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PROTEASE INHIBITOR/PHARMACOKINETIC ENHANCER
Norvir (ritonavir) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) used with other antiretroviral medicines to treat human immunodeficiency virus type 1 (HIV-1) in adults and children.
These insights are based on 118 comments about Norvir from myHIVteam members. These are the experiences of a small number of people and are not meant to be medical advice.
Benefits:
Considerations:
Norvir is a type of antiretroviral medicine called a protease inhibitor. It works by blocking HIV-1 protease, an enzyme the virus needs to make mature copies of itself. In HIV-1 infection, this helps reduce the production of immature virus particles that cannot infect new cells.
Doctors prescribe Norvir with other antiretroviral medicines to treat HIV-1 infection in adults and children.
HIV-1 is the virus that causes acquired immune deficiency syndrome (AIDS).
Norvir is taken by mouth. It is available as tablets and oral powder. Take Norvir with meals.
Swallow Norvir tablets whole. Do not chew, break, or crush them.
Norvir oral powder can be mixed with soft food, such as applesauce or vanilla pudding. It can also be mixed with liquids such as water, chocolate milk, or infant formula.
For adults, Norvir is started at no less than 300 milligrams twice daily. The dose may be increased by 100 milligrams twice daily every two to three days. The recommended dose is 600 milligrams twice daily with meals.
For children, the dose is based on body size, using a calculation called body surface area. The starting dose is 250 milligrams per square meter twice daily with meals. The dose may be increased by 50 milligrams per square meter twice daily every two to three days.
The recommended dose for children is 350 to 400 milligrams per square meter twice daily with meals. The dose should not be more than 600 milligrams twice daily. If a child cannot tolerate 400 milligrams per square meter twice daily, the healthcare provider may use the highest tolerated dose or consider another treatment.
This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 118 comments about Norvir from myHIVteam members.
Members who use Norvir often talk about balancing a regimen that works with concerns about side effects, interactions, and long-term monitoring. Across the community, people most often suggest staying in close contact with an HIV specialist, watching for side effects and lab changes, and being cautious about other medicines and alcohol while taking Norvir.
Keep track of stomach side effects and ask about options.
“Norvir was a nightmare. It gave me terrible diarrhea, but saved my life. Hope it will get better.”
Ask about drug interactions before taking other medicines.
“I’m mostly surprised at how doctors will prescribe medications for other conditions without checking to see if these drugs have major reactions with some HIV drugs that inhibit the CYP3A4 liver pathway. Booster drugs such as Norvir do this, which makes these other drugs much stronger in your system.”
Be careful with alcohol and other substances while taking Norvir.
“My doctor told me to be careful with Norvir; it will make the alcohol more potent!”
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In clinical studies of Norvir, the most common side effects occurred in about 27 percent to 68 percent of people in studies. These include:
Norvir can cause serious side effects that may require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
AbbVie Inc, the manufacturer of Norvir, offers the myAbbVie Assist program. Eligible people who are uninsured, have Medicare, or whose insurance doesn’t adequately cover Norvir may be able to receive the medicine at no cost.
To learn more, visit the AbbVie Patient Assist website or call 800-222-6885.
Before you start Norvir, your healthcare provider may order blood tests. These can include tests for triglycerides, cholesterol, liver enzymes, CPK, and uric acid. Some of these tests may also be repeated during treatment.
Before taking Norvir, tell your doctor if you or your child:
Do not take Norvir if you have had a serious allergic reaction to ritonavir or any of its ingredients.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Norvir can interact with many medicines. Some drug interactions can cause serious or life-threatening side effects. Others can change how well Norvir or another medicine works. Your healthcare provider may need to change a dose, monitor you more closely, or avoid certain medicines.
Norvir should not be taken with certain medicines, including alfuzosin, ranolazine, amiodarone, dronedarone, flecainide, propafenone, quinidine, voriconazole, colchicine, lurasidone, pimozide, dihydroergotamine, ergotamine, methylergonovine, cisapride, lovastatin, simvastatin, lomitapide, suzetrigine, sildenafil when used for pulmonary arterial hypertension, triazolam, midazolam taken by mouth, apalutamide, or St. John’s Wort.
Refill Norvir before you run out. Do not stop taking it without talking with your healthcare provider. If you stop Norvir, even for a short time, the amount of HIV in your blood may increase and the virus may become harder to treat.
If you miss a dose of Norvir, take it as soon as possible. Then take your next dose at the regular time. If it is almost time for your next dose, skip the missed dose and take the next dose at the regular time. Do not take two doses at the same time.
If you are pregnant or plan to become pregnant, tell your healthcare provider.
Norvir may make hormonal birth control work less well. People who can become pregnant should use another effective form of birth control or add a barrier method during treatment.
Tell your healthcare provider if you are pregnant or plan to become pregnant. A pregnancy registry tracks outcomes in people who take Norvir during pregnancy. Healthcare providers can register pregnancies by visiting the Antiretroviral Pregnancy Registry or calling 800-258-4263.
Do not breastfeed while taking Norvir. HIV-1 may pass to a baby through breast milk. If the baby has HIV-1, the virus may become harder to treat. The baby may also have side effects from Norvir.
These answers are fact-checked by our editorial staff.
How effective is Norvir for HIV?
Clinical studies have shown that ritonavir can help treat HIV-1 when used as part of an antiretroviral treatment plan. In one study of 1,090 people with advanced HIV who had already received antiretroviral treatment, 26 percent of people who added ritonavir to their treatment had disease progression or died during the double-blind part of the study. This compared with 42 percent of people who added a placebo.
By the end of follow-up, 18 percent of people originally assigned to ritonavir had died, compared with 26 percent of those originally assigned to placebo.
In another study of 356 people who had not taken antiretroviral medicines before, treatments containing ritonavir produced greater increases in CD4 cell counts by week 12 and greater decreases in HIV-1 RNA by week 2 than zidovudine alone.
How long does Norvir take to work for HIV?
Norvir can begin lowering the amount of HIV in the blood within the first few weeks when it is used with other HIV medicines.
In one clinical study, people taking ritonavir-containing treatment had greater decreases in HIV-1 RNA by week 2. By week 12, they also had greater increases in CD4 cell counts. CD4 cells are immune cells that help the body fight infections, and HIV can damage these cells.
How quickly treatment works can vary from person to person. Your healthcare provider will use blood tests, including viral load and CD4 counts, to see how well your treatment is working.
Can Norvir be used with other medicines for HIV?
Yes. Norvir must be used with other antiretroviral medicines to treat HIV-1.
Norvir can also interact with many other medicines. Some interactions can cause serious or life-threatening problems. Tell your healthcare provider about all prescription medicines, over-the-counter medicines, vitamins, and herbal supplements you take.
Certain medicines should not be taken with Norvir. These include alfuzosin, suzetrigine, apalutamide, ranolazine, dronedarone, lurasidone, pimozide, amiodarone, flecainide, propafenone, quinidine, cisapride, lovastatin, simvastatin, lomitapide, triazolam, midazolam taken by mouth, and St. John’s Wort.
Certain ergot medicines, including dihydroergotamine, ergotamine, and methylergonovine, should also not be taken with Norvir.
Do not take sildenafil when it is used to treat pulmonary arterial hypertension.
Colchicine should not be taken with Norvir if you have kidney or liver problems. Voriconazole should not be taken if your Norvir dose is 400 milligrams every 12 hours or more.
Your healthcare provider should review all of your medicines before you start Norvir and while you are taking it.
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