Ritonavir
A to Z Drug Facts
Ritonavir |
(rih-TON-a-veer) |
Norvir |
Capsules |
100 mg |
Oral solution |
80 mg/mL |
Class: Antiviral |
Action Inhibits human immunodeficiency virus (HIV) protease, the enzyme required to form functional proteins in HIV-infected cells.
Indications Treatment of HIV infection. May be given in combination with nucleoside analogs (eg, zidovudine) or as monotherapy.
Contraindications Concomitant therapy with amiodarone, bepridil, bupropion, cisapride, clozapine, encainide, flecainide, meperidine, pimozide, piroxicam, propafenone, propoxyphene, quinidine, and rifabutin. Coadministration of alprazolam, clorazepate, diazepam, ergot derivatives, estazolam, flurazepam, midazolam, triazolam, and zolpidem.
ADULTS: PO 600 mg bid. If nausea occurs, relief may be provided by dose titration: 300 mg bid for 1 day, 400 mg bid for 2 days, 500 mg bid for 1 day, then 600 mg bid.
CHILDREN GREATER THAN OR EQUAL TO 2 yr: PO Start at 250 mg/m2 bid and increase dose at 2- to 3-day intervals by 50 mg/m2 bid (max, 600 mg bid).
Amiodarone, Bepridil, Bupropion, Cisapride, Clarithromycin, Clozapine, Encainide, Flecainide, Meperidine, Piroxicam, Propafenone, Propoxyphene, Quinidine, Rifabutin, Sildenafil: Ritonavir may elevate blood levels of these drugs, which may increase the risk of arrhythmias, hematologic abnormalities, seizures, or other potential serious adverse effects.
Alprazolam, Clorazepate, Diazepam, Estazolam, Fentanyl, Flurazepam, Midazolam, Triazolam, Zolpidem: Ritonavir may increase blood levels of these drugs, which may produce extreme sedation and respiratory depression. Do not coadminister.
Azole Antifungal Agents (eg, Ketoconazole), Clarithromycin, Interleukins: May elevate ritonavir plasma levels, increasing the risk of side effects.
Carbamazepine, Dexamethasone, Phenobarbital, Phenytoin, Rifabutin, Rifampin, St. Johns Wort: May decrease plasma concentrations of ritonavir.
Desipramine: Desipramine levels may be increased.
Didanosine, Methadone, Theophylline: Levels may be decreased by ritonavir.
Disulfiram, Metronidazole: Ritonavir contains alcohol and may produce a disulfiram-like reaction with these drugs.
Ergot Derivatives (eg, Ergotamine): Because the risk of ergot toxicity may be increased, coadministration with ritonavir is contraindicated.
Oral Contraceptives: Concentrations of ethinyl estradiol, a component of oral contraceptives, may be reduced.
Saquinavir: Ritonavir may inhibit indinavir and saquinavir metabolism and increase their levels.
Warfarin: The risk of bleeding may be increased.
Lab Test Interferences None well documented.
CARDIOVASCULAR: Vasodilation; hemorrhage; hypotension; palpitations, postural hypotension; tachycardia. CNS: Headache; malaise; circumoral paresthesia; paresthesia; dizziness; insomnia; somnolence; abnormal thinking. DERMATOLOGIC: Rash; swelling. EENT: Pharyngitis; sore throat; abnormal taste. GI: Anorexia; constipation; diarrhea; dyspepsia; flatulence; nausea; vomiting; abdominal pain. GU: Impotence; dysuria; kidney failure. HEPATIC: Hepatitis; hepatomegaly; abnormal LFTs. METABOLIC: Increased CPK; hyperlipidemia; diabetes mellitus. OTHER: Asthenia; fever; myalgia.
Pregnancy: Category B. Lactation: Undetermined. HIV-infected mothers should not breastfeed their infants. Children: Not recommended for children less than 2 yr. Hepatic Function Impairment: Use caution; decreased ritonavir clearance may occur.
PATIENT CARE CONSIDERATIONS |
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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts