Generic Name: ritonavir (ri-TOE-na-vir)
Brand Name: Norvir
Use of ritonavir along with certain other medicines (eg, certain antiarrhythmics, certain sleep medicines, ergot medicines) may cause severe and possibly life-threatening side effects. Inform your doctor and pharmacist of all prescription and over-the-counter medicine that you are taking before taking ritonavir.
Ritonavir is used for:
Treating HIV in combination with other medicines.
Ritonavir is an HIV protease inhibitor. It works by blocking the growth of HIV.
Do NOT use ritonavir if:
- you are allergic to any ingredient in ritonavir
- you are taking alfuzosin, amiodarone, astemizole, cabazitaxel, cisapride, conivaptan, crizotinib, dronedarone, ergot medicines (eg, ergotamine, methylergonovine), erythromycin, everolimus, flecainide, inhaled fluticasone, ivabradine, lovastatin, lurasidone, meperidine, oral midazolam, pimozide, propafenone, quinidine, quinine, rivaroxaban, salmeterol, silodosin, simvastatin, St. John's wort, tamsulosin, terfenadine, ticagrelor, tolvaptan, or triazolam
- you are taking sildenafil to treat pulmonary arterial hypertension (PAH)
- you have taken or will be taking eletriptan within 72 hours of taking ritonavir
Contact your doctor or health care provider right away if any of these apply to you.
Before using ritonavir:
Some medical conditions may interact with ritonavir. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have diabetes or high blood sugar, liver problems (eg, hepatitis B or C), abnormal liver function tests, hemophilia, high cholesterol or triglyceride levels, or a history of pancreatitis
- if you have a history of heart problems (eg, heart failure, irregular heartbeat) or heart blood vessel problems
- if you take another HIV protease inhibitor (eg, atazanavir, tipranavir)
- if you take voriconazole. Certain doses of ritonavir should not be taken with voriconazole
Some MEDICINES MAY INTERACT with ritonavir. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Many prescription and nonprescription medicines (eg, used for infections, HIV, inflammation, allergic reactions, breathing problems, pain, birth control, blood circulation problems, blood thinning, cancer, diabetes, drug or other substance abuse or dependence, glaucoma or increased eye pressure, gout, high blood iron levels, irregular heartbeat or other heart problems, high blood pressure, high cholesterol, immune system suppression, nausea and vomiting, overactive bladder, PAH, seizures, sleep disorders, depression or other mood or mental problems), multivitamin products, and herbal or dietary supplements (eg, herbal teas, coenzyme Q10, garlic, ginseng, ginkgo, St. John's wort) may interact with ritonavir.
This may not be a complete list of all interactions that may occur. Ask your health care provider if ritonavir may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use ritonavir:
Use ritonavir as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with ritonavir. Talk to your pharmacist if you have questions about this information.
- Take ritonavir by mouth with food.
- Swallow ritonavir whole. Do not break, crush, or chew before swallowing.
- Continue to take ritonavir even if you feel well. Do not miss any doses.
- If you miss a dose of ritonavir, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. It is important not to miss doses of ritonavir. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use ritonavir.
Important safety information:
- Ritonavir may cause dizziness. This effect may be worse if you take it with alcohol or certain medicines. Use ritonavir with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not change your dose or stop taking ritonavir without checking with your doctor.
- Do NOT take more than the recommended dose without checking with your doctor.
- Ritonavir may improve immune system function. This may reveal hidden infections in some patients. Tell your doctor right away if you notice symptoms of infection (eg, fever, sore throat, weakness, cough, shortness of breath) after you start ritonavir.
- Ritonavir does not stop the spread of HIV to others through blood or sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection. Do not share needles, injection supplies, or items like toothbrushes or razors.
- Ritonavir is not a cure for HIV infection. Patients may still get illnesses and infections associated with HIV. Remain under the care of your doctor.
- When your medicine supply is low, get more from your doctor or pharmacist as soon as you can. Do not stop taking ritonavir, even for a short period of time. If you do, the virus may grow resistant to the medicine and become harder to treat.
- Changes in body fat (eg, an increased amount of fat in the upper back, neck, breast, and trunk; loss of fat from the legs, arms, and face) may occur in some patients taking ritonavir. The cause and long-term effects of these changes are unknown. Discuss any concerns with your doctor.
- Patients taking certain medicines for erectile dysfunction (eg, sildenafil, tadalafil, vardenafil) may experience low blood pressure, prolonged erections, and vision changes while taking ritonavir. Talk to your doctor before taking these medicines with ritonavir.
- Hormonal birth control (eg, birth control pills) may not work as well while you are using ritonavir. To prevent pregnancy, use an extra form of birth control (eg, condoms).
- Hemophilia patients - Some people with hemophilia have developed increased bleeding while taking protease inhibitors, such as ritonavir. Report all bleeding episodes to your doctor.
- Ritonavir may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have fruit-like breath odor. If these symptoms occur, tell your doctor right away.
- Diabetes patients - Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
- Lab tests, including liver function, cholesterol, and triglyceride levels, may be performed while you use ritonavir. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Ritonavir should be used with extreme caution in CHILDREN younger than 1 month old; safety and effectiveness in these children have not been confirmed.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using ritonavir while you are pregnant. Mothers infected with HIV should not breast-feed. There is a risk of passing the HIV infection or ritonavir to the baby.
Possible side effects of ritonavir:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Abnormal skin sensations, especially around the mouth, fingers, and toes; diarrhea; headache; loss of appetite; mild stomach pain; nausea; taste changes; tiredness; vomiting; weakness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest or throat; swelling of the mouth, face, lips, or tongue; unusual hoarseness); chest, jaw or arm pain; decreased urination; dizziness or light-headedness; fainting; fast or irregular heartbeat; fever, chills, or sore throat; flushed face; loss of consciousness; mental or mood changes (eg, depression); mouth sores or ulcers; muscle or joint pain; red, swollen, blistered, or peeling skin; seizures; shortness of breath; sudden, severe nausea or vomiting; symptoms of liver problems (eg, dark urine, pale stools, persistent loss of appetite, right-sided stomach pain, yellowing of the skin or eyes); symptoms of pancreatitis (eg, severe stomach or back pain, with or without nausea or vomiting); unusual bruising or bleeding; unusual sweating; unusual tiredness or weakness; vision changes; wheezing.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include burning, numbness, or tingling; decreased urination.Proper storage of ritonavir:
Store ritonavir between 68 and 77 degrees F (20 and 25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep ritonavir out of the reach of children and away from pets.
- If you have any questions about ritonavir, please talk with your doctor, pharmacist, or other health care provider.
- Ritonavir is to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take ritonavir or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about ritonavir. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to ritonavir. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using ritonavir.
Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.