Norvir

The recommended adult dose of ritonavir is 600 mg taken 2 times daily. For children 2 to 16 years old, the dosage is based on body size. The recommended dose of ritonavir is 400 mg per square metre (m²) of body surface area (to a maximum of 600 mg per dose) as calculated by the doctor. Ritonavir is taken in combination with other anti-HIV medications.

The doctor may start the medication at a lower dose and increase it to the recommended dose so that side effects are minimized.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Ritonavir should be taken with meals if possible. Tablets should be swallowed whole and not crushed or chewed.

If you are using ritonavir solution, use a calibrated delivery device to ensure an accurate dose. If you use the dosage cup provided with the medication, clean the cup with hot water and dish soap immediately after taking a dose to remove any medication residue. Make sure your measuring device is dry before using it for the next dose.

Shake the solution well before measuring a dose. To help cover the taste of the medication, ritonavir solution may be mixed with chocolate milk or a liquid nutritional supplement. If you mix the medication with chocolate milk, take the dose within 1 hour of preparing it.

It is important to take Norvir exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

If you forget many doses in a row, talk to your doctor about how to resume dosing.

Ritonavir tablets and solution should be stored at room temperature. Keep them in their original containers. Do not refrigerate the solution and avoid exposure of the medication to excessive heat.

Keep this and all medication out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may decrease your appetite; it may cause diarrhea; it may cause stomach ache; it may cause unusual tiredness; it may alter your sense of taste; it may cause nausea and vomiting. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Tablet

Each white, oval, film-coated tablet, debossed with the Abbott logo and the Abbo-Code "NK" on the same side, contains 100 mg of ritonavir. Nonmedicinal ingredients: copovidone, colloidal silicon dioxide/colloidal anhydrous silica, dibasic calcium phosphate anhydrous/calcium hydrogen phosphate anhydrous, sorbitan monolaurate/sorbitan laurate, and sodium stearyl fumarate; film coating: colloidal silicon dioxide/colloidal silica anhydrous, hydroxypropyl cellulose, hypromellose, polyethylene glycol 400/ macrogol type 400, polyethylene glycol 3350/macrogol type 3350, polysorbate 80, talc, and titanium dioxide E171.

Oral liquid

Each mL of orange-colored, peppermint and caramel-flavoured oral solution contains 80 mg of ritonavir. Nonmedicinal ingredients: anhydrous citric acid (to adjust pH), creamy caramel flavoring, ethanol, FD&C Yellow No. 6, peppermint oil, polyoxyl 35 castor oil, propylene glycol, saccharin sodium, and water.

Capsule

Norvir Sec is no longer being manufactured for sale in Canada. For brands that may still be available, search under ritonavir. This article is being kept available for reference purposes only. If you are using Norvir, speak with your doctor or pharmacist for information about your treatment options.

Do not use Norvir if you:

• are allergic to ritonavir or any ingredients of Norvir
• are taking any of the following medications:
  • Alfuzosin
  • Amiodarone
  • astemizole
  • cisapride
  • Colchicine
  • Dihydroergotamine
  • Dronedarone
  • ergonovine
  • ergotamine
  • Flecainide
  • fusidic acid
  • Lovastatin
  • Lurasidone
  • methylergonovine
  • midazolam taken by mouth
  • Pimozide
  • Propafenone
  • quinidine
  • Rivaroxaban
  • salmeterol
  • Sildenafil
  • Simvastatin
  • St. John's wort
  • terfenadine
  • Triazolam
  • Vardenafil
  • Venetoclax
  • Voriconazole

There may be an interaction between ritonavir and any of the following:

