Ritonavir was originally marketed and used as a stand-alone protease inhibitor dosed at 600 mg orally twice daily. Gastrointestinal side effects, particularly diarrhea and nausea, were common and limited the drug's tolerability. Dyslipidemias, vomiting, altered taste, and paresthesias were also reported. Today, Ritonavir is usually used at lower doses (100-200 mg twice daily) to inhibit CYP3A4, improve the bioavailability, and increase the half-life of other protease inhibitors. These low Ritonavir doses decrease, but do not entirely eliminate, its gastrointestinal side effects. Ritonavir inhibits the metabolism of all available protease inhibitors but is not used in conjunction with nelfinavir. Ritonavir boosting improves PI efficacy and decreases the occurrence of protease inhibitor resistance after virologic failure, albeit at a cost of an increased incidence of clinically significant drug-drug interactions. In several countries, all preferred PI-based treatment regimens include a recommendation for Ritonavir boosting. When used at full dose, Ritonavir selects for resistance mutations in a genotypic pattern similar to those selected for by indinavir.
Other names for this medication:
Ritonavir,
Kaletra,
Norvir,
Ritomune,
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