Ritonavir Oral: Booster Dosing and Precautions

Therapeutic action

Antiretroviral, HIV protease inhibitor.

Indications

Booster for protease inhibitors such as atazanavir, darunavir, and lopinavir in HIV infection. Ritonavir should not be used alone.

Forms and strengths

• 25 mg tablet.
• 100 mg tablet.

Dose

Dosage depends on the administration schedule of the boosted protease inhibitor. The daily dose is administered once daily or in 2 divided doses.

• Child 14 to under 25 kg: 50 mg 2 times daily, or 100 mg once daily.
• Child 25 kg and over and adult: 100 mg once or 2 times daily.

Duration

Depending on the efficacy and tolerance of the boosted protease inhibitor and ritonavir.

Contra-indications, adverse effects, precautions

• Do not administer to patients with severe hepatic impairment.
• Administer with caution and monitor use in patients with haemophilia or mild to moderate hepatic impairment.
• The adverse effects of ritonavir as a booster are also dependent on the boosted protease inhibitor.
• May cause gastrointestinal disturbances, fatigue, headache, dizziness, paraesthesia, joint and muscle pain, taste disturbances, hyperglycaemia, hyperlipidaemia, lipodystrophy, conduction disorders, pancreatitis, hepatic disorders, and severe skin rash.
• Ritonavir reduces the efficacy of implants and oral contraceptives. Use injectable medroxyprogesterone or an intrauterine device.
• Pregnancy: no contra-indication.
• Take with meals.
• Tablets are not recommended in children under 14 kg.