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Invirase

saquinavir
Used for HIV Treatment
Used for HIV Treatment

Invirase (saquinavir) is an oral tablet that's used as part of an antiretroviral (ARV) regimen to treat human immunodeficiency virus (HIV) in adults and children over 16 years of age. You'll also need to take ritonavir (Norvir) twice daily to help Invirase (saquinavir) work better against the virus. Invirase (saquinavir) belongs to a class of medications called protease inhibitors. Common side effects include nausea, diarrhea, and vomiting.

Last reviewed on November 27, 2023
basics-icon

What is Invirase (saquinavir)?

What is Invirase (saquinavir) used for?

  • Treatment of HIV infection in people over 16 years old

How Invirase (saquinavir) works

Invirase (saquinavir) is a protease inhibitor, which means it blocks a protein called protease. Normally, protease helps to process viral proteins so that the HIV virus can infect healthy cells. By stopping protease from working, Invirase (saquinavir) prevents the virus from making copies of itself and spreading.

Drug Facts

Common BrandsInvirase
Drug ClassHIV-1 protease inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Avg retail price
$344.47(save 11.39%)
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$305.23
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What are the side effects of Invirase (saquinavir)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Nausea (11%)
  • Diarrhea (8%)
  • Vomiting (7%)
  • Stomach pain (6%)
  • Feeling tired (6%)
  • Pneumonia (5%)
  • Changes in fat (5%)
Side effects above were reported in adults taking this medication with ritonavir (Norvir).

Other Side Effects

  • Constipation
  • Fever
  • Back pain
  • Flu-like symptoms (congestion, cough)
  • Rash
  • Itching
  • Dry lips
  • Dry skin
  • High blood sugar

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious liver problems: nausea, vomiting, not feeling hungry, pain in the right side of the stomach, yellowing of the whites of the eyes or skin, dark-colored urine, light-colored stool
  • Abnormal heart rhythm: chest pounding, trouble breathing, chest pain, feeling faint or lightheaded, dizziness

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Chest pain

chills

cough

fever

increased amount of fat in the upper back and neck, or around the chest and stomach area

loss of fat from the legs, arms, and face

sneezing

sore throat

tightness in the chest

trouble breathing

Less common

Blurred vision

cough-producing mucus

diarrhea

dry mouth

flushed, dry skin

fruit-like breath odor

general feeling of discomfort or illness

headache

increased hunger

increased thirst

increased urination

joint pain

loss of appetite

loss of consciousness

muscle aches and pains

nausea

runny nose

shivering

skin rash

sore throat

stomachache

sweating

trouble sleeping

unexplained weight loss

unusual tiredness or weakness

vomiting

Rare

Burning or prickling sensation

confusion

dehydration

dry or itchy skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Back pain

belching

bloated or full feeling

change in taste

decreased interest in sexual intercourse

difficulty having a bowel movement

discouragement

excess air or gas in the stomach or bowels

fear

feeling sad or empty

headache

heartburn

inability to have or keep an erection

indigestion

irritability

lack of appetite

loss in sexual ability, desire, drive, or performance

loss of interest or pleasure

mouth ulcers

nervousness

pain or tenderness around the eyes and cheekbones

passing gas

skin rash, encrusted, scaly, and oozing

skin warts

stomach upset, discomfort, or pain

stuffy nose

tiredness

trouble concentrating

weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Invirase (saquinavir)

thumbs-up

Pros

Approved for use in adults and children over 16 years old

Safe to take for people with mild to moderate kidney problems

Available as a tablet taken by mouth twice daily

thumbs-down

Cons

Might raise blood sugar, body fat, and cholesterol levels

Requires regular blood work and lab tests

Interacts with many medications

pharmacist-tips

Pharmacist tips for Invirase (saquinavir)

pharmacist
  • Invirase (saquinavir) should be taken with ritonavir (Norvir)) and with food (within 2 hours of a meal). This combination helps to keep higher levels of Invirase (saquinavir) in the body, allowing it to work better for you.

    • Get your routine blood tests done on time while you’re taking Invirase (saquinavir). Lab work is important to make sure that the medication works against the virus, and that it isn't causing unwanted side effects.

      • Invirase (saquinavir) can interact with many medications. Some medications might need to be stopped or the dose changed before you start HIV ARV regimen. Let your provider or pharmacist know about all the medications you're taking.

        • Invirase (saquinavir) might raise your blood sugars, which can lead to or worsen diabetes. Talk to your provider to see if you need additional medications to help control your sugar levels during treatment.

          • Invirase (saquinavir) might cause changes to your heart rhythm. Let your provider know right away if you experience dizziness, fainting, or lightheadedness while taking this medication.

