When Crixivan® (indinavir) was first approved by the F.D.A., individuals who took this potent inhibitor of HIV protease were told to take it two hours after -- and one hour before -- eating a meal. This restriction was imposed because foods, especially fatty foods, interfere with the absorption of this drug. The F.D.A. continues to recommend that indinavir be taken on an empty stomach for maximum absorption, and patients who take this drug are strongly encouraged to drink at least six glasses of water during the course of the day, to reduce the slight risk (roughly 2%) that taking indinavir will lead to the development of kidney stones.

In an ideal world, it would always be possible for patients to take indinavir on a completely empty stomach and at precisely the assigned dosing intervals. In the real world, people get hungry at odd hours, and their daily schedules change. To accommodate these realities, the HIV/AIDS Dietetic Practice Group, a division of the American Dietetic Association, has developed the following list of low-fat and no-fat snacks that patients can take along with their indinavir dose, if they need to eat at a scheduled dosing time. All of these foods are available in neighborhood supermarkets, and all of them are restricted in their fat, protein, and carbohydrate content.

When you provide this list to your patients who are taking indinavir, emphasize that it is exceedingly important that individuals limit themselves to the serving size indicated on the chart. If patients eat more than the recommended amount of any given snack, they may reduce the effectiveness of the dose of indinavir they took with that snack. For this reason the A.D.A. encourages individuals to use standard measuring cups and measuring spoons when they serve themselves one of the snacks on the list.

