U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C36H47N5O4
Molecular Weight 613.7895
Optical Activity UNSPECIFIED
Defined Stereocenters 5 / 5
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of INDINAVIR ANHYDROUS

SMILES

CC(C)(C)NC(=O)[C@@H]1CN(CC2=CN=CC=C2)CCN1C[C@@H](O)C[C@@H](CC3=CC=CC=C3)C(=O)N[C@@H]4[C@H](O)CC5=C4C=CC=C5

InChI

InChIKey=CBVCZFGXHXORBI-PXQQMZJSSA-N
InChI=1S/C36H47N5O4/c1-36(2,3)39-35(45)31-24-40(22-26-12-9-15-37-21-26)16-17-41(31)23-29(42)19-28(18-25-10-5-4-6-11-25)34(44)38-33-30-14-8-7-13-27(30)20-32(33)43/h4-15,21,28-29,31-33,42-43H,16-20,22-24H2,1-3H3,(H,38,44)(H,39,45)/t28-,29+,31+,32-,33+/m1/s1

HIDE SMILES / InChI

Description
Curator's Comment: Description was created based on several sources, including https://www.drugs.com/dosage/indinavir.html

Indinavir is an antiretroviral drug for the treatment of HIV infection. Indinavir is a protease inhibitor with activity against Human Immunodeficiency Virus Type 1 (HIV-1). Protease inhibitors block the part of HIV called protease. HIV-1 protease is an enzyme required for the proteolytic cleavage of the viral polyprotein precursors into the individual functional proteins found in infectious HIV-1. Indinavir binds to the protease active site and inhibits the activity of the enzyme. This inhibition prevents cleavage of the viral polyproteins resulting in the formation of immature non-infectious viral particles. Protease inhibitors are almost always used in combination with at least two other anti-HIV drugs.

CNS Activity

Curator's Comment: Median concentration of Indinavir in CSF was 210 nmol/l, which is the threshold for IC95 in vitro. Indinavir is essentially the only PI that reaches CSF concentrations above IC95. From a clinical point of view, the presence of Indinavir in CSF was associated with significant improvement of neurocognitive performances

Originator

Curator's Comment: # Merck & Co

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
47.9 µM [Ki]
0.37 nM [Ki]
100.0 µM [IC50]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
CRIXIVAN®

Approved Use

CRIXIVAN in combination with antiretroviral agents is indicated for the treatment of HIV infection.

Launch Date

1996
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
12617 nM
800 mg 3 times / day steady-state, oral
dose: 800 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
INDINAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
17181 nM
500 mg/m² 3 times / day multiple, oral
dose: 500 mg/m²
route of administration: Oral
experiment type: MULTIPLE
co-administered:
INDINAVIR plasma
Homo sapiens
population: UNHEALTHY
age: CHILD
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
9231 nM × h
800 mg 3 times / day multiple, oral
dose: 800 mg
route of administration: Oral
experiment type: MULTIPLE
co-administered:
INDINAVIR unknown
Homo sapiens
population: PREGNANT
age: ADULT
sex: FEMALE
food status: UNKNOWN
30691 nM × h
800 mg 3 times / day steady-state, oral
dose: 800 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
INDINAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
38742 nM × h
500 mg/m² 3 times / day multiple, oral
dose: 500 mg/m²
route of administration: Oral
experiment type: MULTIPLE
co-administered:
INDINAVIR plasma
Homo sapiens
population: UNHEALTHY
age: CHILD
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
40%
800 mg 3 times / day steady-state, oral
dose: 800 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
INDINAVIR plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
2400 mg single, oral
Overdose
Dose: 2400 mg
Route: oral
Route: single
Dose: 2400 mg
Sources: Page: 20
unhealthy, adult
n = 23
Health Status: unhealthy
Condition: HIV-1
Age Group: adult
Sex: unknown
Population Size: 23
Sources: Page: 20
Disc. AE: Renal disorders NEC, Gastrointestinal disorders NEC...
AEs leading to
discontinuation/dose reduction:
Renal disorders NEC (23 patients)
Gastrointestinal disorders NEC (23 patients)
Sources: Page: 20
1200 mg 2 times / day steady, oral
Higher than recommended
Dose: 1200 mg, 2 times / day
Route: oral
Route: steady
Dose: 1200 mg, 2 times / day
Sources: Page: 97
unhealthy, mean 42 years
n = 5
Health Status: unhealthy
Condition: HIV-1
Age Group: mean 42 years
Sex: M+F
Population Size: 5
Sources: Page: 97
Other AEs: Renal disorders NEC...
Other AEs:
Renal disorders NEC (5 patients)
Sources: Page: 97
AEs

