Ritonavir (By mouth)

Introduction:

Ritonavir (rit-OH-na-vir)

Treats human immunodeficiency virus (HIV) infection. HIV causes acquired immune deficiency syndrome (AIDS). Ritonavir does not cure HIV or AIDS. It is used with other medicines to slow the progress of the disease.

Brand Name(s):

Norvir

When This Medicine Should Not Be Used:

How to Use This Medicine:

Liquid Filled Capsule, Liquid

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• It is best to take this medicine with food or milk.
• Shake the oral liquid medicine thoroughly before each use. Measure the medicine with a marked measuring spoon or medicine cup. You can mix the oral liquid with chocolate milk or nutritional drinks such as Ensure® or Advera® to make it taste better. You should drink this medicine within one hour of mixing.
• Take all other medicines your doctor has prescribed as part of your combination treatment. Do not stop using your medicine unless your doctor tells you to.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the liquid-filled capsules in the refrigerator or at room temperature in a closed container. If stored at room temperature, use the medicine within 30 days. Keep away from heat and direct light.
• Store the liquid in a closed container at room temperature, away from heat and direct light. Do not refrigerate.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• You must avoid many other medicines while you are using ritonavir. Using these medicines together could cause serious health problems, including death. Make sure your doctor knows if you are using fluticasone (Advair®, Flonase®), rifabutin (Mycobutin®), rifampin (Rifadin®, Rifater®, Rifamate®), sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®), or medicine to lower cholesterol, such as atorvastatin (Lipitor®), lovastatin (Mevacor®), or simvastatin (Zocor®). Tell your doctor if you are also using other medicines to treat HIV or AIDS (such as atazanavir, indinavir, saquinavir, delavirdine, didanosine, or tipranavir), a narcotic pain medicine (such as tramadol, propoxyphene, meperidine, or methadone), a blood thinner (such as warfarin, Coumadin®), medicine for heart rhythm problems (such as disopyramide, lidocaine, or mexiletine), or St. John's wort.
• Tell your doctor if you are also using medicine to treat seizures (such as carbamazepine, clonazepam, or ethosuximide), medicine for depression (such as bupropion, fluoxetine, nefazodone, or desipramine), medicine to treat vomiting (such as dronabinol), an antifungal medicine (such as ketoconazole or itraconazole), or antibiotics (such as clarithromycin, atovaquone, or quinine). Make sure your doctor knows if you also use a beta-blocker (such as metoprolol or timolol), asthma medicine (such as theophylline, Theo-24®, Uniphyl®), a calcium channel blocker (such as diltiazem, nifedipine, or verapamil), digoxin, cyclosporine, tacrolimus, sirolimus, medicine for mental illness (such as perphenazine or risperidone), birth control pills (such as ethinyl estradiol), medicine for sleep (such as buspirone, clorazepate, or diazepam), a steroid medicine (such as dexamethasone or prednisone), or a stimulant such as methamphetamine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have diabetes, heart disease or heart rhythm problems, kidney disease, liver disease, or hemophilia (a bleeding disorder).
• You should not breast feed if you have HIV or AIDS, because you may give the infection to your baby through your breast milk.
• This medicine will not keep you from giving HIV to your partner during sex. Make sure you understand and practice safe sex, even if your partner also has HIV. Do not share needles with anyone.
• When you start taking HIV medicines, your immune system may get stronger. If you have infections that are hidden in your body, such as pneumonia or tuberculosis, you may notice new symptoms when your body tries to fight them. If this occurs, be sure to tell your doctor.
• Birth control pills may not work while you are using ritonavir. To keep from getting pregnant, use another form of birth control. Other forms include condoms, a diaphragm, or contraceptive foam or jelly.
• This medicine may cause you to have excess body fat. Tell your doctor if you notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area. You might also lose fat from the legs, arms, and face.
• Tell your doctor about all of the medications you are taking since the dose of ritonavir or other medications you take may need to be adjusted.
• The liquid form of this medicine contains alcohol. Tell your doctor if you are taking, or plan to take disulfiram (Antabuse®) or metronidazole (Flagyl®).
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.
• Do not stop using this medicine suddenly without asking your doctor. This is very important because the amount of virus in your blood may increase and become harder to treat.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Blistering, peeling, or red skin rash.
• Change in how much or how often you urinate, or painful urination.
• Chest pain, or fast, slow, or uneven heartbeat.
• Dark-colored urine or pale stools.
• Fever, chills, cough, sore throat, and body aches.
• Increased hunger or thirst.
• Lightheadedness, dizziness, or fainting.
• Numbness, tingling, burning, or pain in your hands or feet.
• Red or black stools.
• Seizures (convulsions).
• Sudden and severe stomach pain, nausea, vomiting, or loss of appetite.
• Sudden or severe headache, problems with vision, speech, or walking.
• Swelling in your hands, ankles, or feet.
• Unusual bleeding, bruising, or weakness.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Burning or tingling around your mouth.
• Diarrhea, constipation, or upset stomach.
• Gaining weight around your neck, upper back, breast, face, or waist.
• Mild headache.
• Mild skin rash or itching.
• Unusual or bad taste in your mouth.

If you notice other side effects that you think are caused by this medicine, tell your doctor: