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Pronounced: CRIX-i-van
Generic name: Indinavir sulfate

Why is this drug prescribed: Crixivan is used in the treatment of human immunodeficiency virus (HIV) infection. HIV causes the immune system to break down so that it can no longer fight off other infections. This leads to the fatal disease known as acquired immune deficiency syndrome (AIDS). HIV thrives by taking over the immune system's vital CD4 cells (white blood cells) and using their inner workings to make additional copies of itself. Crixivan belongs to a class of HIV drugs called protease inhibitors, which work by interfering with an important step in the virus's reproductive cycle. Although Crixivan cannot eliminate HIV already present in the body, it can reduce the amount of virus available to infect other cells. Crixivan can be taken alone or in combination with other HIV drugs such as Retrovir. Because Crixivan and Retrovir attack the virus in different ways, the combination is likely to be more effective than either drug alone.

Most important fact about this drug: It is important that you drink at least six 8-ounce glasses of liquid (preferably water) daily while taking Crixivan. If you do not get enough liquid, you may develop kidney stones and have to temporarily stop taking Crixivan or even discontinue it altogether.

How should you take this medication: Take this medication exactly as prescribed by your doctor. Do not share this medication with anyone and do not take more than your recommended dosage. To ensure maximum absorption, do not take Crixivan with food. Instead, take it with water 1 hour before or 2 hours after a meal. (Crixivan may also be taken with liquids such as skim milk, juice, coffee, or tea, or even with a light meal such as dry toast with jelly, juice, and coffee with skim milk and sugar, or corn flakes with skim milk and sugar.) --If you miss a dose... Skip it and take the next dose at the regularly scheduled time. Do not double the dose. --Storage instructions... Crixivan capsules are sensitive to moisture. Store Crixivan at room temperature in the original container and leave the drying agent in the bottle to keep the medication dry. Keep the container tightly closed.

What side effects may occur: Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Crixivan. Possible side effects may include: Abdominal distention and pain, allergic reactions, anemia, back pain, bladder infections, blood in the urine, changes in taste, chest pain and heart disorders, depression, diabetes, diarrhea, discolored skin, dizziness, drowsiness, dry skin and mouth, fatigue, general feeling of illness, hair loss, headache, hives, indigestion, inflamed blood vessels, ingrown toenails, insomnia, itching, joint pain, kidney problems, liver problems, loss of appetite, nausea, numbness of the mouth, pain in the side, rash, redistribution of body fat, skin discoloration, stroke, vomiting, weakness, yellow skin or eyes

Why should this drug not be prescribed: If you suffer a severe allergic reaction to Crixivan or any of its ingredients, you should not take this medication.

Special warnings about this medication: Although Crixivan reduces the amount of HIV in the blood and increases the white blood cell count, its long-term effect on survival is still unknown. The virus remains in the body, and you will continue to face the possibility of complications, including opportunistic infections (rare infections that develop when the immune system falters) such as certain types of pneumonia, tuberculosis, and fungal infection. Therefore, it is important that you remain under the care of a doctor and keep all your follow-up appointments. Crixivan is not a cure for HIV infection, and it does not reduce the risk of transmission of HIV to others through sexual contact or blood contamination. Therefore, you should continue to avoid practices that could spread HIV. Protease inhibitors such as Crixivan have been known to trigger diabetes (high blood sugar levels) or worsen existing diabetes. If you have diabetes, the dosages of your diabetes medications may have to be adjusted. People taking HIV medications may also experience a redistribution of body fat, with wasting of the face, arms, and legs, and accumulation of fat around the middle, the upper back, and breasts. Cases of liver failure and death have occurred in patients treated with Crixivan and other medications. If you have a liver problem, particularly cirrhosis of the liver, make sure the doctor is aware of it. Kidney problems, including kidney and urinary stones, are also a possibility, so alert the doctor if you have any type of kidney disease. Some patients have developed severe anemia (loss of red blood cells) while taking Crixivan. If this problem surfaces, you will have to stop taking the drug. If you have hemophilia, you should also be aware that spontaneous bleeding has occurred in hemophilia victims taking protease inhibitors such as Crixivan.

Possible food and drug interactions when taking this medication: Do not take Crixivan with rifampin (Rifadin); it reduces Crixivan's effectiveness. Also avoid the following medications while taking Crixivan. The combination may cause serious or life-threatening effects. Ergot-based drugs such as Cafergot Lovastatin (Mevacor) Midazolam (Versed) Pimozide (Orap) Simvastatin (Zocor) Triazolam (Halcion) It's also best to avoid combining Crixivan with St. John's Wort, which reduces Crixivan's effect. Crixivan may interact with certain other drugs, and the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Crixivan with the following: Atorvastatin (Lipitor) Carbamazepine (Tegretol) Cerivastatin (Baycol) Clarithromycin (Biaxin) Delavirdine (Rescriptor) Dexamethasone (Decadron) Didanosine (Videx) Efavirenz (Sustiva) Fluconazole (Diflucan) Fluvastatin (Lescol) Heart medications known as calcium channel blockers, including Cardizem, Plendil, and Procardia Isoniazid (Nydrazid) Itraconazole (Sporanox) Ketoconazole (Nizoral) Ortho-Novum Phenobarbital Phenytoin (Dilantin) Pravastatin (Pravachol) Quinidine (Quinidex) Rifabutin (Mycobutin) Rifampin (Rifadin) Trimethoprim (Bactrim, Trimpex, Septra) Check with your doctor before using Viagra while on Crixivan. Combining the two increases the risk of side effects from Viagra, including low blood pressure, vision problems, and a dangerously prolonged erection. If an erection lasts more than 4 hours, seek medical help immediately to avoid permanent damage to the penis. Avoid drinking grapefruit juice while taking Crixivan. This kind of juice can reduce the drug's effectiveness. Be sure to tell your doctor and pharmacist about all medications you are taking, both prescription and over-the-counter. Alert them, too, when you stop taking a medication.

Special information if you are pregnant or breastfeeding: The effects of Crixivan during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, tell your doctor immediately. Do not breastfeed your baby. HIV appears in breast milk and can infect a nursing infant.

Recommended dosage: ADULTS: The recommended dose of Crixivan is 800 milligrams (usually two 400-milligram capsules) every 8 hours. Your doctor may lower the dose to 600 milligrams every 8 hours if you have mild-to-moderate liver problems due to cirrhosis. The dose will also need adjustment if you are taking Rescriptor, Mycobutin, Nizoral, Sporanox, Sustiva, or Videx. CHILDREN: Crixivan is more likely to cause kidney stones in children than in adults. If the doctor finds it necessary to prescribe Crixivan anyway, dosage is calculated according to the size of the child.

Overdosage: Any medication taken in excess can have serious consequences. If you suspect an overdose, seek emergency medical treatment immediately. Symptoms of Crixivan overdose may include: Back pain, blood in urine, diarrhea, kidney stones, nausea, vomiting

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