RITONAVIR = RTV oral

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    Last updated: November 2022

     

    Prescription under medical supervision

     

    Therapeutic action

    • Antiretroviral, HIV protease inhibitor

    Indications

    • Booster for protease inhibitors (atazanavir, darunavir, lopinavir, etc.) in HIV infection. Ritonavir should not be used alone.

    Forms and strengths

    • 25 mg and 100 mg tablets

    Dosage

    Dosage depends on the administration schedule of the boosted protease inhibitor. The daily dose is administered once daily or in 2 divided doses.

    • Child 14 to < 25 kg:
      • 50 mg (two 25 mg tablets) 2 times daily, or
      • 100 mg (four 25 mg tablets or one 100 mg tablet) once daily
    • Child ≥ 25 kg and adult: 100 mg (one 100 mg tablet) once or 2 times daily

     

    Duration

    • Depending on the efficacy and tolerance of the boosted protease inhibitor and ritonavir.

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with severe hepatic impairment.
    • Administer with caution and monitor use in patients with haemophilia (increased bleeding) or mild to moderate hepatic impairment.
    • The adverse effects of ritonavir as a booster are also dependent on the boosted protease inhibitor.
    • May cause:
      • gastrointestinal disturbances, fatigue, headache, dizziness, paraesthesia, joint and muscle pain, taste disturbances, hyperglycaemia, hyperlipidaemia, lipodystrophy, conduction disorders;
      • pancreatitis, hepatic disorders, skin rash sometimes severe; in this event, stop treatment immediately.
    • Ritonavir reduces the efficacy of implants and oral contraceptives.: use injectable medroxyprogesterone or an intrauterine device. Only when combined with atazanavir, an oral contraceptive containing at least 30 micrograms of ethinylestradiol per tablet may also be used.
    • Pregnancy: no contra-indication

    Remarks

    • Take with meals.
    • Tablets are not recommended in children < 14 kg. 
    • Also comes in fixed-dose combinations with other protease inhibitors (atazanavir, darunavir, lopinavir, etc.). Preferably use these formulations when available.

    Storage

     
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    –  Below 25 °C