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Generic Name: ritonavir (rit OH na vir)
Brand Names: Norvir

What is Norvir?

Norvir (ritonavir) is an antiviral medicine that prevents human immunodeficiency virus (HIV) from multiplying in your body.

Norvir is used to treat HIV, the virus that can cause acquired immunodeficiency syndrome (AIDS).

Norvir is not a cure for HIV or AIDS.

Important information

Serious drug interactions can occur when certain medicines are used with Norvir. Tell your doctor about all your current medicines and any you start or stop using.

Taking Norvir will not prevent you from passing HIV to other people. Avoid having unprotected sex or sharing razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Before taking this medicine

There are certain medicines that can cause life-threatening drug interactions with ritonavir, and should not be used at the same time. Your doctor may need to change your treatment plan if you use any of the following drugs:

  • alfuzosin;

  • cisapride;

  • colchicine;

  • St. John's wort;

  • sildenafil (Revatio) when used to treat pulmonary arterial hypertension (PAH);

  • voriconazole;

  • antipsychotic medicine - lurasidone, pimozide;

  • cholesterol-lowering medicine - lovastatin, simvastatin;

  • ergot medicine - dihydroergotamine, ergotamine, ergonovine, methylergonovine;

  • heart rhythm medicine - amiodarone, dronedarone, flecainide, propafenone, quinidine; or

  • a sedative - oral midazolam or triazolam.

To make sure Norvir is safe for you, tell your doctor if you have:

  • liver disease (especially hepatitis B or C);

  • pancreas disorder;

  • diabetes;

  • heart disease or heart rhythm disorder;

  • a bleeding disorder such as hemophilia; or

  • high cholesterol or triglycerides.

If you are pregnant, your name may be listed on a pregnancy registry. This is to track the outcome of the pregnancy and to evaluate any effects of Norvir on the baby.

Norvir oral solution contains alcohol and should not be used during pregnancy.

HIV can be passed to your baby if you are not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection.

Ritonavir can make birth control pills less effective. Ask your doctor about using non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy while taking Norvir.

Women with HIV or AIDS should not breast feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

How should I take Norvir?

Take Norvir exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Norvir tablets must be taken with meals. Norvir capsules or liquid should be taken with food if possible.

Do not crush, chew, or break a Norvir tablet. Swallow the tablet whole.

Shake the oral solution (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Liquid Norvir can be mixed with chocolate milk or a nutrition drink such as Ensure. Drink the mixture within 1 hour after mixing.

If a child is using this medicine, tell your doctor if the child has any changes in weight or height. Ritonavir doses are based on body surface area in children.

Use Norvir regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Your blood will need to be tested on a regular basis. Your liver function may also need to be tested.

HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice. Every person with HIV or AIDS should remain under the care of a doctor.

Store Norvir capsules in the refrigerator or at room temperature, away from heat or moisture. If you store the capsules at room temperature you must use them within 30 days. Protect from light.

Store Norvir tablets at room temperature away from heat or moisture.

Store Norvir liquid at room temperature with the cap tightly closed. Do not refrigerate.

Norvir dosing information

Usual Adult Dose for HIV Infection:

Use as a pharmacokinetic (PK) booster for other protease inhibitors: 100 to 400 mg/day orally in 1 or 2 divided doses

Use as an antiretroviral agent (sole protease inhibitor):
-Initial dose: 300 mg orally twice a day; increase by 100 mg twice a day every 2 to 3 days to the full maintenance dose
-Maintenance dose: 600 mg orally twice a day

Comments:
-This drug is most often used and recommended as a PK enhancer of more potent and better tolerated protease inhibitors.
-Use as a PK enhancer for other protease inhibitors is not specifically approved by the US FDA in the manufacturer product information for Norvir.
-The manufacturer product information of the boosted protease inhibitor should be consulted for additional information (including dose recommendations).
-According to experts, this drug should not be used as the sole protease inhibitor for initial therapy.

Use: In combination with other antiretroviral agents, for the treatment of HIV-1 infection

Usual Pediatric Dose for HIV Infection:

Use as a PK booster for other protease inhibitors: The manufacturer product information of the boosted protease inhibitor should be consulted for dose recommendations.

