Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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Pharmacoenhancers

Ritonavir (Norvir, RTV)

Last Updated: December 7, 2018; Last Reviewed: December 7, 2018

Excerpt from Table 10a
Generic Name
(Abbreviation)
Trade Name
Formulation Dosing Recommendations Use in Pregnancy
Ritonavir
(RTV)
Norvir
RTV (Norvir) 
Capsules:
  • RTV 100 mg
Tablets:
  • RTV 100 mg
Oral Solution:
  • RTV 80 mg/mL
Powder:
  • RTV 100 mg/sachet
Standard Adult Dose as PK Booster for Other PIs:
  • RTV 100–400 mg per day in 1–2 divided doses (refer to other PI sections for specific dosing recommendations)
Tablet:
  • Take with food.
Capsule or Oral Solution:
  • To improve tolerability, recommended to take with food if possible.

PK in Pregnancy:
  • Lower levels during pregnancy compared with postpartum.

Dosing in Pregnancy:
  • No dosage adjustment necessary when used as booster.
Low placental transfer to fetus.b

No evidence of human teratogenicity (can rule out 1.5-fold increase in overall birth defects).

Should only be used as low-dose booster for other PIs.

Oral solution contains 43% alcohol and is therefore not recommended during pregnancy, because there is no known safe level of alcohol exposure during pregnancy.

a Individual ARV drug dosages may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Guidelines Appendix B, Table 8).
b Placental transfer categories are determined by mean or median cord blood/maternal delivery plasma drug ratio:
          High: >0.6
          Moderate: 0.3–0.6
          Low: <0.3

Key to Acronyms: PI = protease inhibitor; PK = pharmacokinetic; RTV = ritonavir

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