Ritonavir

Revision as of 16:49, 22 March 2020 by Ihearttroponin (talk | contribs)

Administration

  • Type: Antiviral
  • Dosage Forms: 100 mg
  • Routes of Administration: PO
  • Common Trade Names: Norvir

Adult Dosing

  • HIV Treatment
    • Protease inhibitor boosting
      • 100-400 mg/day QD-BID
    • Sole protease inhibitor
      • 600 mg PO BID
      • Start with 300 mg PO BID, increased by 200 mg/day every 2-3 days
  • HIV post-exposure prophylaxis
    • 100 mg PO QID
    • Part of multi-drug regimen

Pediatric Dosing

  • HIV Treatment
    • Can be given in >1 month old, dosing varies based on other concominant treatments
  • HIV post-exposure prophylaxis
    • Can be given in >3 years old, dosing varies based on other concominant treatments

Special Populations

Pregnancy Rating

  • HIV: Benefits outweight risk during pregnancy. Avoid oral solution due to alcohol content.

Lactation risk

  • Avoid breastfeeding

Renal Dosing

  • Adult: No adjustment
  • Pediatric: Not defined, but likely no adjustment as in adults

Hepatic Dosing

  • Adult:
    • Mild-moderate impairment: no adjustment
    • Severe impairment: not defined
  • Pediatric:
    • Mild-moderate impairment: no adjustment
    • Severe impairment: not defined

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

  • Nausea/vomiting
  • Diarrhea
  • Paresthesia
  • Fatigue
  • Rash
  • Abdominal pain
  • Cough
  • Dysgeusia
  • Oropharyngeal pain
  • Dizziness
  • AST, ALT, CK elevation
  • Edema
  • Acne
  • Lipodystrophy

Pharmacology

  • Half-life: 3-5 hours
  • Metabolism: Liver (CYP450)
  • Excretion: Fecal

Mechanism of Action

  • Binds to active site of HIV protease, preventing maturation of the virus

Comments

A trial of lopinavir/ritonavir is currently being done to study use in COVID-19. So far, studies have not shown significant benefit in time to clinical improvement. Mortality at 28 days is lower but not statistically significant.

See Also

References