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Norvir (Ritonavir) - Oral

What Is Norvir? Norvir (ritonavir) is a medicine used to treat human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS).Norvir falls into the broad category of antiretroviral drugs. It is a protease

  • Posted on 13th May, 2022 11:30 AM
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Norvir (Ritonavir) - Oral Image

What Is Norvir?

Norvir (ritonavir) is a medicine used to treat human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS).

Norvir falls into the broad category of antiretroviral drugs. It is a protease inhibitor (PI), which works by stopping part of the HIV virus’ life cycle, preventing it from making copies of itself. Without the ability to replicate itself, HIV can be suppressed to undetectable levels, which keeps the immune system functioning and also reduces the risk of transmitting the virus to others.

Norvir is also available as a generic product under the name ritonavir. It comes in several different dosage forms: tablets, oral solution, and oral powder. Ritonavir is a prescription product, so you can’t purchase it over-the-counter (OTC). You’ll receive a prescription from your healthcare provider and get the medication from your pharmacy.

Drug Facts

Generic Name: Ritonavir

Brand Name: Norvir 

Drug Availability: Prescription

Therapeutic Classification: Antiretroviral; Protease Inhibitor

Available Generically: Yes

Controlled Substance: N/A

Administration Route: Oral

Active Ingredient: Ritonavir

Dosage Form: Tablet, oral solution, oral powder

What Is Norvir Used For?

Norvir is used to suppress HIV to undetectable levels, meaning a lab test will detect less than 50 copies of the virus per milliliter of blood (the point at which the disease is least likely to progress to AIDs). This is the ultimate goal of treatment.

Ritonavir can be used to treat HIV along with other antiretroviral drugs. This makes it easier to achieve viral suppression as multiple parts of the virus’ replication cycle will be blocked.

How to Take Norvir

Take Norvir as prescribed by your healthcare provider (usually twice a day) and with meals. Taking it with breakfast and dinner may be convenient for you. If you take ritonavir tablets, swallow them whole. Do not break, chew, or crush them.

Norvir oral powder comes in packets of 100 milligrams (mg), so it should only be used if your dose is an increment of 100. This way, you’re able to use whole packets. If your dose is 300 milligrams, use three whole packets, and so on. Pour and mix the contents of the packet(s) over soft food or liquid, such as apple sauce, pudding, water, chocolate milk, or infant formula. Then take the whole dose by finishing all of the food or liquid within two hours.

If you’re taking Norvir oral solution, you can improve the taste by mixing it with chocolate milk or meal replacement drinks.

Storage

Store ritonavir tablets, oral powder, and oral solution at room temperature (between 68 F and 77 F) in the original container. Keep your medication out of reach of children and pets. Do not store ritonavir in an area where it will be exposed to heat and moisture, like the bathroom.

If you’re traveling by plane, you’ll want to keep Norvir in your carry-on luggage so that you aren’t separated from it if your checked baggage goes missing. If you’re traveling by car, take care not to leave your pill bottle in especially hot or cold temperatures for long periods, like overnight in the car.

How Long Does Norvir Take to Work?

Norvir begins working right away at preventing HIV from replicating. However, if you stop taking the medication, even the smallest amount of virus left in your blood will be able to start replicating again and return to high levels. For this reason, it is important to not miss doses of Norvir. You will likely need to be on HIV medication for the rest of your life.

What Are the Side Effects of Norvir?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Some common side effects that you may experience while taking ritonavir include the following. Notify your healthcare provider if any of these side effects seem severe or do not go away:

  • Upper and/or lower abdominal pain
  • Diarrhea
  • Nausea or vomiting
  • Fatigue, or feeling overtired with low energy
  • Muscle or back pain
  • Paresthesias, which are tingling sensations felt in your hands, feet, arms, legs, or face, usually caused by pressure on your peripheral nerves.

