Indinavir Side Effects: What You Need to Know Before Taking It

When you’re managing HIV, every medication matters. Indinavir, a protease inhibitor used to treat HIV infection by blocking the virus’s ability to multiply. Also known as Crixivan, it was one of the first drugs in its class to help turn HIV from a death sentence into a manageable condition. But like all powerful drugs, it doesn’t come without risks. Many people taking Indinavir report kidney stones, nausea, and a strange tingling around the mouth. These aren’t rare side effects—they’re common enough that your doctor should warn you before you start.

Indinavir works by targeting the HIV protease enzyme, which the virus needs to build new copies of itself. It’s a protease inhibitor, a class of antiretroviral drugs that prevent HIV from maturing and infecting new cells. But because it’s processed by the liver and excreted by the kidneys, your body has to work harder. That’s why dehydration and low fluid intake can turn a minor issue into a serious one—like kidney stones, which happen in up to 15% of users. You can reduce that risk by drinking at least 3 liters of water a day, but many people forget until it’s too late.

Other side effects include high bilirubin levels, which can turn your skin or eyes yellow (harmless but scary), and changes in body fat distribution—some people gain fat around the belly, while others lose it from their face and legs. These aren’t just cosmetic. They’re signs your metabolism is being affected. And because Indinavir interacts with so many other drugs—from statins to antifungals—your pharmacist needs to know everything you’re taking. One wrong combo can cause liver damage or dangerously high drug levels.

Compared to newer HIV meds like darunavir or atazanavir, Indinavir is harder to take. You have to take it on an empty stomach—no food for at least an hour before and after. That’s tough if you’re already dealing with nausea or loss of appetite. Newer drugs don’t require that. They’re simpler, safer, and often just as effective. So why is Indinavir still around? Sometimes, it’s because other drugs failed. Sometimes, it’s cost. Sometimes, it’s the only option left.

If you’re on Indinavir, pay attention to your body. Unusual pain in your side or lower back? Could be a kidney stone. Dark urine or yellow eyes? Check your bilirubin. Feeling dizzy or unusually tired? It might not just be the HIV. Your doctor should run regular blood tests and check your kidney function. Don’t wait for symptoms to get bad.

There’s no sugarcoating it—Indinavir has a rough reputation. But for some people, it still makes sense. The key is knowing what you’re signing up for. Below, you’ll find real-world reports from people who’ve taken it, comparisons with other HIV drugs, and what to do when things go wrong. This isn’t just a list of side effects. It’s a guide to staying safe while using a drug that changed the game—but still demands respect.