Ritomune 100mg

Ritomune 100mg Tablet (Ritonavir 100mg)

Description

Ritomune 100mg contains Ritonavir, a peptidomimetic HIV protease inhibitor active against both HIV-1 and HIV-2.

• Ritonavir exhibits antiretroviral activity by inhibiting HIV protease enzymes, preventing the maturation of infectious viral particles.

• It is frequently used in combination with other antiretroviral drugs to enhance therapy and reduce viral resistance.

• Ritonavir is also a CYP3A inhibitor, boosting plasma concentrations of co-administered protease inhibitors.

Medical Uses / Indications

• Treatment of HIV-1 infection in adults and children, in combination with other antiretroviral medications.

Mechanism of Action

• Ritonavir inhibits HIV protease, an enzyme responsible for processing viral polyproteins (Gag and Pol), which are critical for producing mature viral particles.

• Gag proteins: structural components of the virus (core and nucleocapsid).

• Pol proteins: include reverse transcriptase, integrase, and protease enzymes.

• Inhibition leads to immature, non-infectious viral particles, stopping viral replication.

Side Effects

Common:

• Edema, gout, dyslipidemia (increased cholesterol and triglycerides)

• Abdominal pain, nausea, vomiting, dyspepsia, flatulence

• Fat redistribution (lipodystrophy), rash, pruritus, acne

Serious / Rare:

• Liver toxicity, hepatitis, pancreatitis

• Allergic/hypersensitivity reactions, Stevens–Johnson syndrome, epidermal necrolysis

• Cardiovascular problems, hypertension

• Arthralgia, myopathy, myalgia

• GI hemorrhage, gastroesophageal reflux disease

• Cushing’s syndrome

Precautions

• Drug interactions: Serious interactions with CYP3A inducers/inhibitors.

• Hepatic toxicity and pancreatitis: Monitor liver function.

• Metabolic effects: Diabetes mellitus, lipid disorders.

• Immune reconstitution syndrome and fat redistribution may occur.

• Hemophilia: May increase bleeding risk.

• Patients should receive supportive care, counseling, and regular monitoring.

Drug Interactions

• Increases plasma levels of co-administered CYP3A-metabolized drugs.

• Boosts HIV protease inhibitors but may decrease integrase inhibitors’ effect.

• Interacts with analgesics, anti-cancer drugs, anti-arrhythmics, warfarin, anticonvulsants, and antidepressants, altering their plasma levels.

Overdose

• No specific antidote; provide supportive care and monitor symptoms.

• Hemodialysis is not effective due to high plasma protein binding.

Pregnancy & Lactation

• Pregnancy Category C: Use only if benefits outweigh risks.

• Breastfeeding: Not recommended; may transmit HIV to the baby.

Dosage

Adults:

• Typical dose: 600mg orally twice daily.

• Initiate at 300mg twice daily, increase by 100mg every 2–3 days until reaching 600mg.

Pediatrics:

• For children >1 month: 350–400 mg/m² twice daily, max 600 mg.

• Initial dose: 250 mg/m² twice daily, increase by 50 mg/m² every 2–3 days.

• Adjust dose when combined with atazanavir, darunavir, fosamprenavir, saquinavir, or tipranavir.

Administration: Oral, with or without food, as prescribed.

Storage

• Store below 30°C, in a dry place, protected from heat, moisture, and light.

Missed Dose

• Contact your physician for guidance.

• Take missed dose as soon as possible unless it is near the next scheduled dose; do not double doses.