Indinavir

BeschreibungCrixivan was launched in Australia, Switzerland, the UK and the US as an orally-bioavailable HIV-1 protease inhibitor. The compound can be prepared by coupling an optically active piperazine derivative with an epoxide derivative (now commercially available). The synthesis of the proteins, reverse transcriptase, integrase, structural proteins and a protease, required by the virus to complete its lifecycle, can be interupted if the protease enzyme is not capable of cleaving a proform polypeptide chain into these components. lndinavir inhibits this process and is more potent than the first approved protease inhibitor saquinavir. This effect was noted by the increase in CD4+ cells and a decrease in HIV RNA levels. Since indinavir is metabolized by the CYP3A4 isozyme, care must be taken with patients with hepatic insufficiency and to sex-related differences in the level of this enzyme. Other than nephrolithiasis (5%), indinavir is relatively safe and well tolerated.