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The safety and warning information below is essential for understanding the potential risks associated with the use of ritonavir (Norvir). Please read these points carefully and consult your healthcare provider with any concerns.

• Medication Interactions: Some drugs may interfere with the elimination of ritonavir from your body, affecting its effectiveness and the likelihood of side effects.

• Liver Health: Ritonavir can cause severe liver problems, especially within the initial three months of treatment. Regular blood tests are necessary to monitor liver function. Seek medical advice if you experience symptoms like drowsiness, nausea, appetite loss, light-colored stools, upper right abdominal pain, jaundice, or dark urine. This risk is higher for individuals with Hepatitis B or C or a history of liver issues.

• Pancreatic Concerns: Although rare, ritonavir use has been linked to pancreatitis, particularly in those with high triglycerides or advanced HIV. Discontinue use and contact your provider if you experience upper stomach pain, fever, nausea, or vomiting.

• Heart Rhythm Issues: Ritonavir may cause serious heart rhythm disturbances. Those with certain pre-existing conditions or who are on medications affecting heart rhythm, such as digoxin, are at greater risk. Seek immediate medical help if you experience palpitations, breathlessness, chest pain, or dizziness.

• Allergic Reactions: Severe skin and allergic reactions can occur. Continue medication with a mild rash but contact your provider if it worsens. Discontinue and seek medical help immediately for severe rashes with fever, discomfort, muscle or joint pain, sores, blisters, or facial swelling.

• Blood Sugar Levels: Ritonavir can increase blood sugar levels or exacerbate diabetes. Inform your provider if you have a diabetes history; your diabetes medication dosage may need adjustment.

• Cholesterol Levels: Ritonavir may elevate cholesterol and triglycerides, increasing cardiovascular risk. Regular monitoring is essential, and certain cholesterol medications should be avoided. Inform your provider of all current medications.

• Body Fat Changes: Rarely, changes in body fat distribution occur with HIV medications like ritonavir. Report any such changes to your provider.

• Immune System Activity: Combination therapy with ritonavir may cause an overactive immune response, leading to immune reconstitution syndrome or autoimmune conditions. Report new symptoms such as fever, pain, hair loss, bulging eyes, or sweating promptly.

• Bleeding Risk: Individuals with bleeding disorders like hemophilia may experience increased bleeding. Notify your provider if you notice unusual or persistent bleeding.

• Newborn Safety (Oral Solution): The oral solution contains ethanol and propylene glycol, posing risks to premature infants. Seek immediate medical attention for breathing difficulties, dizziness, lack of appetite, nausea, or vomiting in affected infants.

Contraindications: Ritonavir should not be used with certain medications metabolized by the liver enzyme CYP3A4, such as alfuzosin, dronedarone, lovastatin, and simvastatin, due to serious health risks. Always consult your provider if these apply to you.

When taking this medication, some individuals may experience common side effects that are typically mild. These include diarrhea, nausea, a pins and needles sensation, and feelings of weakness or fatigue. Elevated cholesterol levels, vomiting, rash, abdominal pain, and coughing may also occur. Additionally, some people report back and joint pain, throat pain, dizziness, changes in taste, flushing, indigestion, itching, and nerve pain. While these side effects are often manageable, it's important to consult a healthcare provider if they persist or worsen.

There are other side effects that have been reported, which may vary in severity. These include excessive gas, blurry vision, heartburn, swelling, muscle pain, a spinning sensation, changes in attention, increased urination, and feeling cold in the extremities. Some individuals may also experience acne. While these side effects are usually less severe, it is advisable to seek medical advice if they become bothersome.

Serious side effects, although rare, require immediate medical attention. These include severe allergic reactions characterized by facial swelling, hives, itchy skin, blistering or peeling skin, body aches, and breathing difficulties. Serious liver problems may present as nausea, vomiting, loss of appetite, pain on the right side of the abdomen, yellowing of the eyes or skin, dark urine, and light-colored stools. Abnormal heart rhythms, indicated by chest pounding, difficulty breathing, chest pain, faintness, or lightheadedness, also warrant urgent care. If you experience any of these symptoms, seek medical help immediately.