Ritonavir

Ritonavir is an antiviral or antiretroviral medicine. It is used in the treatment of HIV infection. It stops the virus from producing new viruses and clears up your infection. Ritonavir should be taken with food, as this increases the absorption of the medicine into the body. You should take it in the dose and duration as advised by your doctor. Taking it at the same time every day will help you to remember to take it. Do not stop taking it until you have finished the complete course, even when you feel better. If you stop taking this medicine too early then infection may return or worsen. Some people may experience taste changes, headache, nausea, and diarrhea as side effects of this medicine. Please consult your doctor if these side effects persist for a longer duration. Inform your doctor if you have diabetes as it can increase sugar levels in the blood. Before using it, you should tell your doctor if you are allergic to any antibiotics or have any kidney or liver problems. You should also let your doctor know all other medicines you are taking as they may affect, or be affected by this medicine. Pregnant and breastfeeding mothers should consult their doctor before using it. Your doctor may monitor your liver function while taking this medication. Ritonavir is an anti-HIV medication. It works by interfering with an enzyme (protease), which is required by HIV-infected cells to make new viruses. This stops the production of new viruses.

• HIV infection

Ritonavir, a selectively competitive reversible inhibitor of HIV protease, interferes with the formation of essential proteins and enzymes. Afterwhich, the formation of immature and non-infectious viruses follows. It also interferes with the production of infectious HIV and limits further infectious spread of the virus.

Adult Dose: Oral HIV infection Adult: Combined with other antiretrovirals: Initially, 300 mg bid for 1 day. May increase dose gradually by 100 mg bid over a period of up to 14 days to 600 mg bid. Hepatic impairment: Dosage reduction may be required. As a pharmacokinetic enhancer Adult: To enhance the efficacy of other protease inhibitors: 100-200 mg once or twice daily. Hepatic Impairment Monitor therapy carefully with moderate and severe hepatic impairment Child Dose: Oral HIV infection Child: Combined with other antiretrovirals: >2 yr: 250 mg/m2 bid. Increase dose by 50 mg/m2 bid at 2-3 day intervals up to 400 mg/m2 bid. Max: 600 mg bid.

Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Ritonavir is to be taken with food.

If you miss a dose of Ritonavir, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.

Common: • Taste change • Headache • Nausea • Diarrhea • Paresthesia (tingling or pricking sensation) • Dizziness • Cough • Abdominal pain • Throat pain • Peripheral neuropathy (tingling and numbness of feet and hand)

[CONSULT YOUR DOCTOR] It is not known whether Ritonavir alters the ability to drive. Do not drive if you experience any symptoms that affect your ability to concentrate and react. Ritonavir should be taken with food. Do not skip any doses and finish the full course of treatment even if you feel better. Do not take antacids an hour before or two hours after taking Ritonavir. It may cause dizziness or sleepiness. Do not drive or do anything that requires concentration until you know how it affects you. Stop taking medications (prescribed for erectile dysfunction) like sildenafil or tadalafil while on treatment with this medicine. Your doctor may check your liver function regularly. Inform your doctor if you develop abdominal pain, loss of appetite darkened urine or yellowing of the eyes or skin (jaundice). Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.

Hypersensitivity; lactation; severe hepatic impairment.

Decreased plasma conc with phenobarbital, carbamazepine, dexamethasone, phenytoin, rifabutin and rifampicn. Increased plasma conc of certain drugs highly metabolized by CYP3A. May increase serum levels of sildenafil. Potentially Fatal: Avoid concurrent admin of oral solution (contains alcohol) with disulfiram or metronidazole. Increased risk of myopathy when used with simvastatin or lovastatin. Concurrent use with alfuzosin may lead to serious hypotension. Increased risk of cardiac arrhythmias when used with amiodarone, cisapride, propafenone, quinidine, flecainide and pimozide. Risk of acute ergot toxicity when used with ergot derivatives. Increased risk of serious adverse reactions when used with midazolam or triazolam.

[CAUTION] Caution is advised when consuming alcohol with Ritonavir. Please consult your doctor.

[SAFE IF PRESCRIBED] Ritonavir is generally considered safe to use during pregnancy. Animal studies have shown low or no adverse effects to the developing baby; however, there are limited human studies.

[SAFE IF PRESCRIBED] Ritonavir is probably safe to use during breastfeeding. Limited human data suggests that the drug does not represent any significant risk to the baby.

[SAFE IF PRESCRIBED] Ritonavir is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of Ritonavir may not be needed in these patients. Please consult your doctor. [CAUTION] Ritonavir should be used with caution in patients with severe liver disease. Dose adjustment of Ritonavir may be needed. Please consult your doctor. Limited information is available on the use of Ritonavir in these patients. No dose adjustment is recommended in patients with mild to moderate liver disease.

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