Norvir (Ritonavir) Dosage and Side Effects
NORVIR is used for adults who are infected with the human immunodeficiency virus (HIV), the virus which causes AIDS. NORVIR is prescribed for use in combination with other antiretroviral medicines.
Warnings and Precautions
Serious Warnings and Precautions
Tell your doctor if you develop symptoms such as nausea, vomiting and abdominal pain. These may be signs of problems with your pancreas (pancreatitis). Your doctor must decide if these are related to pancreatitis and what to do about them.
BEFORE using NORVIR talk to your doctor or pharmacist if you:
- have liver problems or are infected with hepatitis B or hepatitis C
- have diabetes, or symptoms such as frequent urination and/or increase in thirst
- have hemophilia: patients taking NORVIR may have increased bleeding
- are taking or planning to take other medicines, including prescription, herbal and other medicines you can buy without a prescription
- have heart disease or heart condition
- are pregnant or planning to become pregnant. Pregnant women should not take NORVIR unless specifically directed by the doctor. Be sure to tell your doctor immediately if you are or may be pregnant. If you take NORVIR while you are pregnant, talk to your doctor about how you can be included in the Antiretroviral Pregnancy Registry.
- are breast-feeding or planning to breast-feed. It is recommended that HIV-infected women should not breast-feed their infants because of the possibility the baby could be infected with HIV through breast milk.
NORVIR does not reduce the risk of passing HIV to others with sexual contact or blood contamination. You should use appropriate precautions, such as practicing safe sex, and not reusing or sharing needles.
The most commonly reported side effects of NORVIR are abdominal pain, diarrhea, feeling weak or tired, headache, nausea, vomiting, changes in taste, loss of appetite, dizziness, tingling feeling or numbness in hands, feet or around the lips and rash.
- If you have liver disease such as hepatitis B and hepatitis C, taking NORVIR may worsen your liver disease.
- Some patients taking NORVIR can develop serious problems with their pancreas (pancreatitis) which may cause death. Tell your doctor if you have nausea, vomiting, or abdominal pain. These may be signs of pancreatitis.
- Some patients have large increases in triglycerides and cholesterol (forms of fat that are found in your blood).
- Diabetes and high blood sugar (hyperglycemia) may occur in patients taking protease inhibitors such as NORVIR. Symptoms of diabetes or high blood sugar may include frequent urination or increased thirst. Let your doctor know if you have or develop these symptoms while taking NORVIR.
- Some patients with hemophilia have increased bleeding with protease inhibitors.
- Severe skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported with NORVIR use, with symptoms such as peeling, inflamed, blistering skin and mucous membranes in mouth, nose and throat, flu-like symptoms, fever, and redness in the eye. If these symptoms occur, stop taking the drug and contact a doctor immediately.
- Changes in your immune system (Immune Reconstitution Inflammatory Syndrome) can happen when you start taking HIV medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time, or you could develop an autoimmune disease in which your immune system reacts against your own body (e.g. Grave's disease (which affects the thyroid gland), Guillain-Barré syndrome (which affects the nervous system) or polymyositis (which affects the muscles) and it may develop at any time, sometimes months later after the start of HIV therapy). Sometimes symptoms can be severe, so if you develop high temperature (fever), joint or muscle pain, redness, rash, swelling, or fatigue or any new symptoms contact your doctor straight away.
