Indinavir use while Breastfeeding
Drugs containing Indinavir: Crixivan
Medically reviewed by Drugs.com. Last updated on Dec 30, 2020.
Indinavir Levels and Effects while Breastfeeding
Summary of Use during Lactation
Published experience with indinavir during breastfeeding is limited. Indinavir is not a recommended agent during breastfeeding.[1,2]
Maternal Levels. One woman was receiving indinavir 600 mg twice daily as part of a highly-active antiretroviral combination regimen. During the first 5 days postpartum milk was collected just before and 2 hours after the dose of indinavir. Milk indinavir concentrations ranged between 90 and 540% of the maternal serum concentration. Further details on the timing, or actual breastmilk concentrations were not provided.
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
Effects on Lactation and Breastmilk
Gynecomastia has been reported among men receiving highly active antiretroviral therapy. Gynecomastia is unilateral initially, but progresses to bilateral in about half of cases. No alterations in serum prolactin were noted and spontaneous resolution usually occurred within one year, even with continuation of the regimen.[4-6] Some case reports and in vitro studies have suggested that protease inhibitors might cause hyperprolactinemia and galactorrhea in some male patients,[7,8] although this has been disputed. The relevance of these findings to nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
AIDSinfo. Panel on treatment of pregnant women with HIV infection and prevention of perinatal transmission. Recommendations for use of antiretroviral drugs in transmission in the United States, 2018: Counseling and management of women living with HIV who breastfeed. https://aidsinfo
.nih .gov/guidelines/html /3/perinatal/513/counseling-and-management-of-women-living-with-hiv-who-breastfeed.
World Health Organization. HIV and infant feeding: Update. 2007. http://whqlibdoc
.who .int/publications/2007 /9789241595964_eng.pdf.
Colebunders R, Hodossy B, Burger D, et al. The effect of highly active antiretroviral treatment on viral load and antiretroviral drug levels in breast milk. AIDS. 2005;19:1912–5. [PubMed: 16227801]
García-Benayas T, Blanco F, Martin-Carbonero L, et al. Gynecomastia in HIV-infected patients receiving antiretroviral therapy. AIDS Res Hum Retroviruses. 2003;19:739–41. [PubMed: 14585204]
Pantanowitz L, Evans D, Gross PD, et al. HIV-related gynecomastia. Breast J. 2003;9:131–2. [PubMed: 12603389]
Evans DL, Pantanowitz L, Dezube BJ, et al. Breast enlargement in 13 men who were seropositive for human immunodeficiency virus. Clin Infect Dis. 2002;35:1113–9. [PubMed: 12384846]
Hutchinson J, Murphy M, Harries R, et al. Galactorrhoea and hyperprolactinaemia associated with protease-inhibitors. Lancet. 2000;356:1003–4. [PubMed: 11041407]
Orlando G, Brunetti L, Vacca M. Ritonavir and saquinavir directly stimulate anterior pituitary prolactin secretion, in vitro. Int J Immunopathol Pharmacol. 2002;15:65–8. [PubMed: 12593790]
Montero A, Bottasso OA, Luraghi MR, et al. Galactorrhoea, hyperprolactinaemia, and protease inhibitors. Lancet. 2001;357:473–4. [PubMed: 11273087]
CAS Registry Number
HIV Protease Inhibitors
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