|
|
|
|
NAME
Ritonavir |
BRAND
Norvir |
CLASS
HIV protease inhibitor (PI) |
COST
$8,910/yr., $743/month |
STANDARD DOSE
Six 100 mg (600 mg) soft gelatin capsules twice a day, preferably with food. Dose escalation is important to avoid side effects: 3 capsules twice a day for two or three days, then 4 capsules twice a day for two or three days, followed by 5 capsules twice a day for two or three days before beginning full dose. If you miss a dose, take the next dose as soon as possible. Do not double the dose approved for children ages 3 and older. Liquid formula available but it has a horrible taste. |
POTENTIAL SIDE EFFECTS
Asthenia (weakness), nausea, diarrhea, vomiting, tingling/numbness around the mouth, hands or feet, loss of appetite, taste, disturbance, headache, dizziness, pancreatitis (see nukes) and alcohol intolerance. Seen with all protease inhibitors are: high blood levels of cholesterol and triglycerides (fats) especially with Norvir and perhaps associated heart disease, lipodysrophy (body fat changes, including thinning of the face, arms and legs, with or without fat accumulations in the stomach, breasts and sometimes upper back) worsening or new cases of diabetes (symptoms include increased thirst and hunger, frequent urination, unexplained weight loss, fatigue, and dry itchy skin; see your doctor promptly) and increased bleeding in hemophiliacs. Norvir has been shown to increase liver enzymes (AST, ALT, and GGT) muscle enzyme (CPK) and uric acid. |
POTENTIAL DRUG INTERACTIONS
May cause methadone withdrawal. Do not use Zocor or Mevacor; suggested alternatives are Liptior, Lescol, Baycol and Pravachol (looks best on paper for protease inhibitors) alternatives should still be used with caution because of potential for liver toxicity. Cannot be taken with Cordarone, ergot derivatives such as Cafergot (in any form-serious interactions seen with dilation during gynecological exam) migranal, D.H.E. 45, Halicon, Hismanal, Orap, quindine, Rythmol, Seldane, Tambocor, Vascor, and Versed. Protease inhibitors increase blood levels of Viagra (sidenafil citrate_ and Viagra dose should be started at 12.5 mg increased as needed and tolerated. One report suggested Viagra should start at half that when taken by someone on Norvir. It's recommended that people do not exceed 25 mg in a 48-hour period because of potential for fatal reaction. The street drug ecstasy is greatly increased by Norvir, and at least one death attributed to the combination. GHB is also dangerous with Norvir. Tobacco and alcohol may lower bloods levels of Norvir. Increase clarithromycin (biaxin) levels by 35 percent. Contains alcohol (but should not be enough to trigger relapse) and greatly hastens intoxication. Norvir should not be taken with Antabuse or Flagyl. |
|
|
|
|
|
|
 |
|
