RITONAVIR = RTV oral

Prescription under medical supervision


Therapeutic action

– Antiretroviral, HIV protease inhibitor

Indications

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

Forms and strengths

– 25 mg and 100 mg tablets
– 80 mg/ml oral solution, containing 43% alcohol (v/v), with a graduated syringe for oral administration
Also comes in fixed dose combinations containing ritonavir.

Dosage

Dosage depends on the administration schedule of the boosted protease inhibitor.
– Child 10 to < 14 kg: 40 mg 2 times daily 
– Child 14 to < 25 kg: 50 mg 2 times daily or 100 mg once daily
– Child ≥ 25 kg and adult: 100 mg once or 2 times daily

Weight

80 mg/ml oral sol.*

25 mg tab

100 mg tab

10 to < 14 kg0.5 ml x 2
14 to < 25 kg0.6 ml x 2 
or 1.25 ml x 1

2 tab x 2
or 4 tab x 1

≥ 25 kg and adult1 tab x 1 or 2 

* For doses less than 0.8 ml, use a 1 ml syringe graduated 0.01 ml.

Duration

– The duration of treatment depends 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).
– 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, hyperglycaemia, lipodystrophy, conduction disorders;
• pancreatitis, hepatic disorders, skin rash sometimes severe; in this event, stop treatment immediately.
– Administer with caution and monitor combination with metronidazole when using oral solution of ritonavir that contains alcohol (risk of antabuse reaction).
– Ritonavir reduces the efficacy of oral contraceptives.
 PregnancyCONTRA-INDICATED for oral solution; no contra-indication for tablets

Remarks

– Take with meals.
– The oral solution has a bitter taste.
 Storage: below 25 °C -  - 
Do not refrigerate or freeze the oral solution.