The side effect occurs in the form of flank pain or pain in the urinary tract. This pain is caused by small undissolved crystals of the drug which are being removed by the kidneys. In most instances, this problem has occurred in people with advanced disease who are dehydrated. The solution seems to be to make sure a person using the drug takes adequate liquids along with the drug. Indinavir should be taken one hour before or two hours after a meal to increase absorption.
All protease inhibitors run the risk of triggering the development of viral resistance.
Moreover, once people become resistant to one of these drugs, they are likely to be resistant to the others as well. If side effects occur, it is better to temporarily stop using the drug than to lower the dose. If it becomes necessary to stop and then restart the drug, start again at the full normal dose. Do not restart with a reduced dosage. The three-drug combinations should also minimize the development of viral resistance.