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Because of the complex regimens and side effects associated with the use of indinavirthis drug is rarely used in Canada and other high-income countriesStillif indinavir is prescribed in Canadahere is some information.

See Table 9 for steps to prevent or manage these possible and known significant drug interactionsincluding dosing recommendationsConsider the potential for drug interactions prior to and during CRIXIVAN therapyreview concomitant medications during CRIXIVAN therapyand monitor for the adverse reactions associated with the concomitant medications.

For many people with HIVthe use of ART has increased their CD4cell counts and decreased the amount of HIV in their bloodviral loadThese beneficial effects help to reduce the risk of developing a life-threatening infectionNeither indinavir nor any other anti-HIV medication is a cure for HIVIt is therefore important that you do the following:

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Table 9Established and Other Potentially Significant Drug InteractionsAlteration in Dose or Regimen May Be Recommended Based on Drug Interaction Studies or Predicted InteractionSee also CLINICAL PHARMACOLOGY for magnitude of interactionWARNINGS and DOSAGE AND ADMINISTRATION

See your doctor regularly so that he/she can monitor your healthContinue to practise safer sex and take other precautions so as not to pass HIV on to other people.

Skin and Skin Appendagerash including erythema multiforme and Stevens-Johnson syndromehyperpigmentationalopeciaingrown toenails and/or paronychiapruritus.

Indirect hyperbilirubinemia has occurred frequently during treatment with CRIXIVAN and has infrequently been associated with increases in serum transaminasessee also ADVERSE REACTIONSClinical Trials and Post-Marketing ExperienceIt is not known whether CRIXIVAN will exacerbate the physiologic hyperbilirubinemia seen in neonatesSee Pregnancy

Urogenital Systemnephrolithiasis/urolithiasisin some cases resulting in renal insufficiency or acute renal failurepyelonephritis with or without bacteremiasee WARNINGSinterstitial nephritis sometimes with indinavir crystal depositsin some patientsthe interstitial nephritis did not resolve following discontinuation of CRIXIVANrenal insufficiencyrenal failureleukocyturiasee PRECAUTIONScrystalluriadysuria.

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CRIXIVAN is contraindicated in patients with clinically significant hypersensitivity to any of its components.

Campo REMoreno JNSuarez Get alEfficacy of indinavir-ritonavir-based regimens in HIV-1-infected patients with prior protease inhibitor failuresAIDS2003;17(131933-1939.

Indinavirsold under the brand name Crixivanis a type of anti-HIV drugantiretroviralcalled a protease inhibitorPIIndinavir is used in combination with other anti-HIV drugs to treatbut not cureHIV.

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Boyd MIndinavirthe forgotten HIV-protease inhibitorDoes it still have a roleExpert Opinion in Pharmacotherapy 2007;8(7957-964.

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however, this and other dose combinations of indinavir and ritonavir are experimental.