Crixivan (indinavir)

- Crixivan capsules should be taken one hour before or two hours after a meal. If necessary the medicine can be taken with a low-fat, light meal. If you are taking this medicine in combination with low-dose ritonavir, you should take both medicines with food. If you taking this medicine in combination with didanosine, allow one hour between taking each medicine, because the antacids in didanosine tablets reduce the absorption of indinavir from the gut.
- The HIV virus is very good at becoming resistant to anti-HIV medicines. For this reason it is very important that you carefully follow your doctor's instructions for taking your anti-HIV medicines, in order to maintain effective levels of the medicines in your blood. If the blood levels drop, the virus will be given more chance to replicate and develop resistance to the drugs. Skipping even a few doses increases the risk of treatment failure, so you should try to ensure that you take all your doses at the correct time, and that you visit your doctor for repeat prescriptions before you run out of medicine.
- Treatment of HIV infection with anti-HIV medicines such as this one does not reduce the risk of transmitting the virus to other people through sexual contact or blood contamination. You should continue to use condoms to prevent transmitting the virus to your sexual partner.
- Combination antiretroviral therapy has been associated with a redistribution of body fat (lipodystrophy) in people with HIV. The long-term consequences of this are currently unknown, however your doctor may wish to monitor your body fat, and the levels of lipids (eg cholesterol) and sugar (glucose) in your blood, and may prescribe additional medicines for any lipid disorders that occur during treatment with this medicine. Contact your doctor if you notice any changes in your body fat during treatment with your HIV medicines.
- This medicine can cause kidney stones, and for this reason it is important that you drink plenty of fluids while you are taking it. Children taking this medicine are at a higher risk of kidney stones than adults. If you get any symptoms of kidney stones, for example pain in your lower back or blood in your urine, you should consult your doctor. You may need to stop taking this medicine for a few days.
- If you have any problems with your liver, in particular chronic hepatitis B or C, you will need to have regular blood tests to monitor your liver while you are taking this medicine. Symptoms that may suggest a liver problem include persistent nausea and vomiting, abdominal pain, or the development of jaundice (a yellow colouring to the skin and the whites of the eyes). Consult your doctor if you experience any of these symptoms. People with liver problems also have a higher risk of developing kidney stones.
- Some people being treated with combination antiretroviral therapy may develop a bone condition called osteonecrosis. This condition is caused by loss of blood supply to a bone, causing death of the bone tissue. The risk of the condition is thought to be increased by corticosteroid use, alcohol consumption, severe immunosuppression, higher body mass index, advanced HIV disease and long-term use of antiretroviral medicines. If you notice any joint stiffness, aches and pains (especially of the hip, knee and shoulder) or difficulty in movement while using this medicine, you should tell your doctor so this can be investigated.
- You should store your Crixivan capsules in the container in which they were dispensed and not transfer them to another container. This is because the original container contains a dessicant that stops the capsules absorbing moisture.

Use with caution in

- Decreased liver function.
- Liver disease, particularly chronic hepatitis B or hepatitis C.
- People with the blood clotting disorder haemophilia (this medicine may increase the risk of bleeding in people with haemophilia).
- Hereditary blood disorders called porphyrias.
- Diabetes.

Not to be used in

- Allergy to any ingredient.
- Rare hereditary problems of galactose intolerance, the Lapp lactose deficiency or glucose-galactose malabsorption (Crixivan capsules contain lactose).
- This medicine is not recommended for children under four years of age, as its safety and efficacy have not been studied in this age group.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- The safety of this medicine during pregnancy has not been established. It should only be used during pregnancy if the potential benefit outweighs any potential risks to the developing baby. Seek medical advice from your doctor.
- It is recommended that women infected with the HIV virus must not breastfeed their infants under any circumstances, in order to avoid transmission of the virus to the baby. Seek medical advice from your doctor.

Label warnings

- This medicine should be taken with plenty of water.

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