What is the most important information I should know about ritonavir?
Serious drug interactions can occur when certain medicines are used with ritonavir. Tell your doctor about all your current medicines and any you start or stop using.
What is ritonavir?
Ritonavir is an antiviral medicine that prevents human immunodeficiency virus (HIV) from multiplying in your body.
Ritonavir is used together with other antiviral medicines to treat HIV, the virus that can cause acquired immunodeficiency syndrome (AIDS). Ritonavir is not a cure for HIV or AIDS.
Ritonavir may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking ritonavir?
Serious drug interactions can occur when certain medicines are used with ritonavir. Your doctor may need to change your treatment plan if you use any of the following drugs:
- alfuzosin, cisapride, colchicine, St. John's wort, voriconazole;
- sildenafil (Revatio) when used to treat pulmonary arterial hypertension (PAH);
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antipsychotic medicine --lurasidone, pimozide;
-
cholesterol-lowering medicine --lovastatin, simvastatin;
-
ergot medicine --dihydroergotamine, ergotamine, methylergonovine;
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heart rhythm medicine --amiodarone, dronedarone, flecainide, propafenone, quinidine; or
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a sedative --oral midazolam or triazolam.
To make sure ritonavir is safe for you, tell your doctor if you have:
- liver disease (especially hepatitis B or C);
- heart disease or heart rhythm disorder;
- diabetes; o
- a bleeding disorder such as hemophilia.
Ritonavir liquid contains alcohol and propylene glycol, and should not be used by pregnant women or premature babies.
Tell your doctor if you become pregnant. 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. Your name may be listed on a pregnancy registry to track any effects of ritonavir on your pregnancy or the baby.
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 ritonavir.
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 ritonavir?
Ritonavir must be given in combination with other antiviral medications and it should not be used alone. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Ritonavir tablets must be taken with meals. Ritonavir capsules or liquid should be taken with food if possible.
Do not crush, chew, or break a ritonavir tablet. Swallow it whole.
Shake the oral 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 ritonavir can be mixed with chocolate milk or a nutrition drink such as Ensure. Drink the mixture within 1 hour after mixing.
Follow your doctor's dosing instructions very carefully when giving ritonavir to an infant. Tell your doctor when the child has changes in weight or height. Ritonavir doses are based on body surface area in children.
Your blood will need to be tested on a regular basis. Your liver function may also need to be tested.
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 ritonavir 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 ritonavir tablets at room temperature away from heat or moisture.
Store ritonavir liquid at room temperature with the cap tightly closed. Do not refrigerate.
If you have ever had hepatitis B, ritonavir can cause this condition to come back or get worse. You will need frequent blood tests to check your liver function during treatment and for several months after you stop using this medicine.
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 ritonavir oral liquid could be fatal to a child.
What should I avoid while taking ritonavir?
Ritonavir 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.
What are the possible side effects of ritonavir?
Get emergency medical help if you have signs of an allergic reaction: 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 ritonavir and call your doctor at once if you have:
- irregular heartbeats, feeling like you might pass out;
- 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;
-
liver problems --right-sided stomach pain, itching, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes);
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high blood sugar --increased thirst, increased urination, hunger, dry mouth, fruity breath odor; or
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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.
Ritonavir 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 ritonavir. 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 side effects may include:
- nausea, vomiting, stomach pain, diarrhea;
- numbness or tingling in your hands or feet or 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.
What other drugs will affect ritonavir?
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 ritonavir.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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