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Article: Ritonavir: 25 Years' Experience of Concomitant Medication Management. A Narrative Review.

Quercia, Romina / Di Perri, Giovanni / Pein, Carolina / Bodie, Jennifer / Singh, Ravi Shankar P / Hendrick, Victoria / Boffito, Marta

Infectious diseases and therapy

2024  

Abstract: Ritonavir is a potent inhibitor of the cytochrome P450 3A4 enzyme and is commonly used as a pharmacokinetic (PK) enhancer in antiviral therapies because it increases bioavailability of concomitantly administered antivirals. Decades of experience with ... ...

Abstract Ritonavir is a potent inhibitor of the cytochrome P450 3A4 enzyme and is commonly used as a pharmacokinetic (PK) enhancer in antiviral therapies because it increases bioavailability of concomitantly administered antivirals. Decades of experience with ritonavir-enhanced HIV therapies and, more recently, COVID-19 therapies demonstrate that boosting doses of ritonavir are well tolerated, with an established safety profile. The mechanisms of PK enhancement by ritonavir result in the potential for drug-drug interactions (DDIs) with several classes of drugs, thus making co-medication management an important consideration with enhanced antiviral therapies. However, rates of DDIs with contraindicated medications are low, suggesting these risks are manageable by infectious disease specialists who have experience with the use of PK enhancers. In this review, we provide an overview of ritonavir's mechanisms of action and describe approaches and resources available to mitigate adverse events and manage concomitant medication in both chronic and short-term settings.
Language English
Publishing date 2024-04-12
Publishing country New Zealand
Document type Journal Article ; Review
ZDB-ID 2701611-0
ISSN 2193-6382 ; 2193-8229
ISSN (online) 2193-6382
ISSN 2193-8229
DOI 10.1007/s40121-024-00959-6
Database MEDical Literature Analysis and Retrieval System OnLINE

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