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Indinavir structure.svg
Indinavir ball-and-stick.png
Clinical data
Trade names Crixivan
AHFS/ Monograph
MedlinePlus a696028
License data
  • US: C (Risk not ruled out)
Routes of
ATC code
Pharmacokinetic data
Bioavailability ~65%
Protein binding 60%
Metabolism Hepatic via CYP3A4
Elimination half-life 1.8 ± 0.4 hours
CAS Number
PubChem CID
PDB ligand
Chemical and physical data
Formula C36H47N5O4
Molar mass 613.79 g/mol
3D model (JSmol)
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Indinavir (IDV; trade name Crixivan, manufactured by Merck) is a protease inhibitor used as a component of highly active antiretroviral therapy to treat HIV/AIDS.

HIV-1 protease in complex with indinavir. PDB entry 2avo[1]

It is on the World Health Organization's List of Essential Medicines, a list of the most important medications needed in a basic health system.[2]

Medical uses[edit]

Unfortunately, indinavir wears off quickly after dosing, so requires very precise dosing every eight hours to thwart HIV from forming drug-resistant mutations, including resistances to other protease inhibitors. It has restrictions on what sorts of food may be eaten concurrently. For these reasons it is now rarely used.

Side effects[edit]

The most common side effects of indinavir include:[3]

Indinavir inhibits urinary nitrous oxide production and may inhibit nitric oxide production. Treatment with this drug is frequently associated with renal abnormalities, sterile leukocyturia, and reduced creatinine clearance.[5]

Indinavir impairs endothelial function in healthy HIV-negative men and may accelerate atherosclerotic disease.[6]


The Food and Drug Administration (FDA) approved indinavir on March 13, 1996, making it the eighth antiretroviral drug approved. Indinavir is much more powerful than any prior antiretroviral drug; using it with dual NRTIs set a new standard for treatment of HIV/AIDS.[citation needed] Protease inhibitors changed the nature of AIDS from a terminal illness to a somewhat manageable one.[citation needed]

Increasingly, it is being replaced by newer drugs that are more convenient to take and less likely to promote virus resistance, such as darunavir or atazanavir.


  1. ^ Liu, F.; Boross, P. I.; Wang, Y. F.; Tozser, J.; Louis, J. M.; Harrison, R. W.; Weber, I. T. (2005). "Kinetic, Stability, and Structural Changes in High-resolution Crystal Structures of HIV-1 Protease with Drug-resistant Mutations L24I, I50V, and G73S". Journal of Molecular Biology. 354 (4): 789–800. doi:10.1016/j.jmb.2005.09.095. PMC 1403828Freely accessible. PMID 16277992. 
  2. ^ "WHO Model List of EssentialMedicines" (PDF). World Health Organization. October 2013. Retrieved 22 April 2014. 
  3. ^ "Crixivan® (indinavir sulfate) Capsules. Prescribing Information. Revised December 2013" (PDF). Merck & Co., Inc. Retrieved 6 February 2014. 
  4. ^ Capaldini, L (1997). "Protease inhibitors' metabolic side effects: cholesterol, triglycerides, blood sugar, and "Crix belly"". AIDS Treatment News (277): 1–4. PMID 11364559. 
  5. ^ M. Eira, M. Araujo and A.C. Seguro. Urinary NO3 excretion and renal failure in indinavir-treated patients. Brazilian Journal of Medical and Biological Research (2006) 39: 1065-1070.
  6. ^ Shankar SS, Dubé MP, Gorski JC, Klaunig JE, Steinberg HO. Indinavir impairs endothelial function in healthy HIV-negative men. Am Heart J. 2005 Nov;150(5):933.