Medical Advocates
Ritonavir (Norvir)
 
Journal Citations: Drug Interactions 
General Reports
Albendazole
Acenocoumarol
 Alprazolam
 Amprenavir
 BILR 355
Bortezomib
 Bupropion
 Buspirone
 Carbamazepine
 Corticosteroids
 Digoxin
 Docetaxel
 		 Elvucitabine
 Enfuvirtide
Fentanyl
Fluoxetine        
Fluticasone          
Fosamprenavir    
Ketoconazole      
Mebendazole
 Meperidine            
 Methadone    
Nelfinavir               Normeperidine      

 		 Prednisone
 Risperidone
Sildenafil
 Tacrolimus
Trazodone
 Triamcinolone
Triazolam
 Vinblastine
 Zaleplon 
 Zolpidem 
 Zopiclone


 
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Last Update:  February 03, 2012
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General Reports
 
  Complex Drug Interactions of HIV Protease Inhibitors 1: Inactivation, Induction and Inhibition
of Cytochrome P450 3A by Ritonavir or Nelfinavir.
 Kirby BJ, Collier AC, Kharasch ED,  et al
Drug Metab Dispos. 2011 Mar 15
 Abstract

Induction Effects of Ritonavir: Implications for Drug Interactions (July/August).
 Foisy MM, Yakiwchuk EM, Hughes CA.
Ann Pharmacother. 2008 Jun 24.
 Abstract
 
RTV/Albendazole
 
  Effect of ritonavir on the pharmacokinetics of the benzimidazoles albendazole
and mebendazole: an interaction study in healthy volunteers.
 Corti N, Heck A, Rentsch K, et al
Eur J Clin Pharmacol. 2009 Jun 27.
 Abstract
 
RTV/Acenocoumarol
 
  Severe interaction between ritonavir and acenocoumarol.
Llibre JM, Romeu J, Lopez E, Sirera G.
Ann Pharmacother 2002 Apr;36(4):621-3
Abstract
 
RTV/Alprazolam
 
  Alprazolam-ritonavir interaction: implications for product labeling.
Greenblatt DJ,von Moltke LL, Harmatz JS, et al.
Clin Pharmacol Ther 2000 Apr;67(4):335-41  
Abstract 
 
  Extensive impairment of triazolam and alprazolam clearance by short-term
low-dose ritonavir: the clinical dilemma of concurrent inhibition and induction.
Greenblatt DJ, von Moltke LL, Daily JP,  et al.
J Clin Psychopharmacol 1999 Aug;19(4):293-6
Abstract 

RTV/Amprenavir

 
Ritonavir Increases Plasma Amprenavir (APV) Exposure to a Similar Extent when
Coadministered with either Fosamprenavir or APV.
 Wire MB, Baker KL, Jones LS, et al 
Antimicrob Agents Chemother. 2006 Apr;50(4):1578-80.
 Abstract 

Genotypic inhibitory quotient as predictor of virological response to ritonavir-
amprenavir in human immunodeficiency virus type 1protease inhibitor-experien
ced patients.
Marcelin AG, Lamotte C, Delaugerre C, et al.  
 Antimicrob Agents Chemother 2003 Feb;47(2):594-600
 Abstract
 
FULL-TEXT ARTICLE
 Pharmacokinetic modeling and simulations of interaction of amprenavir and ritonavir.
 Sale M, Sadler BM, Stein DS.
Antimicrob Agents Chemother 2002 Mar;46(3):746-54
 Paper
 
FULL-TEXT ARTICLE
 Low level of cross-resistance to amprenavir (141W94) in samples from patients
pretreated with other protease inhibitors.
Schmidt B, Korn K, Moschik B, et al.
Antimicrob Agents Chemother 2000 Nov;44(11):3213-6  
Paper
 

RTV/BILR 355
 
  A WEEK-IN-REVIEW FEATURED REPORT
 Pharmacokinetics of BILR 355 after multiple oral doses coadministered with a low dose of ritonavir.
 Huang F, Drda K, MacGregor TR,  et al
Antimicrob Agents Chemother. 2009 Jan;53(1):95-103
 Paper

Evaluation of steady-state pharmacokinetic interactions between ritonavir-boosted
BILR 355, a non-nucleoside reverse transcriptase inhibitor, and lamivudine/zidovudine
in healthy subjects.
 Huang F, Allen L, Huang DB,  et al
J Clin Pharm Ther. 2010 Dec 5
 Abstract

RTV/Bortezomib

  Ritonavir Interacts With Bortezomib to Enhance Protein Ubiquitination and Histone Acetylation
Synergistically in Renal Cancer Cells
 Sato A, Asano T, Ito K, Asano T.
Urology. 2012 Jan 30.
 Abstract		  

RTV/Bupropion

 
A WEEK-IN-REVIEW FEATURED REPORT
Dose-Related Reduction in Bupropion Plasma Concentrations by Ritonavir.
 Park J, Vousden M, Brittain C, et al
J Clin Pharmacol. 2010 May 19.
 Abstract

Ritonavir, Efavirenz, and Nelfinavir Inhibit CYP2B6 Activity in Vitro: Potential Drug
Interactions with Bupropion.
Hesse LM, von Moltke LL, Shader RI, Greenblatt DJ 
Drug Metab Dispos 2001 Feb 1;29(2):100-102
Abstract

RTV/Buspirone

  Pseudo-Parkinson disease secondary to ritonavir-buspirone interaction.
 Clay PG, Adams MM. 
Ann Pharmacother 2003 Feb;37(2):202-5
 Abstract		  

RTV/Carbamazepine

  Protease inhibitor-induced carbamazepine toxicity.
Berbel Garcia A, Latorre Ibarra A, Porta Etessam J, M., et al.
Clin Neuropharmacol 2000 Jul-Aug;23(4):216-8  
 Abstract
 
Corticosteroids/RTV
 
  Iatrogenic Cushing's syndrome and secondary adrenal insufficiency after a single intra-articular administration of
triamcinolone acetonide in HIV-infected patients treated with ritonavir.
 Yombi JC, Maiter D, Belkhir L. al 
Clin Rheumatol. 2008 Oct 1
 Abstract
 
RTV/Digoxin
 
  Substantial pharmacokinetic interaction between digoxin and ritonavir in healthy
volunteers.
 Ding R, Tayrouz Y, Riedel KD, et al 
Clin Pharmacol Ther. 2004 Jul;76(1):73-84.
Abstract
 
RTV/Docetaxel
 
  Coadministration of Ritonavir Strongly Enhances the Apparent Oral Bioavailability of
Docetaxel in Patients with Solid Tumors.
 Oostendorp RL, Huitema A, Rosing H, et al 
Clin Cancer Res. 2009 Jun 9.
 Abstract

RTV/Elvucitabine
 
  The Effect of a Single Dose  of Elvucitabine, a Nucleoside Reverse Transcriptase Inhibitor, when Administered
in Healthy Volunteers
 Colucci P, Pottage JC, Robison H, et al
Antimicrob Agents Chemother. 2008 Nov 17.
 Abstract
 
RTV/Enfuvirtide
 
  Lack of Interaction between Enfuvirtide and Ritonavir or Ritonavir-Boosted Saquinavir in
HIV-1-Infected Patients.
 Ruxrungtham K, Boyd M, Bellibas SE, et al    
 J Clin Pharmacol. 2004 Jul;44(7):793-803.
 Abstract

RTV/Fentanyl

  Ritonavir's role in reducing fentanyl clearance and prolonging its half-life.
Olkkola KT, Palkama VJ, Neuvonen PJ
Anesthesiology 1999 Sep;91(3):681-5  
Abstract

RTV/Fluoxetine

  Inhaled Fluticasone Causes Iatrogenic Cushing's Syndrome in Patients Treated with Ritonavir.
Mahlab-Guri K, Asher I, Gradstein S,  et al
J Asthma. 2011 Oct;48(8):860-3.
 Abstract

FULL-TEXT ARTICLE
Effect of fluoxetine on pharmacokinetics of ritonavir.
Ouellet D, Hsu A, Qian J, Lamm JE, et al.
Antimicrob Agents Chemother 1998 Dec;42(12):3107-12
 Paper
 

  
RTV/Fosamprenavir
 
  Ritonavir Increases Plasma Amprenavir (APV) Exposure to a Similar Extent when Coadministered
with either Fosamprenavir or APV.
 Wire MB, Baker KL, Jones LS, et al 
Antimicrob Agents Chemother. 2006 Apr;50(4):1578-80.
 Abstract 
RTV/Indinavir
 
  Effects of Ritonavir on Indinavir Pharmacokinetics in Cerebrospinal Fluid
and Plasma.
 Haas DW, Johnson B, Nicotera J, et al
Antimicrob Agents Chemother. 2003 Jul;47(7):2131-2137.
 Abstract 
 
RTV/Mebendazole
 
  Effect of ritonavir on the pharmacokinetics of the benzimidazoles albendazole
and mebendazole: an interaction study in healthy volunteers.
 Corti N, Heck A, Rentsch K, et al
Eur J Clin Pharmacol. 2009 Jun 27.
 Abstract

RTV/Meperidine
 

  The effect of ritonavir on the pharmacokinetics of meperidine and normeperidine.
Piscitelli SC, Kress DR, Bertz RJ, et al.
Pharmacotherapy 2000 May;20(5):549-53
Abstract 
 
RTV/Methadone
 
  Mechanism of Ritonavir Changes in Methadone Pharmacokinetics and Pharmacodynamics:
II. Ritonavir Effects on CYP3A and P-Glycoprotein Activities.
 Kharasch E, Bedynek P, Walker A, Whittington D, Hoffer C.  
 Clin Pharmacol Ther. 2008 Jul 9.
 Abstract
 
  Mechanism of Ritonavir Changes in Methadone Pharmacokinetics and Pharmacodynamics:
I. Evidence Against CYP3A Mediation of Methadone Clearance.
 Kharasch E, Bedynek P, Park S, et al
 Clin Pharmacol Ther. 2008 Jul 9.
 Abstract 

RTV/Nelfinavir
  Complex Drug Interactions of HIV Protease Inhibitors 2: In Vivo Induction and In Vitro to In Vivo
Correlation of Induction of Cytochrome P450 1A2, 2B6 and 2C9 by Ritonavir or Nelfinavir.
 Kirby BJ, Collier AC, Kharasch ED,  et al
Drug Metab Dispos. 2011 Sep 19
 Abstract

Complex Drug Interactions of HIV Protease Inhibitors 1: Inactivation, Induction and Inhibition
of Cytochrome P450 3A by Ritonavir or Nelfinavir.
 Kirby BJ, Collier AC, Kharasch ED,  et al
Drug Metab Dispos. 2011 Mar 15
 Abstract

Low-dose ritonavir moderately enhances nelfinavir exposure.
 Kurowski M, Kaeser B, Sawyer A, et al.
 Clin Pharmacol Ther 2002 Aug;72(2):123-32
 Abstract 
RTV/Normeperidine
 
  The effect of ritonavir on the pharmacokinetics of meperidine and normeperidine.
 Piscitelli SC, Kress DR, Bertz RJ, et al.
Pharmacotherapy 2000 May;20(5):549-53 
Abstract 
 
RTV/Olanzapine
 
  Influence of Ritonavir on Olanzapine Pharmacokinetics in Healthy
Volunteers.
Penzak SR, Hon YY, Lawhorn WD, et al.
 J Clin Psychopharmacol 2002 Aug;22(4):366-370
 Abstract 
 		  
