Indinavir Zidovudine

Gulick RM, Mellors JW, Havilir D, Eron JJ, et al. 1997. Treatment with indinavir, zidovudine, and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy. NEJM. 337 734-739. 

Ritonavir Delavirdine, efavirenz Didanosine, indinavir, zidovudine... 

Failure of antiretroviral drug therapy has been attributed to an interaction of carbamazepine with indinavir in a 48-year-old man taking indinavir, zidovudine, and lamivudine his HIV-RNA viral load became undetectable after less than 2 months and he developed a Herpes zoster infection (87). Lower doses of carbamazepine are also required during co-administration of ritonavir, as has been shown in two recent cases. 

A 48-year-old HIV-positive man taking indinavir, zidovudine, and lamivudine developed Herpes zoster infection, which was treated with famciclovir. Postherpetic neuralgia was treated with carbamazepine, and his plasma indinavir concentration fell substantially. The carbamazepine was withdrawn after 2.5 months and 2 weeks later HIV-RNA was detectable in his plasma (6 X 10 /ml). His circulating virus was resistant to lamivudine. With a further increase in viral load, his therapy was changed to nevirapine, didanosine, and stavudine. 

Shulman NS, Bosch RJ, MeUors JW, Albrecht MA, Katzenstein DA (2004) Genetic correlates of efavirenz hypersusceptibility. AIDS 13 1781-1785 Staszewski S, Morales-Ramirez J, Tashima KT, Rachlis A, Skiest D, Stanford J, Stryker R, Johnson P, Labriola DE, Earina D et al (1999) Efavirenz plus zidovudine and lamivudine, efavirenz plus indinavir, and indinavir plus zidovudine and lamivudine in the treatment of HIV-1 infection in adults. Study 006 Team. N Engl J Med 341 1865-1873 SteUbrink HJ (2007) Antiviral drugs in the treatment of AIDS what is in the pipeline Eur J Med Res 12 483 95... 

Zidovudine Didanosine Stavudine Lamivudine Abacavir Tenofovir Emtricitabine Nevirapine Efavirenz TMC125 Saquinavir Indinavir Lopinavir Fosamprenavir Atazanavir Tipranavir Darunavir Raltegravir Elvitegravir Enluvirtide Maraviroc Vicriviroc Bevirimat... 

Azithromycin, fluoroquinolones, ketoconazole, isoniazid, penicillin, rifampin, and tetracycline ° Didanosine, indinavir, stavudine, and zidovudine ° Aledronate, risedronate, and levodopa... 

Drugs that should not be combined due to overlapping toxi-cities include amprenavir oral solution plus ritonavir oral solution, atazanavir plus indinavir (due to enhanced hyperbilirubinemia), and any combination of didanosine, stavudine, and zalcitabine. Emtricitabine and lamivudine should not be combined because of their similar chemical structures, and antagonism can result when lamivudine is combined with zalcitabine, or stavudine is combined with zidovudine. 

TC, lamivudine ABC, abacavir APV, amprenavir AST, aspartate aminotransferase ALT, alanine aminotransferase ATV, atazanavir CBC, complete blood cell count D/C, discontinue ddl, didano-sine d4T, stavudine EFV, efavirenz FTC, emtricitabine P1BV, hepatitis B virus F1CV, hepatitis C vims HIV, human immunodeficiency virus IDV, indinavir IV, intravenous LFT, liver function tests LPV/r, lopinavir + ritonavir NNRTI, nonnucleoside reverse transcriptase inhibitor NRTI, nucleoside reverse transcriptase inhibitor NVP, nevirapine PI, protease inhibitor PT, prothrombin time T.bili, total bilirubin TDF, tenofovir disoproxiI fumarate TPV, tipranavir ULN, upper limit of normal ZDV, zidovudine. 

Peptidases encoded by many viruses play essential roles at various stages of viral replication, including the coordinated assembly and maturation of virons [7a]. Viral peptidases have become important drug targets in the treatment of viral infections. Of note are inhibitors of proteases of the human immunodeficiency virus (HIV), particularly HIV-1 protease (HIV-1 retropepsin, EC 3.4.23.16) and HIV-2 protease [47-50], Drugs in this class, which include indinavir, ritonavir, and saquinavir, are useful in the treatment of AIDS, especially when administered as a cocktail together with one of the drugs that act on the viral retrotranscriptase (e.g., didanosine, stavudine, and zidovudine (AZT)). 

Drugs that may affect nelfinavir include anticonvulsants, azithromycin, azole antifungals, efavirenz, delavirdine, HMG-CoA reductase inhibitors, indinavir, interleukins, nevirapine, rifabutin, rifampin, ritonavir, saquinavir, St. John s wort. Drugs that may be affected by nelfinavir include amiodarone, antiarrhythmics (amiodarone, quinidine), azithromycin, benzodiazepines, efavirenz, ergot alkaloids, delavirdine, didanosine, fentanyl, indinavir, lamivudine methadone, nonsedating antihistamines, oral contraceptives, phenytoin, pimozide, quinidine, rifabutin, saquinavir, sildenafil, sirolimus, tacrolimus, zidovudine. 

