Indinavir Dosage
Applies to the following strengths: 100 mg; 200 mg; 400 mg; 333 mg
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for HIV Infection
800 mg orally every 8 hours
Use: In combination with other antiretroviral agents, for the treatment of HIV infection
Panel on Antiretroviral Guidelines for Adults and Adolescents Recommendations: 800 mg orally every 8 hours
- With ritonavir: Indinavir 800 mg plus ritonavir 100 to 200 mg orally twice a day
Comments:
- This drug is no longer recommended for use due to suboptimal antiviral potency, unacceptable toxicities, high pill burden, or pharmacologic concerns.
- Unboosted indinavir is not recommended as initial therapy due to frequency of administration, fluid requirement, and side effects (e.g., nephrolithiasis, crystalluria); indinavir plus ritonavir is not recommended as initial therapy due to fluid requirement and side effects.
- Unboosted indinavir should be administered 1 hour before or 2 hours after meals (may administer with skim milk or low-fat meal); indinavir plus ritonavir may be administered without regard to meals.
- Current guidelines should be consulted for additional information.
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Mild to moderate liver dysfunction due to cirrhosis: 600 mg orally every 8 hours
Severe liver dysfunction: Data not available
Dose Adjustments
Concomitant therapy:
- Coadministration with delavirdine (400 mg 3 times a day): Dose reduction to 600 mg orally every 8 hours should be considered.
- Coadministration with itraconazole (200 mg twice a day) or ketoconazole: Dose should be reduced to 600 mg orally every 8 hours.
- Coadministration with rifabutin: Dose should be increased to 1000 mg orally every 8 hours.
Comments:
- If this drug is used with rifabutin, the standard rifabutin dose should be decreased by half; the manufacturer product information for rifabutin should be consulted.
Precautions
CONTRAINDICATIONS:
- Clinically significant hypersensitivity to the active component or any of the ingredients
- Coadministration with alfuzosin, amiodarone, dihydroergotamine, ergonovine, ergotamine, methylergonovine, cisapride, lovastatin, simvastatin, lurasidone, pimozide, oral midazolam, triazolam, alprazolam, sildenafil (for treatment of pulmonary arterial hypertension)
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Use in combination with other antiretroviral drugs.
- Must administer at 8-hour intervals
- Administer with water 1 hour before or 2 hours after a meal (for optimal absorption); alternatively, may administer with other liquids (e.g., skim milk, juice, coffee, tea) or with a light meal (e.g., dry toast with jelly, juice, and coffee with skim milk and sugar; corn flakes, skim milk, and sugar); do not administer with a high calorie, fat, and protein meal (absorption reduced).
- Ensure patients maintain adequate hydration (at least 1.5 L/24 hours).
- If using with didanosine, administer at least 1 hour apart on an empty stomach; consult the manufacturer product information for didanosine.
- Consult the manufacturer product information regarding missed doses.
Storage requirements:
- Store in tightly-closed bottle at room temperature (15C to 30C [59F to 86F]); protect from moisture.
- Dispense and store in the original container; keep the desiccant in the bottle.
General:
- In addition to adequate hydration, medical management of patients with nephrolithiasis/urolithiasis may include temporary interruption (e.g., 1 to 3 days) or cessation of therapy.
- The capsules are sensitive to moisture.
Monitoring:
- Renal: Urinalysis in patients with asymptomatic severe leukocyturia (often)
Patient advice:
- Read the US FDA-approved patient labeling (Patient Information).
- Drink plenty of fluids, at least 1.5 L (about 48 ounces) during each 24-hour period.
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