Indinavir: What It Is, How It Works, and What You Need to Know

When you hear Indinavir, a protease inhibitor developed in the 1990s to treat HIV infection. Also known as Crixivan, it was one of the first drugs that turned HIV from a death sentence into a manageable condition. Indinavir doesn’t kill the virus—it stops HIV from making new copies of itself by blocking an enzyme called protease. Without this enzyme, the virus can’t mature and become infectious. This made it a game-changer when it launched, especially when paired with other antiretrovirals.

Indinavir is part of a broader group called protease inhibitors, a class of drugs that target HIV’s ability to replicate. Other drugs in this group include ritonavir, lopinavir, and atazanavir. But Indinavir has a unique profile: it needs to be taken on an empty stomach, and it can cause kidney stones in up to 15% of users. That’s why many doctors now prefer newer options with fewer side effects. Still, it’s not obsolete. In some resource-limited settings, or for patients who’ve built resistance to other drugs, Indinavir remains a viable tool.

It’s also linked to antiretroviral therapy, the standard approach to HIV treatment that combines multiple drugs to suppress the virus. Indinavir was rarely used alone—it worked best in triple-drug combos, often with two nucleoside reverse transcriptase inhibitors like zidovudine and lamivudine. These combinations, called HAART, drastically lowered viral loads and helped restore immune function. Even today, the principles behind those early regimens shape how HIV is treated globally.

Side effects like nausea, diarrhea, and high bilirubin levels were common, but the real challenge was adherence. Missing doses led to resistance, and the strict dosing schedule—every 8 hours, without food—made it hard to stick with. That’s why newer drugs like dolutegravir or bictegravir, taken once daily with fewer restrictions, have mostly replaced it in wealthy countries. But in places where access to newer meds is limited, Indinavir still saves lives.

What you’ll find in the posts below isn’t just a list of articles—it’s a collection of real-world insights on how HIV medications work, how they’re chosen, and what patients actually experience. From comparisons of older drugs like Indinavir to newer options, from managing side effects to understanding immune recovery, these guides cut through the noise. Whether you’re a patient, caregiver, or just trying to understand how antiretroviral therapy evolved, you’ll find clear, practical answers here.