What is Norvir (Ritonavir)?

Ritonavir is an antiviral medication that prevents human immunodeficiency virus (HIV) cells from multiplying in your body.
Ritonavir is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Ritonavir is not a cure for HIV or AIDS.
Ritonavir may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Norvir (Ritonavir)?

Life-threatening side effects may occur if you take ritonavir with alfuzosin (Uroxatral), amiodarone (Cordarone, Pacerone), bepridil (Vascor), flecainide (Tambocor), propafenone (Rythmol), quinidine (Quin-G), voriconazole (Vfend), cisapride (Propulsid), pimozide (Orap), midazolam (Versed), triazolam (Halcion), or an ergot medicine such as Ergomar, Cafergot, Wigraine, D.H.E. 45, Migranal, Methergine.
There are many other medicines that can interact with ritonavir. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.
HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Do not change your doses or medication schedule without your doctor’s advice. Every person with HIV or AIDS should remain under the care of a doctor.
Taking this medication will not prevent you from passing HIV to other people. Avoid having unprotected sex or sharing razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

What should I discuss with my healthcare provider before taking Norvir (Ritonavir)?

You should not take ritonavir if you are allergic to it.
Do not take ritonavir with any of the following medications, or life-threatening side effects could occur:

• alfuzosin (Uroxatral)
• amiodarone (Cordarone, Pacerone)
• cisapride (Propulsid)
• flecainide (Tambocor)
• lovastatin (Mevacor) or simvastatin (Zocor)
• midazolam (Versed) or triazolam (Halcion)
• pimozide (Orap)
• propafenone (Rythmol)
• quinidine (Quin-G)
• sildenafil (Revatio) when used to treat pulmonary arterial hypertension (PAH)
• St. John’s wort
• voriconazole (Vfend); or
• ergot medicine such as ergotamine (Ergomar), dihydroergotamine (D.H.E. 45, Migranal Nasal Spray), ergonovine (Ergotrate), or methylergonovine (Methergine)

If you have any of these other conditions, you may need a dose adjustment or special tests:

• liver disease (especially hepatitis B or C)
• diabetes
• heart disease or heart rhythm disorder
• a bleeding disorder such as hemophilia; or
• high cholesterol or triglycerides

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby, but HIV can be passed to your baby if you are not properly treated during pregnancy. Take all of your HIV medicines as directed to control your infection.
Ritonavir can make birth control pills or patches less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking ritonavir.
You should not breast-feed while you are using ritonavir. Women with HIV or AIDS should not breast-feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

Norvir Side Effects

What are the possible side effects of Norvir (Ritonavir)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop taking ritonavir and call your doctor at once if you have any of these serious side effects:

• slow or uneven heart rate, feeling like you might pass out
• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash
• increased urination or extreme thirst
• easy bruising or bleeding (nosebleed or bleeding gums)
• signs of a new infection, such as fever or chills, cough, or flu symptoms
• severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate; or
• low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes)

Less serious side effects may include:

• mild nausea, vomiting, diarrhea, stomach pain
• numbness or tingling, especially around your mouth
• headache, mood changes; or
• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist)

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Norvir Interactions

What other drugs affect Norvir (Ritonavir)?

Many drugs can interact with ritonavir. Below is just a partial list. Tell your doctor if you are using:

• ADHD medication
• atovaquone (Malarone, Mepron) or quinine (Qualaquin)
• bosentan (Tracleer)
• colchicine (Colcrys)
• salmeterol (Advair, Serevent)
• theophylline (Elixophyllin, Theo-24, Uniphyl)
• steroid medication (prednisone, Advair, Flonase, Flovent, DexPak, Dexasone, Cortastat, and others)
• an antibiotic (such as Biaxin, Mycobutin, Rifadin, Rimactane, Rifamate, Rifater)
• an antifungal medication (such as Nizoral or Sporanox)
• an antidepressant (Elavil, Vanatrip, Wellbutrin, Norpramin, nefazodone, Paxil, Zoloft, Desyrel, and others)
• heart or blood pressure medication (Lopressor, Toprol, Blocadren, Norpace, Mexitil, digitalis, Lanoxin, Cartia, Cardizem, Plendil, Nifedical, Procardia, Calan, Covera, Isoptin, Verelan, and others)
• cholesterol-lowering medicine (such as Lipitor, Zocor, Crestor)
• medicines used to prevent organ transplant rejection
• any other HIV/AIDS medicines (especially Invirase, Prezista, Rescriptor, Lexiva, Crixivan, or Aptivus)
• insulin or diabetes medication you take by mouth
• medicine to treat a psychiatric disorder
• erectile dysfunction medication (Viagra, Cialis, Levitra
• pain medication (such as Demerol, Darvon, Darvocet, Ultram, Ultracet)
• a sedative (such as BuSpar, Tranxene, Prosom, Dalmane); or
• seizure medications (such as Carbatrol, Tegretol, Lamictal, Klonopin, Depakote, Zarontin, Dilantin)

This list is not complete and many other medicines can interact with ritonavir. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

What should I avoid while taking Norvir (Ritonavir)?

If you also take didanosine (Videx), take it at least 2.5 hours before or after you take ritonavir.
Ritonavir oral liquid contains alcohol. Avoid drinking alcoholic beverages while using this medicine, and do not take disulfiram (Antabuse) or you could have an alcohol reaction.
Taking this medication will not prevent you from passing HIV to other people. Avoid having unprotected sex or sharing razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Norvir Dosage

How should I take Norvir (Ritonavir)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.
Ritonavir tablets must be taken with meals. Ritonavir capsules or liquid should be taken with food if possible.
Do not crush, chew, or break a ritonavir tablet. Swallow it whole.
Shake ritonavir liquid well just before you measure a dose. Measure the liquid with a special dose-measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.
Liquid ritonavir can be mixed with chocolate milk or a nutrition drink such as Ensure. Drink the mixture within 1 hour after mixing.
Use ritonavir regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.
HIV/AIDS is usually treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor’s advice. Every person with HIV or AIDS should remain under the care of a doctor.
Your blood will need to be tested on a regular basis. Your liver function may also need to be tested. Visit your doctor regularly.
Store ritonavir capsules in the refrigerator or at room temperature, away from heat or moisture. If you store the capsules at room temperature you must use them within 30 days.
Store ritonavir tablets at room temperature away from heat or moisture.
Store ritonavir liquid at room temperature with the cap tightly closed. Do not refrigerate.

What happens if I overdose on Norvir (Ritonavir)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of ritonavir oral liquid could be fatal to a child.

What happens if I miss a dose of Norvir (Ritonavir)?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
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