (high blood sugar levels) or worsen existing diabetes. If you have diabetes, the dosages of your diabetes medications may have to be adjusted.
People taking HIV medications may also experience a redistribution of body fat, with wasting of the face, arms, and legs, and accumulation of fat around the middle, the upper back, and breasts.
Cases of liver failure and death have occurred in patients treated with Crixivan and other medications. If you have a liver problem, particularly cirrhosis of the liver, make sure the doctor is aware of it. Kidney problems, including kidney and urinary stones, are also a possibility, so alert the doctor if you have any type of kidney disease.
Some patients have developed severe anemia (loss of red blood cells) while taking Crixivan. If this problem surfaces, you will have to stop taking the drug.
If you have hemophilia, you should also be aware that spontaneous bleeding has occurred in hemophilia victims taking protease inhibitors such as Crixivan.
Avoid the following medications while taking Crixivan. The combination may cause serious or life-threatening effects.
AmiodaroneAtazanavirCisaprideErgot-based drugs such as ergotamine tartrate, methylergonovine maleate, and dihydroergotamine mesylateLovastatinMidazolamPimozideRifampinSimvastatinSt. John's wortTriazolam
It's also best to avoid combining Crixivan with St. John's wort, which reduces Crixivan's effect.
Crixivan may interact with certain other drugs, and the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Crixivan with the following:
BepridilCarbamazepineCholesterol-lowering drugs such as atorvastatin, fluvastatin, and pravastatinCimetadineClarithromycinCyclosporineDelavirdineDidanosineEfavirenzFluconazoleHeart medications known as calcium channel blockers, including felodipine, nicardipine, and nifedipineIsoniazidItraconazoleKetoconazoleLamivudineLidocaineMethadoneNelfinavirNevirapineOrtho-NovumPhenobarbitalPhenytoinQuinidineRifabutinRifampinRitonavirSaquinavirSirolimusStavudineSulfamethoxazoleTacrolimusTheophyllineTrimethoprimZidovudine
Check with your doctor before using any drug for erectile dysfunction (male impotence), such as Cialis, Levitra, or Viagra while on Crixivan. Combining an erectile dysfunction drug with Crixivan increases the risk of side effects, such as low blood pressure, vision problems, and a dangerously prolonged erection. If an erection lasts more than 4 hours, seek medical help immediately to avoid permanent damage to the penis.
Avoid drinking grapefruit juice while taking Crixivan. This kind of juice can reduce the drug's effectiveness.
Be sure to tell your doctor and pharmacist about all medications you are taking, both prescription and over-the-counter. Alert them, too, when you stop taking a medication.
The effects of Crixivan during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, tell your doctor immediately. Do not breastfeed your baby. HIV appears in breast milk and can infect a nursing infant.
The recommended dose of Crixivan is 800 milligrams (usually two 400-milligram capsules) every 8 hours. Your doctor may lower the dose to 600 milligrams every 8 hours if you have mild-to-moderate liver problems due to cirrhosis. The dose will also need adjustment if you are taking Rescriptor, Mycobutin, Nizoral, Sporanox, or Videx.
Crixivan is more likely to cause kidney stones in children than in adults. If the doctor finds it necessary to prescribe Crixivan anyway, dosage is calculated according to the size of the child.
Any medication taken in excess can have serious consequences. If you suspect an overdose, seek emergency medical treatment immediately.