Major Research Findings

Indinavir is an HIV protease inhibitor that has been shown to be effective in reducing viral load and increasing CD4 cell counts in HIV-infected patients. 16 , 7 However, indinavir can also cause a variety of side effects, including skin problems, metabolic changes, and drug interactions. 17 , 13 , 12 , The absorption and pharmacokinetics of indinavir can be affected by several factors, including food, other drugs, and individual physiological characteristics.

2 found that food increased the solubility of indinavir but decreased its intestinal permeability. This indicates that the absorption of indinavir is influenced by a complex interplay between solubility and permeability.

15 showed that didanosine, another HIV medication, did not affect indinavir exposure when taken one hour before indinavir, despite the fact that didanosine increases gastric pH. This suggests that didanosine and indinavir can be safely co-administered.

1 reported that omeprazole, a proton pump inhibitor, may inhibit the absorption of indinavir. This finding highlights the importance of considering drug interactions when prescribing indinavir.

14 found that grapefruit juice increased gastric pH and slightly delayed the absorption of indinavir, but did not significantly affect systemic bioavailability.

3 showed that indinavir does not affect the disposition of methadone, despite its inhibition of cytochrome P4503A, an enzyme involved in drug metabolism.

12 found that cannabinoids, such as marijuana and dronabinol, can affect the pharmacokinetics of indinavir and nelfinavir, another HIV protease inhibitor.

investigated the potential herb-drug interaction between American ginseng and indinavir and found that ginseng may inhibit the absorption of indinavir.

Benefits and Risks

Benefit Summary

The main benefit of indinavir is its effectiveness in treating HIV-1 infection. 16 , 7 Studies have shown that indinavir can reduce viral load and increase CD4 cell counts, improving the overall health of HIV-infected patients.

Risk Summary

The primary risks associated with indinavir include skin problems, metabolic changes, and drug interactions. 17 , 13 , 12 , These side effects can range from mild to severe, and the frequency and severity of side effects can vary greatly from person to person. Indinavir can also interact with other drugs, which can affect how those drugs work or increase the risk of side effects. 1 , 14 , 3 , 12 , , 4

Comparison of Studies

Similarities Among Studies

Many studies have shown that indinavir is effective in treating HIV-1 infection. However, there are also consistent reports of side effects associated with its use, emphasizing the need for careful monitoring and management.

Differences Among Studies

The studies on indinavir highlight the complexity of its absorption and pharmacokinetics, influenced by factors like food, other drugs, and individual characteristics. The specific details of the studies, such as the population studied, dosage used, and outcome measures, contribute to differences in findings.

Consistency and Contradictions in Results

The results of studies on indinavir show both consistency and contradictions. For example, food can increase indinavir solubility but also decrease its permeability. 2 The specific side effects reported in various studies also differ in frequency and severity. This complexity emphasizes the need for further research to understand these discrepancies.

Implications for Real-World Applications

When considering indinavir therapy, it is essential to be mindful of food interactions, potential drug interactions, and individual characteristics. Diet should be carefully considered, as it can influence indinavir absorption. 2 Consultation with a healthcare professional is crucial when co-administering indinavir with other medications to minimize potential drug interactions. 15 , 1 , 14 , 3 , 12 , , 4 Regular monitoring of indinavir therapy is important due to the individual variability in side effect profiles.

Limitations of Current Research

There are several limitations to current research on indinavir. For example, many studies are conducted on small sample sizes, which may limit the generalizability of the findings. In addition, the populations studied may not be representative of the overall population, making it difficult to apply results to other groups.

Directions for Future Research

Further research on indinavir is necessary to address the existing gaps in knowledge. This research should focus on understanding the factors that affect indinavir absorption and pharmacokinetics, the mechanisms of its side effects, methods for preventing and treating these side effects, and optimizing individualized dosage strategies.

Conclusion

Indinavir is a valuable treatment for HIV-1 infection but should be administered with careful consideration of its side effects and potential interactions. It is important to monitor patients regularly for side effects, and to manage these side effects effectively. Further research is needed to better understand indinavir's effects, develop strategies for optimizing its use, and improve the safety and efficacy of this important medication.