Interactions with this medication
Drugs that may interact with NORVIR include:
NORVIR may interact with certain other medications with possible clinical effects. The following medicines should only be used together with NORVIR if advised by your physician:
- medicines used to treat erectile dysfunction such as sildenafil (e.g., Viagra) or tadalafil (e.g., Cialis); vardenafil (e.g., Levitra) should not be taken with NORVIR
- medicines used to treat pulmonary arterial hypertension such as bosentan (e.g., Tracleer) or tadalafil (e.g., Adcirca)
- medicines used to lower blood cholesterol such as atorvastatin (e.g., Lipitor), rosuvastatin (e.g., Crestor)
- some medicines affecting the immune system such as cyclosporin, sirolimus (e.g., Rapamune) and tacrolimus
- some medicines used to treat seasonal allergies and ear and eye infections such as budesonide, dexamethasone, fluticasone propionate (e.g., Flonase) and prednisone
- medicines used to treat AIDS and related infections such as amprenavir*, indinavir (e.g., Crixivan), nelfinavir (e.g., Viracept), saquinavir (e.g., Invirase), didanosine (e.g., Videx), rifabutin (e.g., Mycobutin), tipranavir (e.g., Aptivus), delavirdine (e.g., Rescriptor), atazanavir (e.g., Reyataz), maraviroc (e.g., Celsentri), fosamprenavir (e.g., Telzir), raltegravir (e.g., Isentress), tenofovir and darunavir (e.g., Prezista)
- medicines used to treat depression such as trazodone, desipramine and bupropion
- certain heart medicines such as calcium channel antagonists including diltiazem (e.g., Tiazac), nifedipine (e.g., Adalat) and verapamil (e.g., Isoptin)
- medicines used to correct heart rhythm such as systemic lidocaine and digoxin
- antifungals such as ketoconazole (e.g., Nizoral) and itraconazole (e.g., Sporanox)
- morphine-like medicines such as methadone and meperidine (e.g., Demerol)
- anticonvulsants such as carbamazepine (e.g., Tegretol), phenytoin (e.g., Dilantin) and phenobarbital
- anticoagulants such as warfarin
- certain antibiotics such as rifabutin (e.g., Mycobutin) and clarithromycin (e.g., Biaxin)
- antibiotics used in the treatment of tuberculosis such as rifampin, also known as Rimactane*, Rifadin, Rifater, or Rifamate*
- bronchodilatators used to treat asthma such as theophylline
- medicines used to treat cancer such as vincristine and vinblastine
- colchicine used for the treatment of gout
- some heart rhythm drugs such as mexiletine and disopyramide
- some anticonvulsants such as clonazepam, divalproex, lamotrigene and ethosuximide
- some narcotic analgesics such fentanyl (e.g., Duragesic) in all forms, as tramadol and propoxyphene
- quetiapine used to treat schizophrenia, bipolar disorder and major depressive disorder
- medicine used to treat hepatitis C such as simeprevir (e.g., Galexos)
- some sedatives or medicines to treat anxiety such as buspirone, clorazepate, diazepam (e.g., Valium), flurazepam (e.g., Dalmane) and zolpidem (e.g., Sublinox)
- stimulants such as methamphetamine
- medicine to treat anxiety and/or trouble sleeping such as midazolam (injected)
If you are taking oral contraceptives (“the pill”) or the contraceptive patch (i.e., ethinyl estradiol) to prevent pregnancy, you should use a different type of contraception since NORVIR may reduce the effectiveness of oral or patch contraceptives.
Proper Use of this medication
It is important that you take NORVIR every day exactly as your doctor prescribed it. Even if you feel better, do not stop taking NORVIRwithout talking to your doctor. Using NORVIR as recommended should give you the best chance to delay the development of resistance to the product.
It is therefore important that you remain under the supervision of your doctor while taking NORVIR.
The usual dose for adults is six 100 mg tablets (600 mg) twice daily orally and should be taken with a meal. NORVIR tablets should be swallowed whole with water and not chewed, broken or crushed.
Your doctor may monitor blood levels of fats (lipids), cholesterol and glucose before and during NORVIR treatment.
If you realize you have taken more NORVIR than you were supposed to, contact your doctor or local poison control centre right away, even if you have no symptoms. If you cannot reach your doctor, go to the hospital.
If you miss a dose of NORVIR, it should be taken as soon as possible and the next scheduled dose taken at its regular time. If it is almost time for your next dose, do not take the missed dose. Wait and take the next dose at the regular time. Do not double the next dose.
Other related products
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.