Ritonavir for HIV

About ritonavir for HIV

Ritonavir is an antiretroviral medicine. It is prescribed for human immunodeficiency virus (HIV) infection. 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.

Es ist wichtig, dass Sie Ihre antiretroviralen Medikamente genau wie vorgeschrieben einnehmen, um den Erfolg zu erhalten und zu verhindern, dass das Virus gegen die Medikamente resistent wird. Diese Medikamente werden in der Regel lebenslang eingenommen.

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.

Before taking ritonavir

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:

• Wenn Sie schwanger sind, ein Kind erwarten oder stillen.

• Wenn Sie Diabetes (Diabetes mellitus) haben.

• 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.

• Wenn Sie eine Leberentzündung (Hepatitis genannt) oder ein anderes Leberproblem haben.

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

• Wenn Sie entweder an Hämophilie oder Porphyrie leiden, beides seltene vererbbare Blutkrankheiten.

• Wenn Sie andere Arzneimittel einnehmen. Dazu gehören alle Arzneimittel, die ohne Rezept erhältlich sind, sowie pflanzliche und ergänzende Arzneimittel.

• Wenn Sie schon einmal eine allergische Reaktion auf ein Arzneimittel hatten.
  

How to take ritonavir

• 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.

Das Beste aus Ihrer Behandlung herausholen

• Halten Sie Ihre regelmäßigen Termine bei Ihrem Arzt ein, damit Ihre Fortschritte überwacht werden können. Sie müssen regelmäßig Blutuntersuchungen durchführen lassen.

• 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.

• Befolgen Sie sorgfältig alle Ratschläge Ihres Arztes, Ihre Lebensweise zu ändern, um das Risiko von Schäden an Ihrem Herz und Ihren Blutgefäßen zu verringern. Dazu kann gehören, mit dem Rauchen aufzuhören, sich gesund zu ernähren und regelmäßig Sport zu treiben.

• Bei manchen Menschen, die antiretrovirale Arzneimittel einnehmen, verändert sich die Verteilung des Körperfetts im Körper. Dies kann zu einer Veränderung des Körperbildes führen. Ihr Arzt wird mit Ihnen über die Möglichkeit einer solchen Veränderung sprechen.

• Die Behandlung mit antiretroviralen Medikamenten kann zwar das Risiko einer HIV-Übertragung durch sexuelle Kontakte verringern, aber nicht verhindern. Es ist wichtig, dass Sie Kondome benutzen.

• Es ist nicht ungewöhnlich, dass sich Menschen mit HIV niedergeschlagen oder sogar depressiv fühlen, vor allem kurz nachdem die Diagnose gestellt und die Behandlung begonnen wurde. Wenn Sie sich deprimiert fühlen oder beunruhigende Gedanken haben, sich selbst zu schaden, sollten Sie sofort mit Ihrem Arzt sprechen.

• Einige Menschen, die antiretrovirale Arzneimittel (insbesondere über einen langen Zeitraum) eingenommen haben, haben eine sogenannte Osteonekrose entwickelt. Dabei handelt es sich um eine Knochenkrankheit, bei der das Knochengewebe abstirbt, weil es nicht mehr ausreichend durchblutet wird. Dies führt zu Gelenkschmerzen und Steifheit und kann zu Bewegungseinschränkungen führen. Wenn Sie eines dieser Symptome bemerken, sollten Sie mit Ihrem Arzt sprechen.

• 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.

• Wenn Sie Diabetes haben, müssen Sie Ihren Blutzucker (Glukose) möglicherweise häufiger kontrollieren, da dieses Arzneimittel den Blutzuckerspiegel beeinflussen kann. Ihr Arzt wird Sie darüber informieren.

• Wenn Sie sich einer Operation oder einer zahnärztlichen Behandlung unterziehen müssen, teilen Sie der behandelnden Person mit, welche Arzneimittel Sie einnehmen.

• 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.

Can ritonavir cause problems?

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.

Important: 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.

Wenn Sie andere Symptome haben, von denen Sie glauben, dass sie auf das Arzneimittel zurückzuführen sind, sprechen Sie mit Ihrem Arzt oder Apotheker, um weiteren Rat zu erhalten.

How to store ritonavir

• Bewahren Sie alle Arzneimittel außerhalb der Reichweite und Sichtweite von Kindern auf.

• An einem kühlen, trockenen Ort aufbewahren, vor direkter Hitze und Licht schützen.

Wichtige Informationen über alle Arzneimittel