Ritonavir may interact with many different types of medicines, in some cases causing severe (sometimes fatal) reactions. Consult your doctor or pharmacist about which medications should not be taken with ritonavir. (See also Drug Interactions section.)

This drug, used in combination with at least 2 other medications, is used to help treat your HIV infection, thereby improving your quality of life. It also lowers your risk of getting HIV complications (such as new infections, cancer). Ritonavir belongs to a class of drugs known as protease inhibitors.

Ritonavir is not a cure for HIV. It does not prevent the spread of HIV to others through sexual contact or blood contamination (such as sharing used needles).

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

This medication may also be used to prevent HIV infection after contact with the virus.

Read the Patient Information Leaflet provided by your pharmacist before you start taking ritonavir and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth with food or up to 2 hours after food, usually 2 times daily or as directed by your doctor.

The dosage is based on your weight, liver function, medical condition, other medications, and response to treatment.

This medication works best when the amount of drug in your body is kept at a constant level. Therefore, take this drug at evenly spaced intervals. To help you remember, take it at the same times each day.

It is very important to continue taking this medication (and other HIV medications) exactly as prescribed by your doctor. Do not take more or less of this drug than prescribed or stop taking it (or other HIV medicines) even for a short time unless directed to do so by your doctor. Skipping or changing your dose without approval from your doctor may cause the amount of virus to increase, make the infection more difficult to treat, or worsen side effects.

Diarrhea, nausea, vomiting, heartburn, stomach pain, loss of appetite, headache, dizziness, tiredness, weakness, changes in taste, or tingling/numbness of hands/feet/mouth area may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: persistent nausea/vomiting, stomach/abdominal pain, dark urine, yellowing eyes/skin, mental/mood changes (such as depression, anxiety), joint pain, muscle weakness/cramps/aches, increased urination (especially at night), increased thirst.

Tell your doctor immediately if any of these rare but serious side effects occur: easy bruising/bleeding, fainting, fast/irregular heartbeat.

Changes in body fat may occur while you are taking this medication (such as increased fat in the upper back and stomach areas, decreased fat in the arms and legs). The cause and long-term effects of these changes are unknown. Discuss the risks and benefits of treatment with your doctor, as well as the possible use of exercise to reduce this side effect.

If you are taking HIV medications for the first time, you may experience symptoms of an old infection. This may happen as your immune system begins to work better. Contact your doctor immediately if you notice any of the following symptoms: new cough, trouble breathing, fever, new vision problems, new headaches, new skin problems.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking ritonavir, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes, heart problems, hemophilia, high cholesterol/triglycerides, liver problems (such as hepatitis B, hepatitis C), pancreatitis.

This medication may cause dizziness. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

If you have diabetes, this product may increase your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor immediately if you have symptoms of high blood sugar, such as increased thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor. Your doctor may need to adjust your diabetes medication(s).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. However, it is now normal to prescribe HIV medicines for pregnant women with HIV. This has been shown to decrease the risk of giving HIV to the baby. Ritonavir may be part of that treatment. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Because breast milk can transmit HIV, do not breast-feed.

Ritonavir interacts with many medications. Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop or change the dosage of any medicine before checking with your doctor or pharmacist first.

This drug should not be used with the following medications because very serious interactions may occur: alfuzosin, certain antiarrhythmics (amiodarone, flecainide, propafenone, quinidine), certain benzodiazepines (midazolam, triazolam), bosentan, conivaptan, disulfiram, eletriptan, ergot alkaloids (such as dihydroergotamine, ergonovine, ergotamine, methylergonovine), pimozide, ranolazine, certain "statin" cholesterol drugs (simvastatin, lovastatin), St John's wort, voriconazole.

If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting ritonavir.

Other medications can affect the removal of ritonavir from your body, which may affect how ritonavir works. Examples include rifampin, other HIV drugs (such as delavirdine), among others.

Ritonavir can slow down or speed up the removal of other medications from your body, which may affect how they work. Examples of affected drugs include digoxin, theophylline, warfarin, certain antiarrhythmics (including disopyramide, mexiletine), antidepressants (such as bupropion, fluoxetine, nefazodone, trazodone), certain beta blockers (metoprolol, timolol), calcium channel blockers (such as nifedipine, felodipine), some cancer drugs (such as dasatinib, sunitinib, vincristine), certain azole fungal medications (ketoconazole, itraconazole), other HIV drugs (including atazanavir, didanosine, maraviroc), anti-seizure drugs (including carbamazepine, phenytoin), drugs for male sexual function problems (such as sildenafil, tadalafil), certain "statin" cholesterol drugs (atorvastatin, rosuvastatin), certain narcotic pain medications (methadone, meperidine, propoxyphene), among others.

If any of these medications are taken with ritonavir, your doctor may change your dose of ritonavir or the other drug(s), or your doctor may monitor you specially. Consult your doctor or pharmacist for more details.

This medication may decrease the effectiveness of some birth control pills. This can result in pregnancy. However, to reduce the risk of spreading HIV to others, always use barrier protections during all sexual activity. (See also Notes section.)

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

To reduce the risk of spreading HIV to others, always use effective barrier protections (such as latex or polyurethane condoms, dental dams) during all sexual activity. Consult your doctor or pharmacist for more details.

Do not share this medication with others.

Laboratory and/or medical tests (such as liver tests, viral load, T-cell counts) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Keep all medical and laboratory appointments.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Store this medication in the refrigerator between 36-46 degrees F (2-8 degrees C) away from light. Do not freeze. This medication may also be stored at room temperature below 77 degrees F (25 degrees C). If stored at room temperature, use within 30 days. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA) or 1-800-668-1507 (Canada).

Information last revised September 2009 Copyright(c) 2009 First DataBank, Inc.