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Tell your doctor if you are pregnant or plan to become pregnant. HIV can be passed to your baby if you are not properly treated during pregnancy. You may also drink juice, coffee, or tea with this medicine.

Drink at least 6 glasses of water each day to prevent kidney stones while you are taking indinavir. If you prefer to take the medicine with food, eat only a light meal, such as dry toast with jelly, or corn flakes with skim milk and sugar. If you also take didanosine, take it 1 hour before or after you take indinavir, on an empty stomach.

Taking indinavir will not prevent you from passing HIV to other people. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person. Indinavir may increase your risk of certain infections or autoimmune disorders by changing the way your immune system works.

Symptoms may occur weeks or months after you start treatment with indinavir.

Selected laboratory abnormalities of severe or life-threatening intensity reported in patients treated with CRIXIVAN alone, CRIXIVAN in combination with zidovudine or zidovudine plus lamivudine, zidovudine alone, or zidovudine plus lamivudine are presented in Table 11. Indinavir is an inhibitor of the cytochrome P450 isoform CYP3A4. Indinavir is metabolized by CYP3A4. Drugs that induce CYP3A4 activity would be expected to increase the clearance of indinavir, resulting in lowered plasma concentrations of indinavir.

Coadministration of CRIXIVAN and other drugs that inhibit CYP3A4 may decrease the clearance of indinavir and may result in increased plasma concentrations of indinavir. Table 8: Drugs That Should Not Be Coadministered with CRIXIVAN Drug Class: Drug Name Clinical Comment Alpha 1-adrenoreceptor antagonist: alfuzosin Potentially increased alfuzosin concentrations can result in hypotension.

Antimycobacterial: rifampin May lead to loss of virologic response and possible resistance to CRIXIVAN or to the class of protease inhibitors or other coadministered antiretroviral agents. There is increased potential for sildenafil-associated adverse events which include visual disturbances, hypotension, prolonged erection, and syncope.

Protease inhibitor: atazanavir Both CRIXIVAN and atazanavir are associated with indirect unconjugated hyperbilirubinemia.

Combinations of these drugs have not been studied and coadministration of CRIXIVAN and atazanavir is not recommended.

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In patients who have been receiving protease inhibitor therapy for at least 10 days, initiate bosentan at 62. For patients on bosentan who need protease inhibitor therapy, discontinue use of bosentan at least 36 hours prior to starting protease inhibitor therapy.

After 10 days of the protease inhibitor therapy, bosentan may be restarted at 62. Bosentan is a substrate for organic anion transport protein OATPCYP3A, and CYP2C9. Additionally, bosentan is a significant inducer of CYP3A4 and CYP2C9 hepatic enzymes. Theoretically, bosentan may increase the clearance of the protease inhibitors and potentially lead to a reduction of anti-retroviral efficacy.

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Protease inhibitors PIs Indinavir Evidence for teratogenicity is not evident for indinavir in animal experiments or human reports. Little of indinavir crosses the placenta Mirochnick 2002. According to the data of the Antiretroviral Pregnancy Registry 2013 the malformation rate of 2.

These data are insufficient for a differentiated risk assessment. There is a theoretical concern that physiologic hyperbilirubinemia might be exacerbated due to indinavir.

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Protease inhibitor PI Indicated for the treatment of human immunodeficiency virus HIV infection in combination with other antiretroviralsPotential for nephrolithiasis 800 mg PO every 8 hours or 800 mg PO twice daily plus ritonavir 100 or 200 mg PO twice daily.

Unboosted indinavir is not recommend during pregnancy. Decrease dose to 600 mg PO every 8 hours when given with delavirdine. In patients with mild to moderate hepatic impairment due to cirrhosis, reduce the recommended dose to 600 mg PO every 8 hours. Dosing in patients with severe hepatic impairment has not been studied.

No dosage adjustments are recommended.

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  • This restriction typically requires that certain criteria be met prior to approval for the prescription.

  • If you already have diabetes, check your blood sugar levels regularly.

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  • Although specific interactions have not been studied, indinavir may interfere with the metabolism of CYP3A4 substrates, such as galantamine, and caution is warranted with coadministration.

In some patients with advanced HIV infection AIDSsigns and symptoms of inflammation from opportunistic infections may occur when combination antiretroviral treatment is started. Usually, this finding has not been associated with liver problems. Tell your doctor promptly about these or any other unusual symptoms. If the condition persists or worsens, seek medical attention. If you suspect that more than the prescribed dose of this medicine has been taken, contact your local poison control center or emergency room immediately.

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  • In addition, administration of anti-retroviral protease inhibitors with bosentan may increase bosentan serum concentrations due to the inhibition of the CYP3A4 isoenzyme.

  • Usually, this finding has not been associated with liver problems.