Ritomune

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BRAND :  RITOMUNE PRICE :  50$ STRENGTH : 100MG ACTIVE :  RITOMUNE-RITONAVIR-100MG COMPANY NAME :  CIPLA TABLETS :  60 TABLETS read more

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Drug profile of Ritomune 100mg

Ritomune tablets are anti-retroviral medication which containing an active moiety known as Ritonavir.

Ritomune is classified as HIV protease inhibitor drug, which is peptidomimetic agent containing both HIV-1 & HIV-2 protease inhibitor activity.

Ritomune is also a CYP3A inhibitor.

Ritomune is exhibits anti-retroviral activity by interceding with reproductive cycles of HIV.

Brand name: Ritomune

Active substance: Ritonavir

Strength: 100Mg

Mfg: Cipla

Pack: 60 tablets in a container

Category: Anti-retroviral drug

 

Prescribing information of Ritomune 100mg

Ritomune tablets are widely used for treating HIV-1 infection by combining with other anti-retroviral medications.

Mechanism of Ritomune 100mg

HIV protease enzymes which is involves in separation of structural & multiplicative proteins that may produce from major HIV genes, like gag & pol. This activity of enzyme should be reduced due to inhibiting the protease enzyme by ritonavir, an active substance of Ritomune tablets.

Gal: conceal the proteins complicated in core & nucleocapsid.

Pol: conceal the reverse transcriptase, ribonuclease H, integrase & protease.

The separation of gal-pal polyprotein should be prevented by ritonavir which leads to production of immature and non infectious viral particles.

Absorption

 The maximum plasma concentration time of ritonavir after the dose administration, causes within 2 hours & 4 hours relatively in both fasted & non fasted state.

Food will decrease the bioavailability slightly.

Cmax value 0.84ng/ml plus or minus 0.39ng/ml

Cmin value: 6.6ng/ml.hr plus or minus 2.4ng/ml.hr

Distribution

Volume of distribution is 20 to 40L

CSF Plasma ratio 0.52

Semen plasma ratio <0.04

Nearly 98 to 99% of drug ritonavir is binds to human plasma protein.

Metabolism

Isopropylthiazole oxidation is the major metabolite of ritonavir and it is similar in action of ritonavir.

CYP3A is a major isoenzymes involved in the metabolism of ritonavir.

Excretion

The excretion of ritonavir should be occurs through urine & feces as an unchanged form

The terminal half life period is 3 to 5 hours

When to take the Ritomune 100mg

Ritomune tablets should be taken with meals, do not crush, chew or broke the tablets.

Ritomune should be combined with other anti-retroviral drugs.

Dosage regimens of Ritomune 100mg

The prescribed doses of Ritomune for adults are;

600mg should be administered orally as two times a day.

Ritomune tablets should be initiated by not less than 300mg as two times a day followed by increased dose at 2 to 3 days by 100mg as twice daily.

The maximum dose is 600mg and it should not be exceeded.

For pediatric;

Ritomune should be used by combining with other antiretroviral drugs.

The prescribed dose of Ritomune is 350 to 400mg/m2 as two times a day for pediatric patients with age of older than 1 month.

The dose should not be exceeded to 600mg

The initial dose of Ritomune is 250mg/m2 two times day and increased at 2 to 3 days interal by 50mg/m2 as two times a day.

Depending on body surface area, the dose should be calculated.

Dose reduction is required when Ritomune is combined with atazanavir, darunavir, fosamprenavir, saquinavir & tipranavir.

Ritomune 100mg caused side effects

Drugs interactions

Liver toxicity

Pancreatitis

Allergic reactions

Blurred vision

Abdominal pain

Dyspepsia

Flatulence

GI hemorrhage

Gastro esophageal reflux disease

Nausea

Vomiting

Fatigue

Increased bilirubin

Hepatitis

Hypersensitivity reactions

Edema

Gout

Increased cholesterol

Increased triglycerides

Lipodystrophy

Arthralgia

Myopathy

Myalgia

Dizziness

Paresthesia

Syncope

Confusion

Elevation in urination

Acne

Pruritus

Rash

Flushing

Hypertension

Hematocrit

Decreased hemoglobulin

Neutropenia

Dehydration

Cushing’s syndrome

Cardiac problems

Epidermal necrolysis

Drug- drug interaction

Ritomune with drugs which are metabolized by CYP3A causes increasing the plasma concentration of these agents.

Ritomune with HIV-1 protease inhibitors causes increasing effect of concentration of these drugs.

Ritomune with integrase inhibitors, causes decreasing the effect of concentration of these drugs.

Ritomune with analgesic causes increasing concentration of analgesics.

Ritomune with anti-cancer or anti-arrhythmic drugs causes increasing the effect of concentration of these drugs.

Ritomune with warfarin causes either decreasing or increasing the concentration of warfarin.

Ritomune with anti-convulsants, anti-depressants causes increasing in concentration of these drugs.

Ritomune with anti-fungal, anti-infective, anti-gout, causes increasing the concentration of these drugs.

Ritomune with cardiovascular drugs, causes increasing in concentration of CVS drugs.

Ritomune with lipid lowering drugs causes increasing the concentration of these drugs.

Food drug interaction

Ritomune tablets should be administered with food, causes diminishing the gastrointestinal side effects.

Possible contraindications

Ritomune should be contraindicated to hypersensitivity acquired patients.

Some drugs are contraindicated to ritonavir;

Alfuzosin, ranolazine, anti-arrhythmia, voriconazole, colchicines, anti-psychotics, ergot derivatives, Cisapride, st. John’s wort, lovastatin, simvastatin, sildenafil, Midazolam

Safety measures

Serious adverse reactions may occur due to drug interactions like

Ritomune with CYP3A inducers or inhibitors

 Hepatic toxicity

Pancreatitis

Allergic reactions

PR interval extension

Lipid disorders

Diabetes mellitus

Immune reconstitution syndrome

Fat redistribution

Hemophilia

Cross resistance

These are all some serious effects occurred during the therapy with Ritomune, to over come the problems patients must be;

Provide with supportive measures

Counsel about the adverse effect before starting the treatment

In severe condition, stop the treatment.

Maintain the lab value

Patient should be frequently monitoring with the signs & symptoms associated to particular effects.

Pregnancy and lactation

Pregnancy category C

Ritomune should not be used in pregnancy & lactating period.

Generally HIV infected women should not undergo breast feeding, for avoiding the spreadness of disease to baby.

Storage and handling

Ritomune tablet container should be stored on below 30oC

Keep the container away from heat, moisture & light.

Missed dose

Patient must get advice from physician to avoid the over dosage problem, in case of missed dose.

Follow the regular dosing schedule prescribed by physician.

Over dosage

Providing supportive measure to the patient with over dosage of ritonavir

Monitor the manifestation associated to over dosage condition of Ritomune.

No special antidote is required for over dosage

Gastric lavage or emesis should be used in patient for eliminating the ritonavir content from the body

Activated charcoal is used to adsorbed the ritonavir content occurred in the body.

Ritonavir is intensively metabolized and largely binds to human plasma protein so hemodialysis process is not valuable for over dosage of ritonavir.

 

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