II. Indications

  1. Used at low dose to "boost" most of the Protease Inhibitors

III. Mechanism

IV. Efficacy

  1. Very effective with Zidovudine (AZT) as well as other Protease Inhibitors

V. Adverse Effects (less common with the lower, "boosting dose")

  1. Gastrointestinal adverse effects may limit medication use
    1. Nausea or Vomiting
    2. Diarrhea
  2. Asthenia
  3. Paresthesias (Circumoral or peripheral)
  4. Triglycerides elevated
  5. Liver Function Tests
    1. Cholestatic enzymes elevated
    2. Hepatic transaminases elevated

VI. Drug Interactions

  1. Rifampin
  2. Dexamethasone
  3. Anticonvulsants

VII. Dosing

  1. Take with food
  2. Anticipate bad taste (Mix with chocolate milk)
  3. Full dose: 600 mg bid (not typically used at full dose due to adverse effects)
  4. Boosting dose varies from 100 mg daily up to 400 mg bid

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Cost: Medications

norvir (on 9/21/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
NORVIR 100 MG TABLET $8.28 each

Ontology: Ritonavir (C0292818)

Definition (NCI_NCI-GLOSS) A drug used to treat infection with HIV (the virus that causes AIDS). It is also being studied in the treatment of some types of cancer. Ritonavir blocks the ability of HIV to make copies of itself and may block the growth of cancer cells. It is a type of anti-HIV agent and a type of protease inhibitor.
Definition (NCI) A peptidomimetic agent that inhibits both HIV-1 and HIV-2 proteases. Ritonavir is highly inhibited by serum proteins but boosts the effect of other HIV proteases by blocking their degradation by cytochrome P450.
Definition (MSH) An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. It also inhibits CYTOCHROME P-450 CYP3A.
Definition (CSP) HIV protease inhibitor that works by interfering with the replication cycle of HIV.
Definition (PDQ) A synthetic aromatic derivative with antiviral properties. Ritonavir is a peptidomimetic agent that inhibits both HIV-1 and HIV-2 proteases, thereby preventing the cleavage of Gag-Pol polyproteins and resulting in the production of noninfectious viral particles. This agent is more active against HIV-1. Because ritonavir targets the HIV replication cycle after translation and before assembly, it is active in chronically infected cells that generally are not affected by nucleoside reverse transcriptase inhibitors. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42665&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=42665&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1609" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D019438
SnomedCT 108693005, 386896009
LNC LP21314-7, MTHU013855
English RTV, Ritonavir, ritonavir, RIT, ritonavir (medication), RITONAVIR, Ritonavir [Chemical/Ingredient], Ritonavir (product), Ritonavir (substance)
Swedish Ritonavir
Czech ritonavir
Finnish Ritonaviiri
Russian RITONAVIR, РИТОНАВИР
Japanese リトナビル
Polish Rytonawir
Spanish ritonavir (producto), ritonavir (sustancia), ritonavir, Ritonavir
French Ritonavir
German Ritonavir
Italian Ritonavir
Portuguese Ritonavir