Generic Name: ritonavir

Pronunciation: NOR-veer

Abbreviation: RTV

Other Market Name: N/A

Drug Class: Protease Inhibitors (PIs)

Pharmaceutical Company: AbbVie

Approval Status: Approved

Generic Version Available: No

Experimental Code: N/A


Drug Recommendation

Used as a booster in recommended, alternative and other regimens for antiretroviral-naive people living with HIV, as indicated by the U.S. Department of Health and Human Services (DHHS) Panel on Antiretroviral Guidelines for Adults and Adolescents. Visit https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/0 for the full DHHS guidelines.


General Info

Norvir is an HIV medication. It is in a category of HIV medicines called protease inhibitors. Norvir was approved by the U.S. Food and Drug Administration for use by people living with HIV in 1996.

Though Norvir was approved as a protease inhibitor with activity against HIV, it is almost always used as a pharmacokinetics booster, for use in combination with other antiretrovirals (notably other protease inhibitors and integrase inhibitors) to improve their effectiveness and simplify their dosing.

Norvir is available as a single drug or in the fixed-dose combination drug Kaletra.


Dosage

Adult Dose: Six 100 mg tablets twice a day. The full dose of Norvir is rarely used. It is most often used at lower doses to boost the levels of other antiretrovirals in the blood.

Pediatric Dose: Age 1 month to 18 years: Twice daily dose based on body surface area and should not exceed 600 mg

Dosing Info: Take with food.


Side Effects

The side effects of Norvir are very common and potentially severe when the full dose (600 mg twice daily) is prescribed. Though these side effects have also been documented in people using the lower doses needed to boost the blood levels of other antiretrovirals, they are less common and mild-to-moderate in intensity. These include:

  • Nausea, vomiting, diarrhea, and appetite loss.
  • Numbness/tingling around the mouth (oral paresthesias) and taste perversion.
  • Possible increased bleeding episodes in people with hemophilia.

Some people may experience increases in their lipid levels (triglycerides and cholesterol) or diabetes risk while being treated with protease inhibitors, including Norvir.

Drug-induced hepatitis (liver injury) has been reported in people taking protease inhibitors, including Norvir. This usually occurred in people who had extremely low CD4 cells, were taking multiple other medications and who were also infected with hepatitis B virus (HBV) or hepatitis C virus (HCV). Lab tests to monitor liver function is an important component of routine follow-up care and important for people using protease inhibitors.


Drug Interactions

The following medications should not be taken while you are being treated with Norvir:
Acid reflux/heartburn medications: Propulsid (cisapride)
Antibiotics: Priftin (rifapentine)
Antifungals: Vfend (voriconazole, if Norvir dose is 400 mg twice daily or greater)
Antimigraine medications: Methergine, Methylergometrine (methylergonovine); Ergostat, Cafergot, Ercaf, Wigraine (ergotamine); Ergotrate, Methergine (ergonovine); or D.H.E. 45, Migranal (dihydroergotamine)
Antihistamines: Hismanal (astemizole) or Seldane (terfenadine)
Heart medications: Cordarone (amiodarone), Tambocor (flecainide), Rythmol (propafenone), or Nudexta/Quinaglute/Quinidex (quinidine)
Cholesterol-lowering drugs (statins): Zocor (simvastatin) and Mevacor (lovastatin)
Antipsychotics: Orap (pimozide)
Sedatives: Versed (midazolam) and Halcion (triazolam)
Enlarged prostate:
Uroxatral (alfuzosin)
Pulmonary Hypertension: Revatio (sildenafil)
Herbal products: St. John's wort

Norvir can increase the levels of many other drugs in the body, potentially increasing the risk of serious side effects. Dosage adjustments or substitutions may be necessary if you are prescribed certain medications from any of the following drug classes: antiarrhythmics, antibiotics, cancer chemotherapeutic drugs, anticoagulants, anticonvulsants, antidepressants, antifungals, anti-gout medications, antimalarial drugs, beta-blockers, calcium channel blockers, corticosteroids (oral and inhaled), endothelin receptor antagonists, hepatitis C medications, statins, hormonal contraceptives, immune-suppressants, inhaled beta agonists, narcotic medications (for pain and opioid dependence), neuroleptics/anti-seizure medications, erectile dysfunction drugs, and sedatives/hypnotics. Consult the Norvir package insert for more details: http://www.rxabbvie.com/pdf/norvirtab_pi.pdf


Other Info

Before taking this medication, tell your doctor if you have kidney disease or liver disease (including hepatitis B). In addition, tell your doctor if you are pregnant or planning to become pregnant, if you are breastfeeding, and all your medical conditions.

It is also very important that your health care provider and pharmacist know all prescription and over-the-counter medications and supplements you are taking at all times while using an HIV treatment regimen that contains Norvir.


For More Info: http://www.rxabbvie.com/pdf/norvirtab_pi.pdf

Co-Pay Program Info: https://www.poz.com/basics/hiv-basics/drug-assistance-programs

Patient Assistance Program Info: https://www.poz.com/basics/hiv-basics/drug-assistance-programs

Last Revised: July 15, 2016