Use as an antiretroviral agent (sole protease inhibitor):
Greater than 1 month:
-Initial dose: 250 mg/m2 orally twice a day; increase by 50 mg/m2 twice a day every 2 to 3 days to the full maintenance dose
-Maintenance dose: 350 to 400 mg/m2 orally twice a day
Maximum dose: 600 mg/dose

Comments:
-This drug is most often used and recommended as a PK enhancer of more potent and better tolerated protease inhibitors.
-Use as a PK enhancer for other protease inhibitors is not specifically approved by the US FDA in the manufacturer product information for Norvir.
-If 400 mg/m2 twice a day is intolerable, the highest tolerated dose may be used for maintenance therapy in combination with other antiretrovirals; however, alternative therapy should be considered.
-The oral solution should not be given to neonates before a postmenstrual age of 44 weeks has been reached.
-According to experts, this drug should not be used as the sole protease inhibitor for initial therapy.
-Special attention should be given to accurate calculation of dose, transcription of medication order, dispensing information, and dosing instructions to reduce risk for medication errors and overdose; particularly important for infants and young children.
-Total amounts of alcohol and propylene glycol from all medications (including the oral solution) to be given to pediatric patients 1 to 6 months of age should be considered to avoid toxicity from these excipients.

Use: In combination with other antiretroviral agents, for the treatment of HIV-1 infection

See also: Dosage Information (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Norvir oral liquid could be fatal to a child.

What should I avoid while taking Norvir?

Norvir capsules and oral liquid contain alcohol. Avoid drinking alcoholic beverages while using this medicine, and do not take disulfiram (Antabuse) or you could have an alcohol reaction.

Taking this medicine will not prevent you from passing HIV to other people. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Norvir side effects

Get emergency medical help if you have signs of an allergic reaction to Norvir: hives, skin sores, mouth sores; joint or muscle pain; wheezing, difficulty breathing, fast or pounding heartbeats; sweating, feeling light-headed; swelling of your face, lips, tongue, or throat.

Stop taking Norvir and call your doctor at once if you have:

  • a light-headed feeling, like you might pass out;

  • irregular heartbeats;

  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

  • pancreas problems - severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

  • liver problems - nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

  • high blood sugar - increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss; or

  • severe skin reaction - fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Norvir may increase your risk of certain infections or autoimmune disorders by changing the way your immune system works. Symptoms may occur weeks or months after you start treatment with Norvir. Tell your doctor if you have:

  • signs of a new infection - fever, night sweats, swollen glands, mouth sores, diarrhea, stomach pain, weight loss;

  • chest pain (especially when you breathe), dry cough, wheezing, feeling short of breath;

  • cold sores, sores on your genital or anal area;

  • rapid heart rate, feeling anxious or irritable, weakness or prickly feeling, problems with balance or eye movement;

  • trouble speaking or swallowing, severe lower back pain, loss of bladder or bowel control; or

  • swelling in your neck or throat (enlarged thyroid), menstrual changes, impotence, loss of interest in sex.

Common Norvir side effects may include:

  • nausea, vomiting, stomach pain, diarrhea;

  • numbness or tingling, especially around your mouth;

  • weakness, tired feeling;

  • mild rash; or

  • changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

What other drugs will affect Norvir?

Many drugs can interact with ritonavir, and some drugs should not be used together. Tell your doctor about all medicines you use, and those you start or stop using, especially:

  • a blood thinner (warfarin, Coumadin, Xarelto, Jantoven);

  • medicine to treat infections (including other drugs to treat HIV);

  • medicine for anxiety, depression, seizures, or severe pain;

  • medicine to treat cancer or prevent organ transplant rejection;

  • heart or blood pressure medicine, cholesterol-lowering medicine;

  • insulin or oral diabetes medicine;

  • medicine to treat seizures or breathing problems; or

  • Viagra and other erectile dysfunction medicines.

This list is not complete and many other drugs can interact with ritonavir. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about Norvir.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Norvir only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2017 Cerner Multum, Inc. Version: 18.01

Date modified: June 06, 2017
Last reviewed: April 24, 2017

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