            • Talk to your provider before stopping Invirase (saquinavir) or any of your HIV medications. Doing so can cause the virus to spread and become harder to treat.

              faqs

              Frequently asked questions about Invirase (saquinavir)

              How do you take Invirase (saquinavir)?
              Take Invirase (saquinavir) and ritonavir (Norvir) at the same time twice daily within 2 hours after a meal. And if you miss a dose of Invirase (saquinavir), you should take the next dose as soon as possible. Don't double up on tablets at your next scheduled dose since it can raise your risk for side effects.
              What other medications must be taken with Invirase (saquinavir)?
              Invirase (saquinavir) is taken with ritonavir (Norvir), which acts as a "booster" to Invirase (saquinavir). This is because ritonavir (Norvir) slows the breakdown of Invirase (saquinavir), which allows Invirase (saquinavir) to stay in your body longer so that it can work better. Without ritonavir (Norvir), Invirase (saquinavir) might not work as well, which can cause the HIV virus to become harder to treat.
              When should Invirase (saquinavir) be taken?
              Invirase (saquinavir) should be taken along with ritonavir (Norvir) twice daily within 2 hours after a meal. Studies show that a high fat meal can raise the amount of Invirase (saquinavir) that your body absorbs, allowing it to work better for you.
              What should I avoid with Invirase (saquinavir)?
              Invirase (saquinavir) interacts with certain medications, potentially causing serious problems. In some instances, Invirase (saquinavir) can raise the levels of some medications in the body, leading to more side effects. In addition, antibiotics like clarithromycin and erythromycin are more likely to cause irregular heartbeat, and anxiolytics like midazolam and triazolam are more likely to cause serious breathing problems when taken with Invirase (saquinavir). To avoid these risks, tell your provider and pharmacist about all the medications you take or plan to take.
              Is Invirase (saquinavir) safe during pregnancy?
              In general, it's recommended that pregnant people with HIV start treatment as soon as possible to lower the risk of transferring the virus to the unborn baby. But it's not entirely clear if Invirase (saquinavir) is completely safe in pregnancy, so it should only be used if the benefit outweighs the risk. If you're pregnant and taking Invirase (saquinavir), you’re encouraged to enroll in the Antiretroviral Pregnancy Registry (APR). This registry collects information about your and your baby’s health during treatment with Invirase (saquinavir). Speak to your provider so you can discuss the benefits and risks of taking this medication while pregnant.
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              What are the risks and warnings for Invirase (saquinavir)?

              Invirase (saquinavir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Interactions with other medications

              Some medications can interfere with how well your body gets rid of Invirase (saquinavir) from your system. This can affect the amount of Invirase (saquinavir) in your body, how well it works, and the risk of side effects.

              Taking certain medications and supplements (like St. John's wort) can lower the amount of Invirase (saquinavir) in your body and make the HIV medication work less well.

              Invirase (saquinavir) can also affect how your body gets rid of other medications. This can raise the levels of these medications in the body and raise your risk for side effects. For example, taking Invirase (saquinavir) with certain statins can raise your risk for serious muscle problems.

              Because of the potential for serious interactions with Invirase (saquinavir) and various medications, tell your provider and pharmacist about all the medications you take or plan to take.

              risk-warning

              Heart rhythm problems

              • Risk factors: History of heart problems | Taking medications that affect heart rhythm | Low potassium or magnesium levels | Liver problems

                Invirase (saquinavir) can sometimes affect your heart rhythm, which can be serious and life-threatening. Your risk is higher if you have certain conditions, including electrolyte levels that are out of balance and heart rhythm problems. Your risk might also be higher if you're taking other medications that cause heart rhythm problems, such as digoxin (Lanoxin) and beta-blockers, among others. In some instances, you might need to have your heart checked before starting this medication. Get medical attention right away if you feel your chest pounding, have trouble breathing, have chest pain, or feel faint or lightheaded while you're taking Invirase (saquinavir).

                risk-warning

                High blood sugar

                • Risk factor: Taking protease inhibitor medications

                  Some people taking protease inhibitor medications like Invirase (saquinavir) developed higher blood sugar levels, which has led to or worsened diabetes. In some cases, people needed to start taking a new medication or their current diabetes treatment plan needed changes to help keep blood sugar under control. If you have a history of diabetes, let your provider know before starting Invirase (saquinavir). Your provider might ask you to check your blood sugar at home to make sure this medication is safe for you.

                  risk-warning

                  Liver problems

                  • Risk factors: Hepatitis B or C | History of liver problems | Alcoholism

                    Some people taking Invirase (saquinavir) have had liver problems, which were sometimes life-threatening. Your provider will order blood tests for you before and during treatment so they can make sure Invirase (saquinavir) is safe for your liver. Let your provider know if you experience signs and symptoms of liver damage, such as sleepiness, nausea, loss of appetite, light-colored stool, upper right stomach pain, yellowing of the skin or eyes, or dark urine.

                    risk-warning

                    Risk of bleeding in people with hemophilia

                    Some people with a bleeding condition called hemophilia have had more bleeding after starting protease inhibitors like Invirase (saquinavir). In about half of reported cases, people continued taking their protease inhibitor medication after the bleeding stopped. Let your provider know if you notice sudden bleeding or have bleeding that's difficult to stop.