Severe Side Effects

Potential side effects of Norvir that were rarer in clinical trials but potentially more severe include:

  • Allergic reactions are possible, such as skin rash, breathing problems, toxic epidermal necrolysis (TEN), and Stevens-Johnson syndrome. The drug should be stopped if these reactions occur.
  • Liver toxicity. Let your healthcare provider know if you also have hepatitis B or C or other liver conditions, as you may be at increased risk of worsening these conditions when taking Norvir.
  • Pancreatitis has been observed in some people taking Norvir, including those who developed hypertriglyceridemia, or high triglyceride levels. If you notice symptoms like persistent nausea, vomiting, or abdominal pain, notify your healthcare provider right away as pancreatitis is a possible diagnosis and you will need treatment and further medical evaluation.
  • Heart arrhythmias are possible when taking ritonavir, as it can make a particular part of your heartbeat last longer. Let your healthcare provider know if you have any kind of heart disease before starting to take Norvir.

Call your healthcare provider right away if you feel like you are experiencing serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Long-Term Side Effects

No specific side effects are noted to be associated with longer term use of Norvir.

Report Side Effects

Norvir may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

(800) 332-1088

Dosage: How Much Norvir Should I Take?

Drug Content Provided and Reviewed byIBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For treatment of HIV infection:
    • For oral dosage forms (capsules, solution, powder, or tablets):
      • Adults—600 milligrams (mg) 2 times per day.
      • Children 1 month of age and older—Dose is based on body size and must be determined by your doctor. The dose is usually 350 to 400 milligrams per square meter (mg/[m]2) of body size 2 times per day. The doctor will adjust your dose as needed and tolerated. However, the dose is usually not more than 600 mg two times per day.
      • Children younger than 1 month of age—Use and dose must be determined by your doctor.

Modifications

You may need to take precautions while using this medication in certain circumstances.

Pregnancy

It is unknown whether taking Norvir while pregnant increases the risk of birth defects or miscarriage. There is an online pregnancy exposure registry that reports outcomes in people exposed to antiretrovirals while pregnant. The overall risk does not seem to be higher in pregnant women exposed to the medicines that Norvir contains. However, there is not enough data here to make any definite conclusions.

One thing to note is that the oral solution dosage form should be avoided in pregnancy due to the ethanol content.

Breastfeeding

It is unknown whether Norvir is present in human breast milk, but due to the risk of transmitting HIV through breast milk, the Centers for Disease Control and Prevention (CDC) recommends against breastfeeding if you are a person living with HIV.

Children

The FDA approved ritonavir to treat HIV in children. In clinical trials, the drug worked similarly and caused similar side effects in children compared to in adults. The recommended daily dose for children will be determined by their healthcare provider.

Older Adults

There have not been specific studies to determine whether older adults (above age 65) respond differently to Norvir compared to younger adults. In general, it should be used cautiously in older individuals, keeping in mind any decreased liver or kidney function and other medications that may interact with Norvir.

Missed Dose

If you forget to take a dose of Norvir, you can take it as soon as you remember, then take your next scheduled dose at its regular time.

If you are closer to your next dose than the dose you missed, go ahead and skip the missed dose and wait for your next scheduled one. For example, if you usually take Norvir at 8 a.m. and 8 p.m., and you remember at 5 p.m. that you forgot your morning dose, skip it and take your next scheduled 8 p.m. dose. Do not double up doses to make up for missed ones.

Overdose: What Happens If I Take Too Much Norvir?

As long as you take Norvir once daily as prescribed, you don’t need to be too concerned about overdosing. There is no specific antidote for overdosage with ritonavir. Treatment would most likely consist of monitoring your vital signs, heart rhythm, and general condition.

What Happens If I Overdose on Norvir?

If you think you or someone else may have overdosed on Norvir, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Norvir, call 911 immediately.

911

Precautions

Drug Content Provided and Reviewed byIBM Micromedex®

It is very important that your doctor check the progress of you or your child at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.

