Ritonavir Oral powder

What is this medication?

RITONAVIR (ri TOE na veer) helps manage the symptoms of HIV infection. It works by limiting the spread of HIV in the body. This medication is not a cure for HIV or AIDS and it may still be possible to spread HIV to others while taking it. It does not prevent other sexually transmitted infections (STIs).

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Norvir

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Diabetes
• Hemophilia
• High cholesterol or triglycerides
• Liver disease
• An unusual or allergic reaction to ritonavir, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

Take this medication by mouth. Follow the directions on the prescription label. Mix the contents of each packet into a container with soft food like applesauce or pudding or 4 ounces of liquid (water, chocolate milk, infant formula). Take the medication within 2 hours after mixing. If any medication remains in container after taking, add more food or liquid, stir, and take the mixture again. Throw it away if you cannot take it within 2 hours. Take your medication at regular intervals. Do not take your medication more often than directed. For your anti-HIV therapy to work as well as possible, take each dose exactly as prescribed. Do not skip doses or stop your medication even if you feel better. Skipping doses may make HIV resistant to this medication and other medications. Do not stop taking except on your care team's advice.

Talk to your care team about the use of this medication in children. While this medication may be prescribed for children as young as 1 month for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medication?

Do not take this medication with any of the following:

• Alfuzosin
• Apalutamide
• Certain medications for irregular heart beat, such as amiodarone, bepridil, dofetilide, dronedarone, flecainide, propafenone, quinidine
• Cobicistat
• Conivaptan
• Eletriptan
• Eliglustat
• Enzalutamide
• Eplerenone
• Ergot alkaloids, such as dihydroergotamine, ergonovine, ergotamine, methylergonovine
• Flibanserin
• Idelalisib
• Isavuconazonium
• Ivabradine
• Lomitapide
• Lovastatin
• Lurasidone
• Meperidine
• Naloxegol
• Pergolide
• Pimozide
• Ranolazine
• Red yeast rice
• Rifampin
• Silodosin
• Simvastatin
• St. John's wort
• Terfenadine
• Tinidazole
• Tolvaptan
• Triazolam
• Voriconazole

This medication may also interact with the following:

• Atovaquone
• Bedaquiline
• Bosentan
• Certain medications for blood pressure, heart disease, irregular heart beat, such as digoxin, disopyramide, lidocaine, mexiletine, metoprolol, timolol
• Certain medications for cancer, such as abemaciclib, dasatinib, encorafenib, ibrutinib, ivosidenib, neratinib, nilotinib, venetoclax, vinblastine, vincristine
• Certain medications for cholesterol, such as atorvastatin, rosuvastatin
• Certain medications for depression, anxiety, or mental health conditions, such as amitriptyline, bupropion, desipramine, fluoxetine, nefazodone, nortriptyline, paroxetine, perphenazine, quetiapine, risperidone, thioridazine, trazodone
• Certain medications for erectile dysfunction, such as avanafil, sildenafil, tadalafil, vardenafil
• Certain medications for fungal infections, such as fluconazole, itraconazole, posaconazole
• Certain medications for seizures, such as carbamazepine, clonazepam, ethosuximide, divalproex, lamotrigine, phenytoin
• Certain medications for sleep, such as buspirone, clorazepate, diazepam, estazolam, flurazepam, zolpidem
• Certain medications that treat or prevent blood clots, such as warfarin, rivaroxaban
• Clarithromycin
• Colchicine
• Cyclosporine
• Dronabinol
• Elagolix
• Estrogen and progestin hormones
• Fostamatinib
• Methamphetamine
• Metronidazole
• Opioid medications for pain
• Other antivirals for HIV
• Quinine
• Rifabutin
• Salmeterol
• Simeprevir
• Sirolimus
• Steroid medications, such as betamethasone, budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, mometasone, prednisolone, triamcinolone
• Tacrolimus
• Theophylline

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not get better or if they get worse. You will need to have important blood work done while on this medication.

HIV is spread to others through sexual or blood contact. Talk to your care team about how to stop the spread of HIV.

Estrogen and progestin hormones may not work as well while you are taking this medication. A barrier contraceptive, such as a condom or diaphragm, is recommended if you are using these hormones for contraception. Talk to your care team about effective forms of contraception.

This medication may increase blood sugar. The risk may be higher in patients who already have diabetes. Ask your care team what you can do to lower your risk of diabetes while taking this medication.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• High blood sugar (hyperglycemia)—increased thirst or amount of urine, unusual weakness or fatigue, blurry vision
• Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
• Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
• Redness, blistering, peeling, or loosening of the skin, including inside the mouth

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Burning or tingling sensation in hands or feet
• Diarrhea
• Dizziness
• Fatigue
• Nausea
• Stomach pain

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Get rid of any unused medication after the expiration date.

To get rid of medications that are no longer needed or have expired:

• Take this medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, empty the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.