                    risk-warning

                    Higher cholesterol levels

                    Taking Invirase (saquinavir) along with ritonavir (Norvir) can raise the amount of cholesterol and triglycerides (fats) in your blood. This can put you at higher risk for serious problems. Your provider will check your blood work before and during treatment to keep track of your levels. If your cholesterol levels are too high, you might need to take medications to help keep them under control. Keep in mind that you shouldn't take certain cholesterol medications, such as lovastatin and simvastatin (Zocor), with Invirase (saquinavir) because of the risk of serious muscle damage.

                    risk-warning

                    Potential harm if lactose intolerant

                    Invirase (saquinavir) oral tablets contain lactose. People with a history of certain genetic problems (e.g., galactose intolerance) are at high risk for diarrhea and other health problems because they can't process it well. For this reason, let your provider know before starting Invirase (saquinavir) if you've a history of genetic conditions.

                    risk-warning

                    Overactive immune system

                    Taking combination ARV therapy, such as Invirase (saquinavir) with other HIV medications, can cause changes to your immune system called immune reconstitution syndrome. This condition happens when your immune system becomes overly active after you start combination therapy. Your immune system begins to fight off different infections that it was too weak to fight off before you started treatment. In rare cases, your immune response might improve so much with treatment that it starts to attack normal cells in your body (autoimmune). You can develop immune reconstitution syndrome at any time during treatment. Tell your healthcare provider right away if you start having any new symptoms, such as fever, pain, hair loss, bulging eyes, or sweating, after starting Invirase (saquinavir).

                    risk-warning

                    Changes in body fat

                    Some people taking HIV medications such as Invirase (saquinavir) have experienced changes in body fat. These changes include fat buildup in the back of the neck, in the breast, and in other parts of the body. Some people also lost fat from the legs, arms, and face. It's not clear whether Invirase (saquinavir) causes these changes to body fat, why this happens, and whether it will affect your health in the future. Let your provider know if these changes occur while you're taking Invirase (saquinavir).

                    dosage

                    Invirase (saquinavir) dosage forms

                    The average cost for 30 tablets of 500mg of Invirase (saquinavir) is $305.23 with a free GoodRx coupon. This is 11.39% off the average retail price of $344.47.
                    tablet
                    Tablet
                    DosageQuantityPrice as low asPrice per unit
                    500mg30 tablets$305.23$10.17

                    Typical dosing for Invirase (saquinavir)

                    The typical dose is 1,000 mg by mouth twice a day taken together with 100 mg ritonavir (Norvir) and food.

                    Your starting dose might differ depending on other HIV medications you've taken in the past.

                    interactions

                    Interactions between Invirase (saquinavir) and other drugs

                    Invirase (saquinavir) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Invirase (saquinavir). Please note that only the generic name of each medication is listed below.

                    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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                    How much does Invirase (saquinavir) cost?

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                    contraindications-icon

                    Invirase (saquinavir) contraindications

                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Invirase (saquinavir) will not be safe for you to take.
                    • History of certain heart problems

                    • Low potassium or low magnesium in your blood

                    • Severe liver problems

                    • Taking certain medication that interact with Invirase (saquinavir) (e.g., amiodarone, lovastatin, or simvastatin (Zocor))

                    alternatives

                    What are alternatives to Invirase (saquinavir)?

                    There are a number of medications that your doctor can prescribe in place of Invirase (saquinavir). Compare a few possible alternatives below.
                    Invirase (saquinavir)
                    Used for:
                    • Treatment of HIV infection in people over 16 years old

                    $305.23 Lowest GoodRx priceView Prices
                    Used for:
                    • Treatment of HIV infection in adults and children weighing at least 88 pounds

                    $2414.21 Lowest GoodRx priceView Prices
                    Used for:
                    $251.28 Lowest GoodRx priceView Prices

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                    References

                    Best studies we found

                    ClinicalInfoHIV.gov. (n.d.). Boosting.

                    ClinicalInfoHIV.gov. (n.d.). Immune reconstitution inflammatory syndrome (IRIS).

                    ClinicalInfoHIV.gov. (n.d.). Protease.

                    View All References (6)

                    Farzam, K., et al. (2023). QT prolonging drugs. StatPearls.

                    Genentech, inc. (2020). Invirase- saquinavir mesylate tablet, film coated [package insert]. DailyMed.

                    HIVinfo.NIH.gov. (2021). Drug resistance.

                    MedlinePlus. (2020). Glucose-galactose malabsorption.

                    Thapa, S., et al. (2023). Immune reconstitution inflammatory syndrome. StatPearls.

                    U.S. Food and Drug Administration. (2017). FDA Drug Safety Communication: Invirase (saquinavir) labels now contain updated risk information on abnormal heart rhythms.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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