Do not use this medicine if you or your child are also using alfuzosin (Uroxatral®), amiodarone (Cordarone®), apalutamide (Erleada®), astemizole (Hismanal®), bepridil (Vascor®), cisapride (Propulsid®), colchicine (Colcrys®), dronedarone (Multaq®), ergot medicines (eg, dihydroergotamine, ergotamine, methylergonovine, Cafergot®, or Ergomar®), flecainide (Tambocor®), lomitapide (Juxtapid®), lovastatin (Altocor®, Mevacor®), lurasidone (Latuda®), oral midazolam (Versed®), pimozide (Orap®), propafenone (Rythmol®), quinidine (Quinaglute®), ranolazine (Ranexa®), sildenafil (Revatio®), simvastatin (Simcor®, Vytorin®, Zocor®), terfenadine (Seldane®), triazolam (Halcion®), or voriconazole (Vfend®). Using these medicines together with ritonavir may increase your chance of having serious side effects.

This medicine may decrease the effects of some birth control pills. Use an additional form of birth control along with your pills to keep from getting pregnant. Other forms of birth control include condoms, a diaphragm, or a contraceptive foam or jelly.

Ritonavir oral liquid contains alcohol, which should not be given to pregnant women and preterm babies.

Check with your doctor right away if you or your child have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, unusual tiredness or weakness, or yellow eyes or skin. These could be symptoms of a serious liver problem.

Pancreatitis may occur while you are using this medicine. Check with your doctor right away if you or your child have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema. These reactions can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, blistering, peeling, or loosening of the skin, fever or chills, trouble breathing or swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you or your child have any of the following symptoms while taking this medicine: blistering, peeling, or loosening of the skin, fever, chills, cough, diarrhea, itching, joint or muscle pain, rash, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swelling of your hands, face, tongue, or throat, or unusual tiredness or weakness.

This medicine may cause heart rhythm problems. Tell your doctor right away if you or your child gets dizzy or lightheaded, have fast or irregular heart beats, or feels like fainting.

This medicine may increase the amount of cholesterol and fats in your blood. If this condition occurs, your doctor may give you some medicines that can lower the amount of cholesterol and fats in the blood. Talk to your doctor if you or your child have concerns.

This medicine may increase your blood sugar levels. Check with your doctor right away if you or your child have the following symptoms: confusion, nausea or vomiting, increased hunger, thirst or urination, or unusual tiredness or weakness.

Your immune system may get stronger when you start taking HIV medicines. Tell your doctor right away if you notice any changes in your health. Sometimes the immune system will start to fight infections that were hidden in your body, such as pneumonia or tuberculosis, or may result in a flare-up of a hidden autoimmune disorder such as Graves disease, polymyositis, or Guillain-Barré syndrome.

This medicine may cause you to have excess body fat. Tell your doctor if you or your child notice changes in your body shape, such as an increased amount of fat in the upper back and neck, or around the chest and stomach area. You might also lose fat from the legs, arms, and face.

This medicine may increase the risk of bleeding in patients with hemophilia (a bleeding disorder). Talk with your doctor about this risk.

This medicine will not keep you from giving HIV to your partner during sex. Make sure you understand this and practice safe sex, even if your partner also has HIV, by using a latex condom or other barrier method. This medicine will also not keep you from giving HIV to other people if they are exposed to your blood. Do not re-use or share needles with anyone.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription and nonprescription (over-the-counter [OTC]) medicines, and herbal (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn't Take Norvir?

You should not take Norvir if you:

  • Also have hepatitis B or C that is not well controlled and has caused your liver function tests to be elevated. Make sure your healthcare provider is aware if you also have hepatitis or other liver diseases, as Norvir may worsen these conditions.
  • Have a heart condition, such as underlying structural heart disease, conduction system abnormalities (also called heart block), ischemic heart disease, or cardiomyopathies.
  • Also take a drug that interacts significantly with Norvir, such as the ones listed below.

