Antiretroviral medication
Ritonavir Pronunciation rih-TO -nə-veer Trade names Norvir Other names RTV AHFS /Drugs.com Monograph MedlinePlus a696029 License data
Pregnancy category Routes of administration By mouth ATC code Legal status
Protein binding 98–99% Metabolism Liver Elimination half-life 3–5 hours Excretion Mostly fecal
1,3-thiazol-5-ylmethyl N -[(2S ,3S ,5S )-3-hydroxy-5-[(2S )-3-methyl-2-{[methyl({[2-(propan-2-yl)-1,3-thiazol-4-yl]methyl})carbamoyl]amino}butanamido]-1,6-diphenylhexan-2-yl]carbamate
CAS Number PubChem CID DrugBank ChemSpider UNII KEGG ChEBI ChEMBL NIAID ChemDB PDB ligand CompTox Dashboard (EPA ) ECHA InfoCard 100.125.710 Formula C 37 H 48 N 6 O 5 S 2 Molar mass 720.95 g·mol−1 3D model (JSmol )
CC(C)c4nc(CN(C)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](Cc1ccccc1)C[C@H](O)[C@H](Cc2ccccc2)NC(=O)OCc3cncs3)cs4
InChI=1S/C37H48N6O5S2/c1-24(2)33(42-36(46)43(5)20-29-22-49-35(40-29)25(3)4)34(45)39-28(16-26-12-8-6-9-13-26)18-32(44)31(17-27-14-10-7-11-15-27)41-37(47)48-21-30-19-38-23-50-30/h6-15,19,22-25,28,31-33,44H,16-18,20-21H2,1-5H3,(H,39,45)(H,41,47)(H,42,46)/t28-,31-,32-,33-/m0/s1
Y Key:NCDNCNXCDXHOMX-XGKFQTDJSA-N
Y
Ritonavir , sold under the brand name Norvir , is an antiretroviral medication used along with other medications to treat HIV/AIDS .[4] [5] [6] This combination treatment is known as highly active antiretroviral therapy (HAART).[6] Ritonavir is a protease inhibitor, though it now mainly serves to boost the potency of other protease inhibitors .[6] [7] It may also be used in combination with other medications to treat hepatitis C and COVID-19 .[8] [9] It is taken by mouth .[6] Tablets of ritonavir are not bioequivalent to capsules, as the tablets may result in higher peak plasma concentrations.[6]
Common side effects of ritonavir include nausea, vomiting, loss of appetite, diarrhea, and numbness of the hands and feet.[6] Serious side effects include liver complications, pancreatitis , allergic reactions , and arrythmias .[6] Serious interactions may occur with a number of other medications including amiodarone and simvastatin .[6] At low doses, it is considered to be acceptable for use during pregnancy.[10] Ritonavir is of the protease inhibitor class.[6] However, it is also commonly used to inhibit the enzyme that metabolizes other protease inhibitors.[11] This inhibition allows lower doses of these latter medications to be used.[11]
Ritonavir was patented in 1989 and came into medical use in 1996.[12] [13] It is on the World Health Organization's List of Essential Medicines .[14] [15] Ritonavir capsules were approved as a generic medication in the United States in 2020.[16]
^ "FDA-sourced list of all drugs with black box warnings (Use Download Full Results and View Query links.)" . nctr-crs.fda.gov . FDA . Retrieved October 22, 2023 .
^ "Notice: Nirmatrelvir (COVID-19) added to Prescription Drug List (PDL)" . Health Canada . January 17, 2022. Archived from the original on May 29, 2022. Retrieved June 25, 2022 .
^ "Norvir Product information" . Health Canada . April 25, 2012. Retrieved June 25, 2022 .
^ a b "Norvir- ritonavir tablet, film coated Norvir- ritonavir solution Norvir- ritonavir powder" . DailyMed . Archived from the original on November 18, 2021. Retrieved November 17, 2021 .
^ a b Cite error: The named reference Norvir EPAR
was invoked but never defined (see the help page ).
^ a b c d e f g h i "Ritonavir" . The American Society of Health-System Pharmacists. Archived from the original on October 17, 2015. Retrieved October 23, 2015 .
^ Talha B, Dhamoon AS (August 8, 2023). "Ritonavir" . StatPearls . StatPearls Publishing. PMID 31335032 . Retrieved January 6, 2024 .
^ Cite error: The named reference FDA-ucm427530
was invoked but never defined (see the help page ).
^ Akinosoglou K, Schinas G, Gogos C (November 2022). "Oral Antiviral Treatment for COVID-19: A Comprehensive Review on Nirmatrelvir/Ritonavir" . Viruses . 14 (11): 2540. doi :10.3390/v14112540 . PMC 9696049 . PMID 36423149 .
^ "Ritonavir Pregnancy and Breastfeeding Warnings" . drugs.com . Archived from the original on September 7, 2015. Retrieved October 23, 2015 .
^ a b British National Formulary 69 (69 ed.). Pharmaceutical Pr. March 31, 2015. p. 426. ISBN 9780857111562 .
^ Hacker M (2009). Pharmacology principles and practice . Amsterdam: Academic Press/Elsevier. p. 550. ISBN 9780080919225 . Archived from the original on June 17, 2020. Retrieved September 10, 2017 .
^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery . John Wiley & Sons. p. 509. ISBN 9783527607495 . Archived from the original on June 20, 2021. Retrieved August 27, 2020 .
^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019 . Geneva: World Health Organization. hdl :10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021) . Geneva: World Health Organization. hdl :10665/345533 . WHO/MHP/HPS/EML/2021.02.
^ "First Generic Drug Approvals" . U.S. Food and Drug Administration (FDA) . Archived from the original on January 26, 2021. Retrieved February 13, 2021 .