Ritonavir for HIV

About ritonavir for HIV

Ritonavir is an antiretroviral medicine. It is prescribed for infecção pelo vírus da imunodeficiência humana (HIV). It slows the progress of HIV infection, but it is not a cure. HIV destroys cells in the body, called CD4 T cells. These cells are a type of white blood cell and are important because they are involved in protecting your body from infection. If left untreated, the HIV infection weakens your immune system so that your body cannot defend itself against bacteria, viruses and other germs. Ritonavir slows down the progress of HIV infection by reducing the amount of virus in your body. It does this by stopping the production of a protein that the virus needs to copy (replicate) itself.

Ritonavir will be prescribed for you by a doctor who is a specialist. It belongs to a group of antiretroviral medicines known as protease inhibitors (PIs). It is given alongside a number of other antiretroviral medicines, as part of a combination therapy. It is often prescribed to boost the action of these other antiretroviral medicines - when it is given like this, it is referred to as 'low-dose' ritonavir. Taking three or more antiretroviral medicines at the same time is more effective than taking one alone. Taking a combination of different medicines also reduces the risk that the virus will become resistant to any individual medicine. One brand of ritonavir (called Kaletra®) also contains another antiretroviral medicine called lopinavir. There is more information available about this brand in a separate medicine leaflet called Lopinavir with ritonavir for HIV.

It is vital to take your antiretroviral medicines exactly as prescribed in order to maintain success and to help to prevent the virus from becoming resistant to the medicines. These medicines are usually taken for life.

Ritonavir is also available in combination with nirmatrelvir in a medicine called Paxlovid®. It is used for the treatment of COVID-19 disease. For more information on this read our leaflet called Paxlovid tablets for COVID-19 disease.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking ritonavir it is important that your doctor knows:

• Se você está grávida, tentando ter um bebê ou amamentando.

• Se você tem diabetes (diabetes mellitus).

• If you are being treated for low levels of thyroid hormone (hypothyroidism).

• If you have a heart problem or have been told you have a heart rhythm disorder.

• If you have liver inflammation (called hepatitis), or any other liver problem.

• If you have inflammation of the pancreas (pancreatitis).

• If you have either haemophilia or porphyria, which are both rare inherited blood disorders.

• Se você estiver tomando outros medicamentos. Isso inclui quaisquer medicamentos que estejam disponíveis para compra sem receita médica, bem como medicamentos fitoterápicos e complementares.

• Se você já teve uma reação alérgica a um medicamento.
  

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about ritonavir, and it will also provide you with a full list of the side-effects which you could experience from taking it.

• Take ritonavir exactly as your doctor tells you to - the directions will be printed on the label of the pack to remind you about what the doctor said to you. Depending upon which other medicines you are taking, you may be prescribed a 'high dose' of ritonavir (adult dose: six tablets twice daily), or a 'low dose' (adult dose: 1-2 tablets once or twice daily). If you are prescribed high-dose ritonavir, you will be given three tablets twice a day for three days to start with, and then your dose will be increased over the next two weeks to the maintenance dose of six tablets twice a day. Twice-daily doses should ideally be taken 12 hours apart, so take the first dose in the morning and the other in the evening.

• If ritonavir is being prescribed for your child, the dose prescribed will depend upon your child's weight and height. Your doctor will advise you about how much you should give for each dose.

• Tablets should be swallowed with a drink of water. Do not crush or break the tablet before you swallow - it should be swallowed whole. If you have any difficulties swallowing tablets, let your doctor know about this, as either the sachets or liquid medicine could be more suitable for you.

• Take ritonavir after a meal or with a snack, and try to take your doses at the same times of day each day, as this will help you to remember to take it regularly.

• If you (or your child) are using powder sachets, open the sachet and pour the 100 mg of ritonavir powder from the sachet on to soft food (such as apple sauce or vanilla pudding). Swallow the mixture within two hours. Alternatively the powder from the sachet can be mixed with 9.4 ml of liquid (water, chocolate milk, or infant formula) in the mixing cup provided. If you do this, make sure you mix the solution well, allow the bubbles to disappear, and then measure out your dose using the dosing syringe provided. Wash and dry the mixing cup and syringe after each use.

• If you forget to take a dose, take it as soon as you remember (unless it is nearly time for your next dose, in which case do not take the forgotten dose but take the next dose when it is due). Do not take two doses together to make up for a missed dose.

• Keep your regular appointments with your doctor so that your progress can be monitored. You will need to have regular blood tests.

• It is important that you continue to take antiretroviral treatment regularly. This will help to prevent the HIV from becoming resistant to the medicines you are taking. Even if you miss only a small number of doses, the virus can become resistant to treatment.

• If you develop any infection soon after you start this treatment, let your doctor know. As a result of taking ritonavir, your immune system may start fighting an infection which was present before you started the treatment, but which you may not have been aware of.

• Siga cuidadosamente qualquer conselho que seu médico lhe der sobre fazer mudanças no estilo de vida para reduzir qualquer risco de danos ao seu coração e vasos sanguíneos. Isso pode incluir parar de fumar, comer de forma saudável e fazer exercícios regularmente.

• Algumas pessoas que tomam medicamentos antirretrovirais desenvolvem alterações na forma como a gordura corporal é distribuída no corpo. Isso pode resultar em mudanças na imagem corporal. Seu médico discutirá a possibilidade disso com você.

• Embora o tratamento com medicamentos antirretrovirais possa reduzir o risco de você transmitir o HIV a outras pessoas através do contato sexual, ele não o elimina. É importante que você use preservativos.

• Não é incomum que pessoas com HIV se sintam desanimadas ou até deprimidas, especialmente logo após o diagnóstico ter sido feito e o tratamento ter começado. Se você tiver qualquer sentimento de depressão, ou pensamentos angustiantes sobre se machucar, você deve falar com seu médico imediatamente.

• Algumas pessoas que tomaram medicamentos antirretrovirais (particularmente por um longo período) desenvolveram uma condição chamada osteonecrose. Esta é uma doença óssea em que o tecido ósseo morre devido à redução do suprimento de sangue. Isso leva a dores nas articulações e rigidez, e pode causar dificuldades de movimento. Se você notar algum desses sintomas, fale com seu médico.

• If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines. This is because some medicines interfere with ritonavir, and vice versa. This can mean either that the ritonavir does not work properly, or that it increases the risk of side-effects from the other medicines. In particular, do not take St John's wort while you are on ritonavir.

• If you have diabetes you may need to check your blood sugar (glucose) more frequently, as this medicine can affect the levels of sugar in your blood. Your doctor will advise you about this.

• Se você for se submeter a uma operação ou tratamento dentário, informe à pessoa que está realizando o tratamento quais medicamentos você está tomando.

• Treatment for HIV is usually lifelong. Continue to take this medicine regularly for as long as your doctor tells you to, even if you feel well. This is to keep your immune system healthy.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with ritonavir. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Importante: some people taking ritonavir have developed inflammation of the pancreas (pancreatitis) - the most common signs of this are persistent stomach pain, feeling sick (nausea) or being sick (vomiting), high temperature (fever), and feeling generally unwell. Let your doctor know straightaway if you develop these symptoms.

Se você sentir quaisquer outros sintomas que acha que podem ser devido ao medicamento, fale com seu médico ou farmacêutico para mais conselhos.

• Mantenha todos os medicamentos fora do alcance e da vista das crianças.

• Armazene em local fresco e seco, longe de calor e luz diretos.