Indinavir and Ketoconazole (Systemic)

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Using indinavir together with ketoconazole may increase the blood levels and effects of both drugs. Contact your doctor if you experience fever, chills, cough, nausea, stomach pain, loss of appetite, dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration of ketoconazole has been reported to increase the mean area under the plasma concentration-time curve of indinavir by 68%. The proposed mechanism is inhibition of CYP450 3A4 hepatic metabolism by ketoconazole. In addition, indinavir and ritonavir also inhibit CYP 450 3A4 and consequently may increase the plasma concentrations of ketoconazole.

MANAGEMENT: The manufacturer recommends that a 600 mg dose of indinavir be given every eight hours if these agents must be used concomitantly. In patients with liver disease, further dosage reductions may be necessary. In addition, a dosage reduction of ketoconazole should be considered when coadministered with indinavir and ritonavir. Some authorities suggest that ketoconazole doses greater than 200 mg per day are not recommended when administered with HIV-protease inhibitors boosted with ritonavir. The patient should be monitored for the therapeutic and adverse effects of both ketoconazole and indinavir, and dosage adjustments should be made as necessary.

Indinavir

Generic Name: indinavir

Brand name: Crixivan

Synonyms: n.a.

What is Indinavir?

Ketoconazole (Systemic)

Generic Name: ketoconazole

Brand name: Nizoral

Synonyms: Ketoconazole

What is Ketoconazole (Systemic)?