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®

 Indinavir, see there.

Crixivan

A brand name for INDINAVIR.
References in periodicals archive ?
The University of Sydney Table 1 Drugs whose metabolism is inhibited and bioavailability increased by grapefruit juice (6,7) Anti-hypertensive Calcium channel blockers FELODPINE ('Agon'; 'felodur'; 'Plendil' NIFEDIPINE ('Adalat'; 'Nyefax') NISOLDIPINE NITRENDIPINE NIMODIPINE ('Nimotop') Certain HMG CoA Reductase inhibitors SIMVASTATIN ('Lipex'; 'Zocor') LOVASTATIN ATORVASTATIN ('Lipitor') Immunomodifiers CYCLOSPORIN ('Neoral') TACROLIMUS ('Prograf') An Anti-convulsant CARBAMAZEPINE ('Tegretol') Certain Benzodiazepine sedatives MIDAZOLAM ('Hypnovel') TRIAZOLAM ('Halcion') Certain Anti-viral agents INDINAVIR ('Crixivan') SAQUINAVIR ('Invirase'; 'Fortovase') GI Motility stimulant CISAPRIDE ('Prepulsid') An Azopirone Anxiolytic BUSPIRONE ('Buspar') (9)
Pls--Agenerase, Crixivan, Kaletra, Viracept, Norvir, Fortovase, Invirase
treatment protocol (e.g., "He put me on 3TC, Adenivir, and Crixivan
This ad, one of a series for the AIDS drug Crixivan, advises: "Remember to ask your doctor about Crixivan." Warnings about side effects such as swollen organs, kidney stones, respiratory infections, pneumonia, muscle pain, blood in the urine, abdominal swelling, cirrhosis and liver failure and confined to a page of small print which also states that the clinical significance of the drug's supposed benefits "has not been established." Like a series of Viramune ads depicting HIV-positive Odysseans crossing the Pacific, this ad reinforces the image of gay men as dutifylly enduring their regimen of drugs.
While on Crixivan, I ended up in the hospital with kidney stones.
(236) Merck, the German drug manufacturer of the antiretroviral Indivanir Sulphate (Crixivan) "warned the South African government that it was reconsidering a fifty million Rand investment in South Africa in light of the bill ...
Two anti-HIV medications -- Crixivan and Stocrin -- are being provided for a discount of 85% to patients in Haiti, Trinidad & Tobago, the Dominican Republic, Guyana and Suriname, said Merck & Co.
Medical experts in Romania fear supplies of AIDS medicine Crixivan will run out in two weeks.
The drug company Merck recently came forward to make its drug, Crixivan available at $600 per patient per year (U.S.
When South African President Thabo Mbeki considered enacting "compulsory licensing" for AIDS drugs--allowing the South African government to sell its citizens cheap, generic versions of high-priced, patented medications--Downey lobbied the Clinton administration on behalf of Merck & Company (which manufactures CRIXIVAN, a popular AIDS medication) to pressure Mbeki to back down.
In one report earlier this year, eight healthy men and women were given a protease inhibitor called indinavir (Crixivan), which combats the HIV virus, along with St.