Foods You Can Eat When You Take Crixivan

Food	Serving	Grams of Carbohydrate	Grams of Protein	Grams of Fat	Calories
1. Nabisco™ Newton Cobbler bars	3 bars	54	2.4	0	180
2. Fig bars and juice	2 fig bars 1 cup juice	50	1.5	2.5	224
3. Cream of Rice with skim milk, raisins, and brown sugar	1/2 cup cooked Cream of Rice 1/2 cup skim milk 2 tsp. brown sugar 1 Tbs. raisins	36	5.6	0.4	168
4. Snack Well™ wheat crackers with fat-free cream cheese and juice	8 Snack Well™ crackers 2 Tbs. fat-free cream cheese 1/2 cup of soda or juice	34	5.7	0.1	161
5. Pretzels and soda	1 cup pretzels 1/2 can soda or juice	59	4.4	2.0	275
6. Jello with canned fruit and Nabisco™ ginger snaps	1 cup jello 1/2 cup canned fruit 3 Nabisco™ ginger snaps	31	4	2.1	158
7. Applesauce and Nabisco™ ginger snaps	1 cup applesauce 2 Nabisco™ ginger snaps	62	1.3	1.9	252
8. Bagel and juice	1/2 bagel (no seeds or nuts) 1 cup juice	55	3.7	0.8	241
9. Spaghettios in tomato sauce and soda	1 cup Spaghettios 1/2 can soda or juice	61	5.3	2.1	282
10. Corn tortilla with steamed rice and salsa	1 corn tortilla 1/2 cup rice (prepared without butter or oil) 3 Tbs. salsa	35	4.1	1.5	169
11. Citrosource™ or Resource™ Fruit Beverage supplement	1/2 box = 1/2 cup	18	4.4	0	90
12. Rice cakes with jam and juice	2 rice cakes 2 Tbs. jam 1 cup juice	79	1.4	0.8	324
13. Tomato soup, oyster crackers, tea with milk and sugar	1 cup tomato soup (prepared with water) 6 oyster crackers 1 cup tea 2 Tbs. skim milk 1 tsp. sugar	25	3	2.2	126
14. Powerbar™ with Gatorade™	1/2 bar 8 oz. Gatorade™	36	5.0	1.3	173
15. Cereal with skim milk and banana	1/2 cup dry cereal* 1/2 cup skim milk 1/2 medium banana	31-45	4-5	1 to 2	150-180
16. Spaghetti (prepared without butter or oil) with tomato sauce and juice	1/2 cup cooked spaghetti 1/2 cup tomato sauce 1 cup juice	65	4.9	0.9	279
17. Toast (no added butter or margarine) with jam and tea or coffee with skim milk and sugar	1 slice bread 2 Tbs. jam 8 oz. tea or coffee 1 tsp. sugar 2 Tbs. skim milk	57	3.8	1.2	250
18. Plain popcorn (low-fat or fat-free, no butter or oil added, air popped or microwavable) and soda	3 cups popped corn 1 can of soda or juice	53	3.0	0	226
19. English muffin with jam (no butter or margarine) and regular or herb tea with sugar	1 English muffin 1 Tbs. jam 1 cup herb or regular tea 2 tsp. sugar	49	4.4	1.0	226
20. Rice (prepared without oil, butter or margarine) with vegetables and soy sauce	1/2 cup prepared rice 1/2 cup steamed vegetables 1 Tbs. soy sauce	28	5.6	0.5	136
21. Fruit (not coconut or avocado)	1 cup or 1 medium	20 to 50	0	0 to 0.5	73
22. Angelfood cake with canned fruit or berries and coffee	1 medium slice angelfood cake 1/2 cup berries or canned fruit 8 oz. coffee 2 Tbs. skim milk 1 tsp. sugar	50	5	0.7	218
23. Miso soup with a rice ball	8 oz. soup 1 plain rice ball (about 1/4 cup cooked rice)	33	5.7	0.9	164
24. Noodles (prepared without oil, butter, or margarine) and steamed vegetables	1/2 cup cooked noodles 1/4 to 1/2 cup steamed vegetables	25	4.9	1.5	130
25. Low fat or fat free vegetable soup and bread (without butter or margarine)	1 cup soup** 1 slice bread (no added nuts or seeds)	19	4.6	2.1	120
26. Quaker™ Low-fat Chewy Granola Bar	1 bar	22	2	2	110
27. Dried fruit (without coconut or nuts, seeds, or banana chips)	1/2 cup dried fruit	52	2	0	220
28. Snack Well™ Cereal Bar	1 bar	29	1	0	120
29. Fruit roll-up	1 roll-up	12	0	1	50
30. Dry toast (no butter or margarine) with jelly, apple juice, and coffee with skim milk and sugar	1 slice bread 1 Tbs. jelly 1 cup apple juice 1 cup coffee 2 Tbs. skim milk 1 tsp. sugar	52	4	1.1	250
31. Jello™ Snack Cup	1 snack cup	23	5.1	0.4	89
32. Fat free pudding cup	1 pudding cup	21	3	0.4	90
33. Popsicle (juice based, not ice cream based)	1 each (2 fl. oz.)	11	0	0	43
34. Corn tortilla with cucumber, tomato, lime juice, and green onion	1 corn tortilla 1 medium tomato 1 medium cucumber 1 green onion 3 Tbs. lime juice	30	4.2	1.2	130
35. Matzoh and salsa	1 Matzoh board 1/4 cup salsa	23	3.5	0	120
36. Baked potato and salsa	1 medium baked potato (no skin)	36	3.5	0.3	162
37. Jicama, raw	1 cup	10	1	0.2	46
38. Pita bread (white, not wheat)	1 whole pita	33	5.4	1.1	165
39. Health Valley™ Fat-Free Breakfast Bar and juice	1 bar 8 oz. juice	50	2	0	210
40. Kellogg's Rice Krispies Treats™ crispy marshmallow squares and juice	1 square = 0.78 oz. 8 oz. juice	45	1	2	200
*Choose a cereal that contains less than 2 grams protein or fat per 1/2 cup serving. Examples include Corn Pops™, Froot Loops™, Golden Grahams™, Chex™, rice puffs, Cornflakes™, Wheaties™, Special K™, Cocoa Puffs™, Cheerios™, Frosted Mini-Wheats™, Raisin Bran™, Total™, Shredded Wheat™. Do not choose a cereal with added nuts, granola, or Cracklin Oat Bran™ Cereal.
**Choose a soup that contains less than 1 gram fat and less than 3 grams protein per 1-cup serving.

This list was developed by Sabina Beesley, M.S., R.D., Project Coördinator of the Chicken Soup Brigade in Seattle, working with Marcy Fenton, M.S., R.D., of AIDS Project in Los Angeles, and Joya Melissa of Project Angel Food in Los Angeles.