ritonavir 100 mg oral powder packet

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Medication name

Generic name:
Ritonavir powder packet - oral

Pronunciation
(ri-TON-na-vir)

Brand name(s)
Norvir

Warning

Ritonavir may interact with many different types of medicines, in some cases causing severe (sometimes fatal) reactions. Consult your doctor or pharmacist about which medications should not be taken with ritonavir. (See also Drug Interactions section.)

Uses

This drug is used with other HIV medications to help control HIV infection. It helps to decrease the amount of HIV in your body so your immune system can work better. This lowers your chance of getting HIV complications (such as new infections, cancer) and improves your quality of life.

Ritonavir belongs to a class of drugs known as protease inhibitors. It increases ("boosts") the levels of other protease inhibitors, which helps these medications work better.

Ritonavir is not a cure for HIV infection. To decrease your risk of spreading HIV disease to others, continue to take all HIV medications exactly as prescribed by your doctor. Use an effective barrier method (latex or polyurethane condoms/dental dams) during sexual activity as directed by your doctor. Do not share personal items (such as needles/syringes, toothbrushes, and razors) that may have contacted blood or other body fluids. Consult your doctor or pharmacist for more details.

Other uses

This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This product may also be used to lessen the risk of HIV infection after contact with the virus (for example, due to a needle stick). Ask your doctor for more details.

How to use

Read the Patient Information Leaflet and Instructions for Use if available from your pharmacist before you start taking ritonavir and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth with a meal as directed by your doctor, usually 1 to 2 times daily. Take ritonavir at the same time(s) as your other protease inhibitor. Open the packet and mix the powder with soft food (such as applesauce, vanilla pudding) or liquid (such as water, infant formula, milk) as directed. If giving through a feeding tube, the powder should be mixed with water. The dose of the medication should be taken within 2 hours after mixing.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Children's dosage may also be based on body size.

For the best effect, take this medication at evenly spaced times. To help you remember, take this medication at the same time(s) every day.

It is very important to keep taking this medication (and other HIV medications) exactly as prescribed by your doctor. Do not take more or less of this drug than prescribed or stop taking it (or other HIV medicines) even for a short time unless directed to do so by your doctor. Doing so may cause the amount of virus to increase, make the infection more difficult to treat (resistant), or worsen side effects.

Side effects

Diarrhea, nausea, vomiting, heartburn, stomach pain, dizziness, tiredness, weakness, changes in taste, or tingling/numbness of the mouth area may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

As your immune system gets stronger, it can begin to fight off infections you already had, possibly causing disease symptoms to come back. You could also have symptoms if your immune system becomes overactive. This reaction may happen at any time (soon after starting HIV treatment or many months later). Get medical help right away if you have any serious symptoms, including:

  • unexplained weight loss
  • severe tiredness
  • muscle aches/weakness that doesn't go away
  • headaches that are severe or don't go away
  • joint pain
  • numbness/tingling of the hands/feet/arms/legs
  • vision changes
  • signs of infection (such as fever, chills, swollen lymph nodes, trouble breathing, cough, non-healing skin sores)
  • signs of an overactive thyroid (such as irritability, nervousness, heat intolerance, fast/pounding/irregular heartbeat, bulging eyes, unusual growth in the neck/thyroid known as a goiter)
  • signs of a certain nerve problem known as Guillain-Barre syndrome (such as unsteadiness, loss of coordination, trouble swallowing/speaking/chewing, trouble moving your eyes)

Tell your doctor right away if you have any serious side effects, including:

  • nausea/vomiting that doesn't stop
  • stomach/abdominal pain
  • yellowing eyes/skin
  • dark urine
  • loss of appetite
  • mental/mood changes (such as depression, anxiety)
  • increased thirst/urination

Get medical help right away if you have any very serious side effects, including:

  • symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating)
  • easy bruising/bleeding
  • fainting
  • fast/irregular heartbeat

Changes in body fat may occur while you are taking this medication (such as increased fat in the upper back and stomach areas, decreased fat in the arms and legs). The cause and long-term effects of these changes are unknown. Discuss the risks and benefits of treatment with your doctor, as well as the possible use of exercise to reduce this side effect.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking ritonavir, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • diabetes
  • heart problems (coronary artery disease, heart attack)
  • hemophilia
  • high cholesterol/triglycerides
  • gout/high uric acid in the blood
  • liver problems (such as hepatitis B, hepatitis C)
  • pancreatitis

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

If you have diabetes, this product may increase your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if you are pregnant before using this medication. Treatment can lower the risk of passing HIV infection to your baby. Discuss the risks and benefits with your doctor.

This medication passes into breast milk. Because breast milk may transmit HIV, consult your doctor before breastfeeding.

Drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Ritonavir interacts with many medications. Some products that may interact with this drug are:

  • cobicistat
  • orlistat

Ritonavir can slow down or speed up the removal of other medications from your body, which may affect how they work. Examples of affected drugs include alfuzosin, antiarrhythmics (such as amiodarone, dronedarone, flecainide, propafenone, quinidine), certain benzodiazepines (midazolam, triazolam), certain "blood thinners" (such as rivaroxaban, warfarin), eletriptan, drugs to treat erectile dysfunction-ED or pulmonary hypertension (such as avanafil, sildenafil), ergot alkaloids (such as dihydroergotamine, ergotamine, methylergonovine), lurasidone, certain opioid pain medications (such as fentanyl, meperidine), pimozide, ranolazine, salmeterol, "statin" cholesterol drugs (such as simvastatin, lovastatin), among others.

Other medications can affect the removal of ritonavir from your body, which may affect how ritonavir works. Examples include apalutamide, rifampin, St. John's wort, among others.

This medication may decrease the effectiveness of hormonal birth control such as pills, patch, or ring. This could cause pregnancy. Discuss with your doctor or pharmacist if you should use reliable backup birth control methods while using this medication. Also tell your doctor if you have any new spotting or breakthrough bleeding, because these may be signs that your birth control is not working well.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669.

Notes

Do not share this medication with others.

Lab and/or medical tests (such as liver function, viral load, T-cell counts, blood sugar, triglycerides/cholesterol) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

Missed dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Storage

Store at room temperature. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised August 2024.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.