AEs

AESignificanceDosePopulation
Gastrointestinal disorders NEC 23 patients
Disc. AE
2400 mg single, oral
Overdose
Dose: 2400 mg
Route: oral
Route: single
Dose: 2400 mg
Sources: Page: 20
unhealthy, adult
n = 23
Health Status: unhealthy
Condition: HIV-1
Age Group: adult
Sex: unknown
Population Size: 23
Sources: Page: 20
Renal disorders NEC 23 patients
Disc. AE
2400 mg single, oral
Overdose
Dose: 2400 mg
Route: oral
Route: single
Dose: 2400 mg
Sources: Page: 20
unhealthy, adult
n = 23
Health Status: unhealthy
Condition: HIV-1
Age Group: adult
Sex: unknown
Population Size: 23
Sources: Page: 20
Renal disorders NEC 5 patients
1200 mg 2 times / day steady, oral
Higher than recommended
Dose: 1200 mg, 2 times / day
Route: oral
Route: steady
Dose: 1200 mg, 2 times / day
Sources: Page: 97
unhealthy, mean 42 years
n = 5
Health Status: unhealthy
Condition: HIV-1
Age Group: mean 42 years
Sex: M+F
Population Size: 5
Sources: Page: 97
Overview

OverviewOther

Other InhibitorOther SubstrateOther Inducer




Drug as perpetrator​Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
weak
no (co-administration study)
Comment: Coadministration of quinidine sulfate (CYP2D6 inhibitor) did not significantly alter the pharmacokinetics of indinavir
Page: 145.0
yes
yes
yes (co-administration study)
Comment: Clarithromycin (500 mg q12h) increased the AUC of indinavir (800 mg q8h) by 29±42% and increased Cmax by 18±44%.
Page: 2.0
Sourcing

Sourcing

Vendor/AggregatorIDURL
PubMed

PubMed

TitleDatePubMed
Design and fast synthesis of C-terminal duplicated potent C(2)-symmetric P1/P1'-modified HIV-1 protease inhibitors.
1999 Sep 23
4-Aryl-2,4-dioxobutanoic acid inhibitors of HIV-1 integrase and viral replication in cells.
2000 Dec 28
Novel inhibitors of HIV protease: design, synthesis and biological evaluation of picomolar inhibitors containing cyclic P1/P2 scaffolds.
2000 Jun 5
A mutation in human immunodeficiency virus type 1 protease, N88S, that causes in vitro hypersensitivity to amprenavir.
2000 May
PMS-601, a new platelet-activating factor receptor antagonist that inhibits human immunodeficiency virus replication and potentiates zidovudine activity in macrophages.
2000 Nov
Anti-toxoplasma activities of antiretroviral drugs and interactions with pyrimethamine and sulfadiazine in vitro.
2000 Sep
Comparison of P-triglyceride levels among patients with human immunodeficiency virus on randomized treatment with ritonavir, indinavir or ritonavir/saquinavir.
2001
Virologic outcome and predictors of virologic failure of highly active antiretroviral therapy containing protease inhibitors.
2001 Apr
Gynecomastia associated with highly active antiretroviral therapy.
2001 Apr
Chemotherapy for human immunodeficiency virus-associated non-Hodgkin's lymphoma in combination with highly active antiretroviral therapy.
2001 Apr 15
[Acute porphyria and indinavir].
2001 Feb
Sensitive and rapid method for the simultaneous quantification of the HIV-protease inhibitors indinavir, nelfinavir, ritonavir, and saquinavir in human plasma by reversed-phase liquid chromatography.
2001 Feb
Association between high serum prolactin levels and concomitant infections in HIV-infected patients.
2001 Feb
Economic analysis of initial HIV treatment. Efavirenz- versus indinavir-containing triple therapy.
2001 Jan
The absence of hyperbilirubinaemia is highly predictive of treatment failure in advanced HIV-infected patients treated with indinavir.
2001 Jan
Efficacy, tolerance, and pharmacokinetics of the combination of stavudine, nevirapine, nelfinavir, and saquinavir as salvage regimen after ritonavir or indinavir failure.
2001 Jan 20
The use of and response to second-line protease inhibitor regimens: results from the EuroSIDA study.
2001 Jan 26
Changes in host cell molecules acquired by circulating HIV-1 in patients treated with highly active antiretroviral therapy and interleukin-2.
2001 Jan 5
Severe lactic acidosis and thiamine administration in an HIV-infected patient on HAART.
2001 Jun
Indinavir, nevirapine, stavudine, and lamivudine for human immunodeficiency virus-infected, amprenavir-experienced subjects: AIDS Clinical Trials Group protocol 373.
2001 Mar 1
Sequencing of protease inhibitor therapy: insights from an analysis of HIV phenotypic resistance in patients failing protease inhibitors.
2001 Mar 30
Assessment of active transport of HIV protease inhibitors in various cell lines and the in vitro blood--brain barrier.
2001 Mar 9
Secreted aspartic proteases of Candida albicans, Candida tropicalis, Candida parapsilosis and Candida lusitaniae. Inhibition with peptidomimetic inhibitors.
2001 May
Sexual dysfunction associated with protease inhibitor containing highly active antiretroviral treatment.
2001 May 25
Metabolic effects of indinavir in healthy HIV-seronegative men.
2001 May 4
Indinavir hair concentration in highly active antiretroviral therapy-treated patients: association with viral load and drug resistance.
2001 May 4
Patents

Sample Use Guides

Usual Adult Dose for HIV Infection 800 mg orally every 8 hours or indinavir 800 mg plus ritonavir 100 to 200 mg orally every 12 hours
Route of Administration: Oral
Indinavir (10 nM) gave 14% inhibition of HIV replication alone and 81% in combination with P-gp/MRP inhibitors.
Name Type Language
INDINAVIR ANHYDROUS
Common Name English
(.ALPHA.R,.GAMMA.S,2S)-.ALPHA.-BENZYL-2-(TERT-BUTYLCARBAMOYL)-.GAMMA.-HYDROXY-N-((1S,2R)-2-HYDROXY-1-INDANYL)-4-(3-PYRIDYLMETHYL)-1-PIPERAZINEVALERAMIDE
Common Name English
indinavir [INN]
Common Name English
D-ERYTHRO-PENTONAMIDE, 2,3,5-TRIDEOXY-N-(2,3-DIHYDRO-2-HYDROXY-1H-INDEN-1-YL)-5-(2-(((1,1-DIMETHYLETHYL)AMINO)CARBONYL)-4-(3-PYRIDINYLMETHYL)-1-PIPERAZINYL)-2-(PHENYLMETHYL)-, (1(1S,2R),5(S))-
Common Name English
Indinavir [WHO-DD]
Common Name English
INDINAVIR [MI]
Common Name English
Classification Tree Code System Code
NDF-RT N0000175889
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
NCI_THESAURUS C97366
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
WHO-ATC J05AE02
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
NDF-RT N0000000246
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
Code System Code Type Description
EVMPD
SUB08174MIG
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY
FDA UNII
9MG78X43ZT
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY
MERCK INDEX
m6253
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY Merck Index
RXCUI
1546024
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY RxNorm
DRUG BANK
DB00224
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY
DAILYMED
9MG78X43ZT
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY
PUBCHEM
5362440
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY
INN
7444
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY
EPA CompTox
DTXSID4043802
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY
CAS
150378-17-9
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY
NCI_THESAURUS
C74585
Created by admin on Fri Dec 15 16:03:37 GMT 2023 , Edited by admin on Fri Dec 15 16:03:37 GMT 2023
PRIMARY