Norvir

Before taking this medicine

Do not take Norvir (ritonavir) if you have a known allergy to ritonavir or any of its ingredients, including a previous severe skin reaction such as Stevens–Johnson syndrome or toxic epidermal necrolysis. Do not take ritonavir with alfuzosin, ranolazine, amiodarone, dronedarone, flecainide, propafenone, quinidine, voriconazole, colchicine, lurasidone, pimozide, dihydroergotamine, ergotamine, methylergonovine, cisapride, lovastatin, simvastatin, lomitapide, triazolam, midazolam taken by mouth, or sildenafil (Revatio) used to treat pulmonary arterial hypertension. These combinations can cause serious or life-threatening reactions. Apalutamide and St. John’s wort must also not be taken with ritonavir because they can reduce its effect and may lead to drug resistance. All medicines and herbal products should be reviewed before and during treatment because ritonavir has many potentially serious interactions. If it is taken with another protease inhibitor, that medicine’s contraindications and precautions also apply. Tell your prescriber if you have liver disease, hepatitis B or C, abnormal liver tests, heart disease, heart conduction problems, high cholesterol or triglycerides, diabetes, or haemophilia. Important precautions include: • Liver injury, including fatal cases, has been reported. Liver function should be monitored before and during treatment, particularly in people with existing liver problems. • Inflammation of the pancreas can occur and has sometimes been fatal. Nausea, vomiting or abdominal pain should be assessed; treatment must be stopped if pancreatitis is diagnosed. • Severe allergic reactions, including anaphylaxis and serious skin reactions, require treatment to be stopped. • Ritonavir can slow electrical conduction through the heart. Extra caution and monitoring are needed with existing heart disease or other medicines that affect heart conduction. • Cholesterol and triglycerides should be checked before treatment and periodically afterwards. Monitoring for high blood sugar or new or worsening diabetes should also be considered. • Increased bleeding has been reported in people with haemophilia. Inflammation related to recovering immune function, autoimmune disorders and changes in body fat have also been reported during antiretroviral treatment. Continuing ritonavir after loss of viral suppression may increase resistance to other protease inhibitors. Women with HIV should not breastfeed because of the risk of transmitting HIV.