Crixivan


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Related to Crixivan: Invirase, Fortovase

indinavir sulfate

Crixivan

Pharmacologic class: Protease inhibitor

Therapeutic class: Antiretroviral

Pregnancy risk category C

Action

Inhibits replication, function, and maturation of human immunodeficiency virus (HIV) protease, an enzyme essential to formation of infectious virus. As a result, further spread of virus is prevented.

Availability

Capsules: 100 mg, 200 mg, 333 mg, 400 mg

Indications and dosages

HIV infection

Adults: 800 mg P.O. q 8 hours

Dosage adjustment

• Mild to moderate hepatic insufficiency secondary to cirrhosis

Contraindications

• Hypersensitivity to drug or its components
• Concurrent use of amiodarone, ergot derivatives, cisapride, pimozide, or oral midazolam, triazolam, alprazolam, alfuzosin, sildenafil

Precautions

Use cautiously in:
• renal or severe hepatic impairment, history of renal calculi
• pregnant or breastfeeding patients
• children.

Administration

• Know that drug is usually given with other antiretrovirals.
• Give with full glass of water on empty stomach 1 hour before or 2 hours after meals.
• If GI upset occurs, give with a light meal.

Don't give concurrently with alfuzosin, amiodarone, sildenafil, cisapride (not available in U.S.), ergot derivatives, midazolam, pimozide, or triazolam.

Adverse reactions

CNS: depression, dizziness, headache, drowsiness, malaise, asthenia

CV: angina, myocardial infarction

EENT: oral paresthesia

GI: nausea, vomiting, diarrhea, abdominal pain or distention, dyspepsia, acid regurgitation, pancreatitis

GU: dysuria, crystalluria, nephrolithiasis or urolithiasis leading to renal insufficiency or failure, interstitial nephritis

Hematologic: anemia, acute hemolytic anemia, increased spontaneous bleeding (in hemophiliacs)

Hepatic: jaundice, hepatic dysfunction, hepatic failure

Metabolic: new onset or exacerbation of diabetes mellitus, hyperglycemia

Musculoskeletal: joint or back pain

Respiratory: cough, dyspnea

Skin: urticaria, rash, pruritus

Other: abnormal taste, increased or decreased appetite, body fat redistribution or accumulation, fever, anaphylactoid reactions

Interactions

Drug-drug.Azole antifungals, delavirdine, interleukins: elevated indinavir blood level, greater risk of toxicity

Cisapride, ergot derivatives, midazolam, pimozide, triazolam: CYP3A4 inhibition by indinavir, leading to increased blood levels of these drugs and dangerous reactions

Didanosine, efavirenz, rifamycins: decreased indinavir effects

Drug-diagnostic tests.Alanine aminotransferase, amylase, aspartate aminotransferase, bilirubin, cholesterol, glucose, triglycerides: increased values

Hemoglobin, neutrophils, platelets: decreased values

Drug-food.Any food: decreased indinavir absorption

Drug-herbs.St. John's wort: decreased indinavir blood level

Patient monitoring

• Assess fluid intake and output to ensure adequate hydration and help prevent nephrolithiasis or urolithiasis.
• Monitor for adverse GI and CNS effects.
• Evaluate liver function test results. Assess for hyperbilirubinemia.
• Monitor cholesterol, glucose, and CBC with white cell differential.

Patient teaching

• Tell patient to take 1 hour before or 2 hours after meals with a full glass of water.
• If GI upset occurs, advise patient to take with a light meal.

Instruct patient to report severe nausea or diarrhea, fever, chills, flank pain, urine or stool color changes, yellowing of skin or eyes, or personality changes.
• Tell patient that drug doesn't cure HIV infection and that its long-term effects are largely unknown.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and herbs mentioned above.

Crixivan

(krĭk′sə-văn)
A trademark for the drug indinavir sulfate.

Crixivan

a trademark for an antiretroviral protease inhibitor (indinavir).

Crixivan®

 Indinavir, see there.

Crixivan

A brand name for INDINAVIR.
References in periodicals archive ?
Once this inmate got to Parchman, he was not allowed Crixivan.
COLUMN A COLUMN B Crixivan Combivir Kaletra Retrovir plus Epivir Norvir plus Fortovase Retrovir plus Videx Norvir plus Kaletra Trizivir Sustiva Zerit plus Epivir Viracept Zerit plus Videx
With prices currently announced for poor countries by other pharmaceutical companies (which might be reduced in the near future), prices to Africans for triple therapy including either Crixivan or Stochrin (efavirenz) will still be over $1000 per person per year.
Schranz has worked on many anti-infective clinical and commercial development programs including CRIXIVAN, PRIMAXIN, CEFOXITIN, INVANZ, AUGMENTIN XR, ERAXIS, CANCIDAS, PREVENAR and PREVENAR 13.
The first shipments of indinavir, sold as Crixivan, will be available through Stadtlanders next week, and Merck is scrambling to begin full production of the drug by October.
The committee is expected to approve another AIDS drug, Crixivan, developed by Merck & Co.
The prices of other formulations of STOCRIN and Merck's other HIV/AIDS medicine, CRIXIVAN (indinavir sulfate), remain unchanged.
The drug, sold by GlaxoSmithKline (NYSE: GSK), has a convenient dosing and favorable metabolic profile relative to first-generation protease inhibitors such as Agenerase, Crixivan, and Viracept.
During her tenure at Merck she was responsible for the rapid approval of Crixivan to treat HIV infection.
At the end of 2005, nearly 500,000 patients in 76 developing countries were being treated with antiretroviral regimens containing either of Merck's two current HIV/AIDS medicines, STOCRIN and CRIXIVAN (indinavir sulfate).
2 billion * Other reported products comprise: AGGRASTAT, ARCOXIA, CANCIDAS, COSOPT, CRIXIVAN, EMEND, INVANZ, MAXALT, PRIMAXIN, PROPECIA, PROSCAR, STOCRIN, TIMOPTIC/TIMOPTIC XE, TRUSOPT, Vaccines and VASOTEC/VASERETIC.