What Other Medications Interact With Norvir?

Ritonavir has some important drug interactions. Make sure the healthcare provider that is prescribing ritonavir for you is aware of all other medicines and supplements that you take.

Norvir is metabolized by certain proteins called cytochromes, which also metabolize other drugs you take. When these proteins are too busy metabolizing Norvir, other drugs can build up in your system, or vice versa. For this reason, you may either need a dose adjustment or avoid some other drugs altogether.

Ritonavir can interact with:

  • Birth control pills, or combined hormonal contraceptives, may not work as well if you’re also taking Norvir. You should consider another contraceptive method or an additional barrier method of contraception.
  • Anticonvulsants, or seizure drugs, such as Depakote (divalproex sodium), Lamictal (lamotrigine), Dilantin (phenytoin), and Tegretol (carbamazepine), may be influenced by Norvir. You may need dosage adjustments.
  • Antiarrhythmic drugs, such as Pacerone (amiodarone), Multaq (dronedarone), Tambocor (flecainide), Rythmol (propafenone), and Quinalan (quinidine), should be avoided because of Norvir’s potential to cause arrhythmias.
  • Antidepressants, including selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and others, may need to have their doses increased or decreased due to the influence of Norvir on their metabolism.

What Medications Are Similar?

Dozens of drugs across different classes and mechanisms of action exist to treat HIV. It is necessary to use more than one drug class to treat HIV and prevent it from replicating effectively. Sometimes drugs from different classes are combined into one combination product.

Norvir is a single-drug product only used with other protease inhibitors to keep their concentration in your body high enough to work against HIV. Some other protease inhibitors include:

  • Tybost (cobicistat), another drug that is taken alongside any of the following four drugs but not with Norvir
  • Aptivus (tipranavir)
  • Lexiva (fosamprenavir)
  • Prezista (darunavir)
  • Reyataz (atazanavir)

Except for Tybost, these are some other drugs you may take along with Norvir. Ask your pharmacist or a healthcare provider if you have questions.

Frequently Asked Questions

  • What is Norvir used for?

    Norvir is used to treat human immunodeficiency virus (HIV), the virus that leads to acquired immunodeficiency syndrome (AIDS). This disease can lead to weight loss and severe infections.

  • How does Norvir work?

    Norvir is a protease inhibitor (PI) that is taken along with other PIs. Norvir keeps the concentration of other PIs high enough in your body to make sure they can work well enough to fight HIV and its viral replication.

  • What other drugs interact with Norvir?

    Some important drug interactions exist that may necessitate dose changes or just stopping other drugs altogether while taking Norvir. These include birth control pills, antiarrhythmic drugs, antidepressants, and anticonvulsant (e.g., anti-seizure) drugs. This is a shortened list and is not comprehensive. Make sure your healthcare provider is aware of all the other medicines you take.

How Can I Stay Healthy While Taking Norvir?

An HIV diagnosis can feel daunting. There is certainly a stigma around HIV, and it can feel scary and overwhelming to find out that you are positive for the virus. The good news is that HIV treatments have advanced rapidly in the last couple of decades, and life expectancy is close to the same as an uninfected person. People diagnosed with HIV can typically live normal lives if they begin treatment promptly and remain compliant.

Achieving viral suppression is the goal of treatment with antiretroviral medications. This means the HIV viral load will be undetectable in your blood so that a test run with a sample of your blood can only pick up a minimal amount of the virus, or none at all. Having an undetectable viral load drastically reduces your chances of transmitting HIV to others and your chances of developing infections.

Learn all you can about HIV and the medications you are receiving, as this can make treatment more approachable and help you understand how important it is. When living with a condition like HIV, it’s also essential to prioritize your mental health. Exercising, joining support groups, or seeking counseling, if necessary, can help improve or maintain your mental well-being.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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