RTV/Prednisone
 
  Prednisolone Pharmacokinetics in the Presence and Absence of Ritonavir After Oral
Prednisone Administration to Healthy Volunteers.
Penzak SR, Formentini E, Alfaro RM, et al
J Acquir Immune Defic Syndr. 2005 Dec 15;40(5):573-580
 Abstract 
 
RTV/Risperidone
  Reversible coma caused by risperidone-ritonavir interaction.
Jover F, Cuadrado JM, Andreu L, Merino J.  
 Clin Neuropharmacol 2002 Sep-Oct;25(5):251-3
 Abstract 

Extrapyramidal Symptoms with Ritonavir/Indinavir plus Risperidone.
Kelly DV, Beique LC, Bowmer MI..
Ann Pharmacother 2002 May;36(5):827-30
 Abstract 
 

  
RTV/Sildenafil
 
  Interaction of sildenafil and indinavir when co-administered to HIV-positive
patients. 
 Merry C, Barry MG, Ryan M, et al.
AIDS 1999 Oct 22;13(15):F101-7
Abstract
 
 

RTV/Tacrolimus
 
  Significant interaction of tacrolimus with ritonavir during allogeneic hematopoietic SCT
in an HIV-infected patient.
Miceli M, Cronin S, Ayash L
 Bone Marrow Transplant. 2011 Nov 28
 Abstract
 

RTV/Trazodone
 
  Short-term exposure to low-dose ritonavir impairs clearance and enhances
adverse effects of trazodone.
 Greenblatt DJ, von Moltke LL, Harmatz JS
Clin Pharmacol 2003 Apr;43(4):414-22
 Abstract
 
RTV/Triamcinolone
 
 

Metabolic derangement after injection of triamcinolone into the hip of an HIV-infected patient
receiving ritonavir.
 Danaher PJ, Salsbury TL, Delmar JA. 
Orthopedics. 2009 Jun;32(6):450
 Abstract

FULL-TEXT PDF ARTICLE
 Adrenal suppression due to an interaction between ritonavir and injected triamcinolone:
a case report.
 Ramanathan R, Pau AK, Busse KH, et al 
Clin Infect Dis. 2008 Nov 7.
Paper
 
RTV/Triazolam
 
  Differential impairment of triazolam and zolpidem clearance by ritonavir.
Greenblatt DJ, von Moltke LL, Harmatz JS, et al.
J Acquir Immune Defic Syndr 2000 Jun 1;24(2):129-36  
Abstract 
 
RTV/Vinblastine
 
  Detrimental clinical interaction between ritonavir-boosted protease inhibitors
and vinblastine in HIV-infected patients with Hodgkin's lymphoma.
 Cingolani A, Torti L, Pinnetti C,  et al
AIDS. 2010 Jul 27.
Abstract 
 
RTV/Zaleplon
 
  Clinically important drug interactions with zopiclone, zolpidem and
zaleplon.
 Hesse L, Von Moltke L, Greenblatt D.
CNS Drugs 2003;17(7):513-32
 Abstract 
 
RTV/Zolpidem
 
 
Differential impairment of triazolam and zolpidem clearance by ritonavir.
Greenblatt DJ, von Moltke LL, Harmatz JS, et al
J Acquir Immune Defic Syndr 2000 Jun 1;24(2):129-36  
Abstract 
 
Clinically important drug interactions with zopiclone, zolpidem and
zaleplon.
 Hesse L, Von Moltke L, Greenblatt D.
CNS Drugs 2003;17(7):513-32
 Abstract 
 
RTV/Zopiclone
 
Clinically important drug interactions with zopiclone, zolpidem and
zaleplon.
 Hesse L, Von Moltke L, Greenblatt D.
CNS Drugs 2003;17(7):513-32
 Abstract 
 
RTV/SQV/Ketoconazole
 
  Effect of ketoconazole on ritonavir and saquinavir concentrations in plasma and
cerebrospinal fluid from patients infected with human immunodeficiency virus.
Khaliq Y, Gallicano K, Venance S,et al.
Clin Pharmacol Ther 2000 Dec;68(6):637-46
Abstract

 
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