Ritonavir
 
What is Ritonavir and why is it prescribed?
Ritonavir is prescribed to slow the progress of HIV (human immunodeficiency virus) infection. Ritonavir belongs to a class of HIV drugs called protease inhibitors, which work by interfering with an important step in this process. Although Ritonavir cannot get rid of HIV already present in the body, it can reduce the amount of virus available to infect other cells. Ritonavir is used in combination with other HIV drugs called nucleoside analogues (Retrovir, Hivid, and others). These two types of drugs act against HIV in different ways thus improving the odds of success. Do not take Ritonavir with the following medications: Amiodarone (Cordarone), Bepridil (Vascor), Dihydroergotamine (D.H.E.), Ergonovine, Ergotamine (Wigraine), Flecainide (Tambocor), Methylergonovine (Methergine), Midazolam (Versed), Pimozide (Orap), Propafenone (Rythmol), Quinidine (Quinidex), or Triazolam (Halcion). The combination could cause serious, even life-threatening, effects. Be sure to tell your doctor and pharmacist what medications you are taking, both prescription and over-the-counter, and let them know when you stop taking any medication.

How should you take Ritonavir?
Follow your doctors directions for taking Ritonavir. Do not share Ritonavir with anyone and do not take more than your recommended dosage. Take Ritonavir with food, if possible, or the medication may not work properly. Ritonavir is available in soft gelatin capsule and oral solution forms. If you are taking Ritonavir oral solution and want to improve the taste, you can mix the liquid with chocolate milk or a liquid nutritional product (Ensure or Advera) within 1 hour of taking the dose. Use a measuring cup or spoon to measure each dose of the oral solution accurately. A household teaspoon may not hold the correct amount of oral solution. If you miss a dose take it as soon as possible. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Never double the dose. Capsules are best kept in the refrigerator, although they do not require refrigeration if used within 30 days and stored below 77ºF. Protect Ritonavir from light and heat. Do not refrigerate the oral solution. Store at room temperature. Shake before each use. Avoid exposure to extreme heat and keep cap tightly closed. Keep Ritonavir in its original container and use by the expiration date.

Are there any Ritonavir side effects?
Ritonavir side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Possible Ritonavir side effects may include abdominal pain, allergic reactions, anxiety, bedwetting, confusion, constipation, diarrhea, disturbed thoughts, dizziness, drowsiness, fatigue, fever, gas, general feeling of illness, headache, incontinence, indigestion, insomnia, joint pain, loss of appetite, muscle aches, nausea, numbness or tingling sensation around the face or mouth, pain, "pins and needles" sensation in the arms and legs, rash, sore or irritated throat, sweating, taste alteration, vomiting, weakness, weight loss, and yellowing of skin.

What are the possible food and drug interactions when taking Ritonavir?
If Ritonavir is taken with certain other drugs, the effects of either could be increased, decreased, or altered. Be sure to inform your doctor of all the prescription and over the counter medications you are taking. It is especially important to check with your doctor before combining Ritonavir with Anticonvulsants (such as Depakote, Dilantin, Klonopin, Lamictal, Tegretol, and Zarontin), Antidepressants (such as Norpramin, Prozac, Serzone, and Wellbutrin), Anti-nausea drugs (such as Marinol), Atovaquone (Mepron), Calcium channel blockers (such as Calan, Cardizem, and Procardia), Cholesterol-lowering drugs (such as Lipitor, Mevacor, and Zocor), Clarithromycin (Biaxin), Didanosine (Videx), Disulfiram (Antabuse), Heart medications (such as lidocaine, Mexitil, and Norpace), Immunosuppressants (such as Neoral, ProGraf, and Sandimmune), Indinavir (Crixivan), Ketoconazole (Nizoral), Medications for mental illness (such as Mellaril, Risperdal, and Trilafon), Methadone, Methamphetamine, Metoprolol (Lopressor), Metronidazole (Flagyl), Oral contraceptives, Pain-killers (such as Demerol, Darvon, and Ultram), Quinine, Rifabutin (Mycobutin), Rifampin (Rifadin), St. John's Wort (hypericum perforatum), Saquinavir (Invirase), Sildenafil (Viagra), Sedatives (such as Ambien, Dalmane, ProSom, Tranxene, and Valium), Steroids (such as dexamethasone and prednisone), Timolol (Timoptic), Theophylline (Theo-Dur), or Warfarin (Coumadin). Less significant interactions may occur with many other drugs. Your wisest course is to check with your doctor before combining any drug with Ritonavir. Tobacco use decreases the effects of Ritonavir. The effects of antacids taken with Ritonavir have not been studied.

Are there any special warnings about Ritonavir?
Ritonavir has been studied for only a limited period of time. Its long-term effects are still unknown. Ritonavir is not a cure for AIDS or HIV infection. You may continue to experience symptoms and develop complications, including opportunistic infections. Ritonavir does not reduce the danger of transmission of HIV to others through sexual contact or blood contamination. Therefore, you should continue to avoid practices that could give HIV to others. If you have liver disease, take Ritonavir with caution. It has caused liver damage in some patients. Ritonavir has also been known to trigger or aggravate cases of diabetes. It may increase your cholesterol levels. And it can also cause a serious problem called pancreatitis. If you develop warning signs such as nausea, vomiting, and abdominal pain, be sure to tell your doctor. You may have to stop taking the drug. Some patients undergo an accumulation or redistribution of body fat while taking Ritonavir. It's not known whether this has any ill-effects on health over the long term.
 

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