• Abiraterone
• Aliskiren
• Almotriptan
• alpha-blockers (e.g., alfuzosin, Doxazosin, Silodosin, Tamsulosin)
• amiodarone
• anticancer medications (e.g., Cabazitaxel, Docetaxel, Doxorubicin; Etoposide, Ifosfamide, Irinotecan, Vincristine)
• antipsychotics (e.g., Aripiprazole, Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• Apixaban
• Aprepitant
• Atomoxetine
• atovaquone
• "azole" antifungals (fluconazole, itraconazole, voriconazole)
• benzodiazepines (e.g., Alprazolam, Diazepam, Lorazepam, midazolam)
• birth control pills
• Bosentan
• Bromocriptine
• Buprenorphine
• Bupropion
• Buspirone
• Calcitriol
• calcium channel blockers (e.g., Amlodipine, Nifedipine, Verapamil)
• Canagliflozin
• cannabis
• Carvedilol
• cetirizine
• chloroquine
• Cobicistat
• colchicine
• conivaptan
• corticosteroids (e.g., budesonide, Dexamethasone, fluticasone, Methylprednisolone, Prednisone)
• Cyclosporine
• dabigatran
• Dantrolene
• Dapsone
• Darifenacin
• Deferasirox
• Dextromethorphan
• Digoxin
• Dipyridamole
• Disopyramide
• disulfiram
• Domperidone
• dronedarone
• Dutasteride
• Edoxaban
• Enzalutamide
• Eplerenone
• ergot derivatives (e.g., dihydroergotamine, ergotamine, ergonovine, methylergonovine)
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• Everolimus
• flecainide
• Flutamide
• fusidic acid
• garlic
• "gliptin" diabetes medications (e.g., Linagliptin, Saxagliptin, Sitagliptin)
• grazoprevir
• Guanfacine
• hepatitis C antivirals (e.g., asunaprevir, daclatasvir, elbasvir, velpatasvir)
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• other HIV protease inhibitors (e.g., atazanavir, indinavir, saquinavir)
• insulin
• lidocaine
• Lomitapide
• Loperamide
• Losartan
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• maraviroc
• Mefloquine
• Metoprolol
• Metronidazole
• Mexiletine
• mifepristone
• Mirabegron
• Mirtazapine
• Modafinil
• Montelukast
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nefazodone
• nitrates (e.g., isosorbide mononitrate, isosorbide dinitrate)
• Phenobarbital
• phosphodiesterase-5 inhibitors (e.g., sildenafil, Tadalafil, vardenafil)
• Pioglitazone
• Prasugrel
• praziquantel
• Primaquine
• procainamide
• progestins (e.g., Dienogest, Levonorgestrel, medroxyprogesterone, Norethindrone)
• propafenone
• Propranolol
• proton pump inhibitors (e.g., Lansoprazole, Omeprazole)
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• Ranitidine
• Repaglinide
• rifabutin
• rifampin
• Riociguat
• rivaroxaban
• Romidepsin
• Rosiglitazone
• salmeterol
• seizure medications (e.g., Carbamazepine, Gabapentin, Levetiracetam, Phenytoin, Topiramate)
• selective serotonin reuptake inhibitors (e.g., Fluoxetine, Paroxetine, Sertraline)
• serotonin antagonists (anti-emetic medications; e.g., Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• Solifenacin
• Sotalol
• "statin" cholesterol-lowering medications (e.g., Atorvastatin, lovastatin, simvastatin)
• St. John's wort
• Tacrolimus
• Tamoxifen
• Tetrabenazine
• Tetracycline
• Theophylline
• Ticagrelor
• Ticlopidine
• Tolterodine
• Tolvaptan
• Tramadol
• Trazodone
• tretinoin
• tricyclic antidepressants (e.g., Amitriptyline, Desipramine, Nortriptyline)
• Trimethoprim
• tyrosine kinase inhibitors (e.g., Bosutinib, Dasatinib, imatinib, Nilotinib)
• Ulipristal
• Warfarin
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Norvir. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Norvir.

Birth control: Birth control pills may be less effective while taking Norvir. Talk to your doctor or pharmacist about forms of birth control that may be more reliable.

Diabetes: Ritonavir can cause diabetes or increase blood sugar levels. If you have diabetes, discuss with your doctor how Norvir may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norvir, and whether any special monitoring is required.

If you experience symptoms of diabetes, such as frequent urination or increased thirst, or a fruity odour to your breath, contact your doctor.

Heart conditions: Ritonavir may cause unusual heart rhythms. If you have heart disease or abnormal heart rhythms, discuss with your doctor how Norvir may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norvir, and whether any special monitoring is needed.

Hemophilia: Ritonavir may put people with hemophilia at a higher risk of bleeding. If you have hemophilia, discuss with your doctor how Norvir may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norvir, and whether any special monitoring is needed.

Hepatitis B or C: People who have hepatitis B or Hepatitis C are more likely to experience decreased liver function and side effects involving the liver when they are taking ritonavir. If you have hepatitis B or C, discuss with your doctor how Norvir may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norvir, and whether any special monitoring is needed.

If you experience symptoms of worsening liver function such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Immune reconstitution syndrome: Norvir may cause immune reconstitution syndrome, where signs and symptoms of inflammation from previous infections appear. These symptoms occur soon after starting anti-HIV medication and can vary. They are thought to occur as a result of the immune system improving and being able to fight infections that have been present without symptoms (such as pneumonia, herpes, or Tuberculosis). Report any new symptoms to your doctor immediately.

Liver function: Ritonavir is removed from the body by the liver and may cause liver problems. If you have liver disease or decreased liver function, discuss with your doctor how Norvir may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Norvir, and whether any special monitoring is needed.

Ritonavir can also cause decreased liver function. If you experience symptoms of liver problems (e.g., abdominal pain, persistent vomiting, feeling unwell, fever, itching, yellowing of the skin and eyes, dark urine), contact your doctor immediately.

Pancreatitis (inflammation of the pancreas): Ritonavir may cause or worsen pancreatitis. If you have a history of or are at risk for developing pancreatitis, you should be closely monitored by your doctor while taking Norvir. If you develop signs of pancreatitis (e.g., upper left abdominal pain, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen), contact your doctor.

Stopping the medication: If you stop taking Norvir, your HIV infection could get worse. Take the medication exactly as prescribed by your doctor, and do not stop taking the medication without checking with your doctor first.

Pregnancy: Norvir should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Norvir, contact your doctor immediately. The oral solution should not be used during pregnancy due to the alcohol and propylene glycol content.

Breast-feeding: Ritonavir passes into breast milk. Breast-feeding is not recommended by HIV-positive women since the virus can be transmitted through breast milk.

Children: The safety and effectiveness of Norvir have not been established for children under the age of 2 years.

Seniors: There is an increased risk of liver, kidney, or heart problems for seniors taking ritonavir. Your doctor should closely monitor you for these problems while you are taking ritonavir.

This medication is typically used twice a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. You should take this medication at approximately the same time each day. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. This medication should be swallowed whole. It should not be split, crushed or chewed. This medication is more effective if taken with food. Always take it with a meal or a snack.