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Indinavir Sulfate and Vitamin C

Determining the interaction of Indinavir Sulfate and Vitamin C and the possibility of their joint administration.

Check result:

Indinavir Sulfate <> Vitamin C

Relevance: 21.05.2022 Reviewer: Shkutko P.M., M.D., in

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.

Consumer:

Consumer information for this minor interaction is not currently available. Some minor drug interactions may not be clinically relevant in all patients. Minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

Professional:

Coadministration with high dosages of vitamin C (1 g/day or more) may decrease the plasma concentrations of indinavir. The exact mechanism of interaction is unknown, although preliminary data suggest that vitamin C may induce CYP450 3A4, the isoenzyme responsible for the metabolic clearance of indinavir. In seven healthy volunteers (six males and one female), pretreatment with vitamin C (1000 mg daily for 7 days) decreased the mean peak plasma concentration (Cmax) and systemic exposure (AUC) of indinavir (800 mg for 4 doses, 8 hours apart) by 20% and 14%, respectively, compared to administration of indinavir alone. Mean indinavir trough plasma concentration (Cmin) was 32% lower with vitamin C, but the difference was not statistically significant. There was no significant difference in indinavir oral clearance and elimination half-life. The clinical relevance of this interaction is uncertain. A study involving a larger number of patients (including more women), use of higher dosages of vitamin C, and concomitant administration of ritonavir would be helpful.

References

Slain D, Amsden JR, Khakoo RA, Fisher MA, Lalka D, Hobbs GR "Effect of high-dose vitamin C on the steady-state pharmacokinetics of the protease inhibitor indinavir in healthy volunteers. Available from: URL: http://www.icaac.org/ICAAC.asp." ([2003 Sep 14-7]):
"Anti-HIV agents. High-dose vitamin C may affect indinavir users." TreatmentUpdate 15 (2003): 5-6

Indinavir Sulfate

Generic Name: indinavir

Brand name: Crixivan

Synonyms: Indinavir

What is Indinavir Sulfate?

Vitamin C

Generic Name: ascorbic acid

Brand name: Acerola, Ascorbic Acid Quick Melts, C/Rose Hips, Cecon, Cemill 500, C-Time, Ester-C, N Ice with Vitamin C, Sunkist Vitamin C, Vasoflex HD, Vicks Vitamin C Drops, Vitamin C, Cenolate, Mega-C-Acid Plus, Cee-500, C-500-Gr, Centrum Singles-Vitamin C, Ascot, Cevi-Bid, Vitamin C TR, Vitamin C with Rose Hips, Cemill 1000, Ascor L NC, Ascor, Ascor L 500, Betac, Cemill, Protexin

Synonyms: n.a.

What is Vitamin C?

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In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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