MEDICAL INFORMATION FOR HEALTH CARE PROFESSIONALS

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Treatment  / Medication Fact Sheets

WHY is this medication prescribed ?

Ritonavir belongs to a new class of drugs called protease inhibitors (pronounced PRO-teo-ase). It interferes with a different step in virus reproduction than other drugs previously available to fight HIV. Ritonavir is an antiretroviral medication that slows down the replication of the human immunodeficiency virus (HIV) and may therefore slow the progression of HIV disease. Ritonavir does not cure HIV nor does it prevent HIV transmission. As the effect of ritonavir may decrease with time, it is important that your progress is assessed regularly. It is not currently known how long the beneficial effects of this medication will last.

HOW should this drug be taken ?

The recommended dose of ritonavir is 600 mg (6 capsules or 7.5 mL oral solution) twice daily, taken with meals if possible. The taste of the oral solution may be improved by mixing with chocolate milk, Ensureâ, or Adveraâ. Mix only one dose at a time, and take the whole dose within 1 hour of mixing. The effects of antacids on the absorption of ritonavir have not been studied.

Some people experience nausea when beginning treatment with ritonavir. Thus, it may be helpful to start at a lower dose and increase slowly (e.g., start at 300 mg twice daily for 3-4 days, then 400 mg twice daily for 3-4 days, 500 mg twice daily for 3-4 days, then 600 mg twice daily) to reach the full dose by 10-14 days.

In addition, people beginning combination regimens with ritonavir may wish to start with ritonavir alone, and add the nucleosides later before completing two weeks of ritonavir monotherapy.

What should you do if you FORGET a dose ?

The missed dose should be taken as soon as you remember, then just carry on with your regular dosing schedule. However, do not take 2 doses at the same time. If you are unsure what to do, consult your doctor or pharmacist.

What ADVERSE EFFECTS can this drug cause? What should you do about them?

The most commonly reported side effects include: feeling weak/tired, nausea, vomiting, diarrhea, loss of appetite, abdominal pain, taste disturbance (with oral solution), tingling sensation or numbness in hands, feet, or around lips, headache, or dizziness.

If you are concerned about these or any other unexpected effects experienced while taking ritonavir, please call the clinic or discuss them at your next visit.

IT IS IMPORTANT THAT YOU KEEP YOUR REGULAR DOCTOR'S APPOINTMENTS, SO THAT YOUR PROGRESS CAN BE ASSESSED.

IF YOU ARE EXPERIENCING ANY ADVERSE EFFECTS, PLEASE DISCUSS THEM WITH YOUR HEALTH CARE TEAM.

What other PRECAUTIONS should you follow while using this drug?

Ritonavir can interact with many other drugs. It is important that your physician or pharmacist knows about other drugs you are taking, even medications you can buy without a prescription.

Do not take the following medications while you are taking ritonavir:

Please inform your physician or pharmacist if you are taking any of the above medications so that your dosage may be adjusted, or an alternative medication may be selected.

The safety of ritonavir has not been established during pregnancy or breast feeding. Please discuss this with your doctor or pharmacist if this is a concern.

How should this medication be STORED ?

Keep ritonavir in the bottle it came in. Do not transfer the medication to any other container. Ritonavir capsules must be kept in the refrigerator. When travelling, always keep ritonavir in a cooler bag or use ice packs. Bottles of ritonavir oral solution may be kept at room temperature for 30 days. After 30 days at room temperature, discard any leftover oral solution. Do not store in direct light or in extreme heat or cold. Keep well out of the reach of children.

IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT THIS MEDICATION, PLEASE DISCUSS THEM WITH YOUR PHARMACIST, NURSE, OR PHYSICIAN.

PLEASE WRITE DOWN YOUR QUESTIONS OR CONCERNS TO ENSURE THEY ARE ADDRESSED.

Adapted from the Norvir®Product Monograph, 1996, Abbott Laboratories, U.S.A. Edited by the CSHP Ont. Branch Professional Specialty Group in HIV Disease in conjunction with the HIV/AIDS Outpatient Network of Ontario Coordinators Sub-Group, 1996.