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13N. ANTI-RETROVIRALS (DRUGS FOR HIV) in 13. ANTI-INFECTIVES |
RITONAVIR |
PROTEASE INHIBITOR | ANTI-RETROVIRAL |
PK: A: Variable D: 0.16-0.66L/kg M: Hepatic E: Urine & feces |
Indications & Dose: HIV INFECTION & AIDS PO Adult 600mg BID, to minimize nausea it may start with 300mg BID, gradually increased up to 14 days by 100mg BID, total of 600mg BID Child Initially: 250mg/m2 BID, increased by 50mg/m2 BID at 2-3 days gap up to 350-400mg/m2 BID | PHARMACOKINETIC ENHANCER FOR PROTEASE INHIBITOR PO Adult 100-200mg OD/TID with other HIV-protease inhibitors |
Contra: Hypersensitivity
Precautions: Hepatic disease, DM, hemophilia types A & B, CVD, cardiomyopathies, pancreatitis, polypharmacy ADR: Serious: fatal pancreatitis, allergic reactions, SJS, abnormal laboratory results, metabolic abnormalities, syncope, vasodilation, postural hypotension, Others: anxiety, dizziness, insomnia, pharyngitis, rash, asthenia, GI disturbances, headache, taste disorder, numbness around mouth DDI: Serious Disulfiram/Alcohol/Metronidazole causes disulfiram-like reaction, Salmeterol causes QT prolongation, Astemizole/Alfuzosin/Lovastatin/Propafenone/Simvastatin/Terfenadine concentration increases, Pimozide/Clozapine effects increases, Midazolam efficacy increases, Voriconazole/Amiodarone level increases, Cisapride level raises, Pethidine/Bupropion levels decreases, Ergotamine/Dihydroergotamine/Methylergometrine/Norpethidine levels increases, Buprenorphine levels raises, Dexamethasone/Carbamazepine/Phenobarbital/Phenytoin/Rifampicin levels reduces, Sildenafil levels rises, Tramadol/Dextropropoxyphene metabolism are decreases, Morphine metabolism increased, Rifabutin/Fusidic acid raises plasma levels of both drugs, Triazolam results in prolonged sedation Diet: With food Monitor: TG, TC, CBC, LFTs, CPK, uric acid, basic HIV monitoring, viral load, CD4 count, glucose, serum amylase & lipase |