Drugs that might affect amprenavir include abacavir, aldesleukin, antacids, anticonvulsants, azole antifungals, clarithromycin, cyclosporine, dexamethasone, buffered didanosine, disulfiram, ethanol, indinavir, methadone, metronidazole, nelfinavir, nonnucleoside reverse transcriptase inhibitors, oral contraceptives, rifamycins, ritonavir, saquinavir, St. John s wort, tacrolimus, and zidovudine. 

Drugs that might be affected by amprenavir include antiarrhythmics, anticonvulsants, azole antifungals, benzodiazepines, calcium channel blockers, cisapride, clarithromycin, cyclosporine, ergot alkaloids, fentanyl, HMG-CoA reductase inhibitors, indinavir, methadone, nelfinavir, oral contraceptives, pimozide, rifabutin, ritonavir, saquinavir, sildenafil, tacrolimus, trazodone, tricyclic antidepressants, warfarin, and zidovudine. 

TC Lamivudine ABC Abacavir d4T Stavudine ddC Zalcitabine ddl Didanosine TDF Tenofovir ZDV Zidovudine, also abbreviated as AZT FTC Emtricitabine NVP Nevirapine DLV Delavirdine EFV Efavirenz RTV, r Ritonavir Pl/r Ritonavir boosted protease inhibitor SQV Saquinavir IDV Indinavir LPV Lopinavir NEV Nelfinavir APV Amprenavir ATV Atazanavir DRV Darunavir... 

Fosamprenavir Abacavir, atazanavir, delavirdine, etravirine, indinavir, lopinavir, ritonavir, tipranavir, zidovudine Didanosine, efavirenz, nevirapine, saquinavir... 

Indinavir Delavirdine, nelfinavir, ritonavir, zidovudine, darunavir Fosamprenavir, didanosine, efavirenz, etravirine, nevirapine... 

Zidovudine Fosamprenavir, indinavir, lamivudine Didanosine, nelfinavir, ritonavir... 

Sataszewski S, Morales-Ramirez J, Tashima KT, Rachlis A, et al. 1999. Efavirenz plus zidovudine and lamivudine, efavirenz plus indinavir, and indinavir plus zidovudine and lamivudine in the treatment of HIV-1 infection in adults. Study 006 team. NEJM. 341 1865-1873. 

The effects of the protease inhibitor indinavir and the NNRTI efavirenz on lipid concentrations have been compared in a large comparative randomized study (154). Each of the two comparison drugs were used in one arm (with a zidovudine + lamivudine backbone) and the combination of the two drugs in a third arm. Zidovudine and lamivudine did not play a role in the lipid changes. However, both of the comparison drugs significantly increased cholesterol concentrations. 

At the present time, there are at least 14 compounds that have been formally approved for the treatment of human immunodeficiency virus (HIV) infections. There are six nucleoside reverse transcriptase inhibitors (NRTIs) that, after their intracellular conversion to the 5 -triphosphate form, are able to interfere as competitive inhibitors of the normal substrates (dNTPs). These are zidovudine (AZT), didanosine (ddl), zalcitabine (ddC), stavudine (d4T), lamivudine (3TC), and abacavir (ABC). There are three nonnucleoside reverse transcriptase inhibitors (NNRTIs) — nevirapine, delavirdine, and efavirenz — that, as such, directly interact with the reverse transcriptase at a nonsubstrate binding, allosteric site. There are five HIV protease inhibitors (Pis saquinavir, ritonavir, indinavir, nelfinavir, and amprenavir) that block the cleavage of precursor to mature HIV proteins, thus impairing the infectivity of the virus particles produced in the presence of these inhibitors. 

Indinavir Delavirdine, lopinavir, nelfinavir, zidovudine Amprenavir, delavirdine, efavirenz, nevirapine, ritonavir... 

HIV infection Health care workers exposed to blood after needle-stick injury Zidovudine and lamivudine indinavir or nelfinavir Good... 

Indinavir sulfate is a protease inhibitor and is used in combinations for the treatment of viral infection. During the high risk of HIV infection, indinavir is combined with zidovudine and lamivudine.65 Indinavir sulfate should be used with caution in patients with hepatic impairment and avoided in patients with severe liver damage. Caution is needed in diabetic patients and in patients with hemophilia. Adverse effects of indinavir sulfate include nausea, vomiting, diarrhea, fatigue, dizziness, headache, skin rashes, and allergic reactions (hematuria). 

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