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indinavir oral

Protease Inhibitors/Midazolam; Triazolam

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process your antianxiety medicine properly.

What might happen:

The blood levels of your antianxiety medicine may increase. This may cause toxic effects such as decreased coordination, drowsiness, slurred speech, amnesia, or difficulty breathing.

What you should do about this interaction:

Contact your healthcare professionals (e.g. doctor or pharmacist) as soon as possible about taking these two medicines together. They may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Agenerase (amprenavir) summary of product characteristics. GlaxoSmithKline UK January 18, 2005.
2.Agenerase (amprenavir) Oral Solution US prescribing information. GlaxoSmithKline May, 2005.
3.Reyataz (atazanavir) UK summary of product characteristics. Bristol-Myers Squibb Pharmaceuticals Limited September 8, 2008.
4.Reyataz (atazanavir sulfate) US prescribing information. Bristol-Myers Squibb Company August, 2013.
5.Prezista (darunavir) Canadian prescribing information. Jannsen-Ortho June, 2008.
6.Prezista (darunavir) UK Summary of product characteristics. Janssen-Cilgat LTD August 8, 2008.
7.Prezista (darunavir) US prescribing information. Tibotec Inc. November, 2013.
8.Telzir (fosamprenavir calcium) UK summary of product characteristics. GlaxoSmithKline UK October 18. 2013.
9.Lexiva (fosamprenavir calcium) US prescribing information. GlaxoSmithKline February, 2013.
10.Crixivan (indinavir sulfate) Canadian prescribing information. Merck Frosst February, 2007.
11.Crixivan (indinavir sulfphate) UK summary of product characteristics. Merck Sharp & Dohme Limited September, 2008.
12.Crixivan (indinavir sulfate) US prescribing information. Merck & Co., Inc. February, 2011.
13.Kaletra (lopinavir/ritonavir) Canadian prescribing information. Abbott Limited June, 2007.
14.Kaletra (lopinavir/ritonavir) UK summary of product characteristics. Abbott Laboratories, Limited July 11, 2008.
15.Kaletra (lopinavir/ritonavir tablets) US prescribing information. Abbott Laboratories January, 2013.
16.Viracept (nelfinavir mesylate) Canadian prescribing information. Pfizer September, 2006.
17.Viracept (nelfinavir mesylate) UK summary of product characteristics. Roche Products Limited August 4, 2008.
18.Viracept (nelfinavir mesylate) US prescribing information. Agouron Pharmaceuticals, Inc. May, 2013.
19.Norvir (ritonavir) Canadian prescribing information. Abbott January, 2005.
20.Norvir (ritonavir) UK summary of product characteristics. Abbott Laboratories, Limited July 2, 2008.
21.Norvir (ritonavir) US prescribing information. Abbott Laboratories November, 2012.
22.Invirase (saquinavir mesylate) Canadian prescribing information. Roche March, 2007.
23.Invirase (saquinavir mesylate) UK summary of product characteristics. Roche Products Limited July 11, 2008.
24.Invirase (saquinavir mesylate) US prescribing information. Roche Laboratories, Inc. February, 2012.
25.Aptivus (tipranavir) Canadian prescribing information. Boehringer Ingelheim May, 2008.
26.Aptivis (tipranavir) UK Summary of product characteristics. Boehringer Ingelheim Limited August 28, 2008.
27.Aptivus (tipranavir) US prescribing information. Boehringer Ingelheim Pharmaceuticals, Inc. February, 2012.
28.Yeh RF, Gaver VE, Patterson KB, Rezk NL, Baxter-Meheux F, Blake MJ, Eron JJ Jr, Klein CE, Rublein JC, Kashuba AD. Lopinavir/ritonavir induces the hepatic activity of cytochrome P450 enzymes CYP2C9, CYP2C19, and CYP1A2 but inhibits the hepatic and intestinal activity of CYP3A as measured by a phenotyping drug cocktail in healthy volunteers. J Acquir Immune Defic Syndr 2006 May;42(1):52-60.
29.Palkama VJ, Ahonen J, Neuvonen PJ, Olkkola KT. Effect of saquinavir on the pharmacokinetics and pharmacodynamics of oral and intravenous midazolam. Clin Pharmacol Ther 1999 Jul;66(1):33-9.
30.Greenblatt DJ, von Moltke LL, Harmatz JS, Durol AL, Daily JP, Graf JA, Mertzanis P, Hoffman JL, Shader RI. Differential impairment of triazolam and zolpidem clearance by ritonavir. J Acquir Immune Defic Syndr 2000 Jun 1;24(2):129-36.
31.von Moltke LL, Durol AL, Duan SX, Greenblatt DJ. Potent mechanism-based inhibition of human CYP3A in vitro by amprenavir and ritonavir: comparison with ketoconazole. Eur J Clin Pharmacol 2000 Jun;56(3):259-61.
32.Weemhoff JL, von Moltke LL, Richert C, Hesse LM, Harmatz JS, Greenblatt DJ. Apparent mechanism-based inhibition of human CYP3A in-vitro by lopinavir. J Pharm Pharmacol 2003 Mar;55(3):381-6.
33.Greenblatt DJ, Peters DE, Oleson LE, Harmatz JS, MacNab MW, Berkowitz N, Zinny MA, Court MH. Inhibition of oral midazolam clearance by boosting doses of ritonavir, and by 4,4-dimethyl-benziso-(2H)-selenazine (ALT-2074), an experimental catalytic mimic of glutathione oxidase. Br J Clin Pharmacol 2009 Dec;68(6):920-7.
34.Halcion (triazolam) US prescribing information. Pharmacia & Upjohn Company December, 2008.

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