Indinavir (Crixivan): quick facts, risks, and smart tips

Indinavir is an older HIV protease inhibitor that helped many people control HIV. Today it's used less often because newer drugs have fewer side effects. Still, you might encounter it in older regimens or in places with limited drug options, so it helps to know the basics.

How indinavir works and typical use

Indinavir blocks HIV protease, an enzyme the virus needs to make new infectious copies. Blocking that enzyme reduces viral load and helps your immune system recover. Doctors usually prescribe it as part of a combination therapy, not alone. Dosage and schedule depend on whether it’s given with a boosting drug like ritonavir—your prescriber will choose the right plan.

Side effects and what to watch for

The most talked-about side effect is kidney stones. Indinavir can form crystals in urine, and that can cause painful stones or even block urine flow. Drink plenty of water unless your doctor tells you otherwise — staying well hydrated lowers the stone risk. If you get sharp flank pain, blood in urine, or trouble peeing, contact your provider right away.

Other common effects: nausea, headache, and elevated bilirubin (which can turn skin or eyes slightly yellow). Protease inhibitors as a class can cause changes in blood fats and blood sugar. That means your doctor will likely check lipid panels and glucose from time to time.

Rare but serious problems include liver problems and severe allergic reactions. If you notice dark urine, severe belly pain, jaundice, or symptoms of a strong allergic reaction, seek care immediately.

Indinavir interacts with many drugs. It’s processed by the liver enzyme system CYP3A4, so drugs that strongly speed up or slow down CYP3A4 can change indinavir levels. That affects both safety and effectiveness. Tell your clinician about all meds, supplements, and even herbal products (for example, some heart meds, certain sedatives, or St. John’s wort can cause trouble).

Because interactions are common, don’t start or stop other medicines without asking your HIV team. They can adjust doses or pick safer alternatives.

Before starting indinavir you’ll likely get baseline blood tests: liver function, kidney function, and lipids. Your team will repeat these during treatment to spot problems early.

Buying medicines online? Indinavir requires a prescription. Use licensed pharmacies, check for clear contact info, and avoid sites that sell prescription drugs without a prescription. If a deal looks too good to be true, it probably is.

Final practical tip: keep a simple checklist — take your pills as prescribed, hydrate well, report new pain or jaundice, and keep regular blood tests. Newer HIV drugs are easier to live with, but when indinavir is part of care, small habits (like good hydration and open communication with your provider) make a big difference.