Ritonavir drug interactions | Litt's Drug Eruption and Reaction Database

Ritonavir

TRADE NAMES: Kaletra (AbbVie); Norvir (AbbVie)
INDICATIONS: HIV infection
CLASS: Antiretroviral, CYP3A4 inhibitor, HIV-1 protease inhibitor
HALF-LIFE: 3–5 hours

CLINICALLY IMPORTANT, POTENTIALLY HAZARDOUS INTERACTIONS WITH:

Abiraterone, Afatinib, Alfentanil, Alfuzosin, Alprazolam, Amiodarone, Amitriptyline, Amprenavir, Aprepitant, Astemizole, Atazanavir, Atorvastatin, Atovaquone, Atovaquone/Proguanil, Avanafil, Azithromycin, Bepridil, Boceprevir, Bosentan, Brigatinib, Buprenorphine, Bupropion, Buspirone, Cabazitaxel, Cabozantinib, Calcifediol, Carbamazepine, Ceritinib, Chlordiazepoxide, Ciclesonide, Citalopram, Clozapine, Cobicistat/Elvitegravir/Emtricitabine/Tenofovir Disoproxil, Colchicine, Conivaptan, Copanlisib, Crizotinib, Cyclosporine, Cyproterone, Darifenacin, Dasatinib, Deferasirox, Delavirdine, Diazepam, Diclofenac, Dihydroergotamine, Docetaxel, Dronedarone, Dutasteride, Efavirenz, Eletriptan, Eluxadoline, Ergot alkaloids, Ergotamine, Erlotinib, Estazolam, Estradiol, Eszopiclone, Etravirine, Everolimus, Ezetimibe, Fentanyl, Fesoterodine, Flecainide, Flibanserin, Flurazepam, Fluticasone Propionate, Fosamprenavir, Glecaprevir & Pibrentasvir, Halazepam, Indacaterol, Isavuconazonium Sulfate, Itraconazole, Ivabradine, Ixabepilone, Ketoconazole, Lapatinib, Ledipasvir & Sofosbuvir, Levomepromazine, Levothyroxine, Lomitapide, Lumateperone, Macitentan, Maraviroc, Meloxicam, Meperidine, Meptazinol, Methylergonovine, Methysergide, Midazolam, Midostaurin, Mifepristone, Naldemedine, Nelfinavir, Neratinib, Nifedipine, Nilotinib, Olaparib, Oliceridine, Oral Contraceptives, Osimertinib, Paclitaxel, Palbociclib, Paroxetine Hydrochloride, Pazopanib, Phenytoin, Pimozide, Piroxicam, Pitavastatin, Ponatinib, Posaconazole, Propafenone, Propoxyphene, Propranolol, Quazepam, Quinidine, Quinine, Ranolazine, Ribociclib, Rifabutin, Rifampin, Rifapentine, Rilpivirine, Rimonabant, Risperidone, Rivaroxaban, Romidepsin, Rosuvastatin, Ruxolitinib, Saquinavir, Sildenafil, Silodosin, Simeprevir, Simvastatin, Sofosbuvir, Sofosbuvir/Velpatasvir/Voxilaprevir, Solifenacin, St John's Wort, Sunitinib, Tadalafil, Telaprevir, Telithromycin, Temsirolimus, Tenofovir Disoproxil, Ticagrelor, Tolvaptan, Trabectedin, Triazolam, Ulipristal, Vardenafil, Vemurafenib, Venetoclax, Vorapaxar, Voriconazole, Zolpidem, Zuclopenthixol

PREGNANCY CATEGORY: B

Under investigation for treating COVID-19

See adverse reactions attributed to class:

Antiretroviral

HIV-1 protease inhibitor

NOTE

Protease inhibitors cause dyslipidemia which includes elevated triglycerides and cholesterol and redistribution of body fat centrally to produce the so-called 'protease paunch', breast enlargement, facial atrophy, and 'buffalo hump'.

Kaletra is ritonavir and lopinavir.

See also separate entry for ombitasvir/paritaprevir/ritonavir.

BLACK BOX WARNING

DRUG-DRUG INTERACTIONS LEADING TO POTENTIALLY SERIOUS AND/OR LIFE-THREATENING REACTIONS

See full prescribing information for complete boxed warning.

Skin

Acneiform eruption / acneiform dermatitis / acneiform rash 4%

(package insert)

Allergic granulomatous angiitis / Eosinophilic Granulomatosis with Polyangiitis (EGPA) / Churg-Strauss syndrome (see also anti-neutrophil cytoplasmic antibody (ANCA) vasculitis (angiitis)

(2002): Kawsar M+, Int J STD AIDS 13(4), 273

Bruise / bruising / contusion / ecchymosis (ecchymoses) <2%

(package insert)

Bullous dermatosis <2%

(package insert)

Cold extremities 1%

(package insert)

Cutaneous toxicity / skin toxicity

(2012): Dal Verme A+, Medicina (B Aires) (Spanish) 72(6), 475 (with ergotamine)

(2011): Acle S+, Rev Med Chil (Spanish) 139(12), 1597 (3 cases) (with ergotamine)

Dermatitis <2%

(2005): Calista D, Eur J Dermatol 15(2), 97 (with lopinavir)

Diaper rash

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5712% (with fosamprenavir)

Diaphoresis (see also hyperhidrosis) <10%

(package insert)

DRESS syndrome

(2014): Almudimeegh A+, Br J Dermatol 171(4), 895 (with adiazine, levetiracetam, pyrimethamine and HAART)

Eczema / eczematous reaction / eczematous eruption <2%

(package insert)

Edema / fluid retention (see also peripheral edema) 6%

(package insert)

Exanthems <2%

(2005): Calista D+, Eur J Dermatol 15(2), 97 (with lopinavir)

(1997): Bachmeyer C+, Dermatology 195, 301 (2 cases) (HIV patients)

Facial edema 8%

(package insert)

Flushing / rubefaction 13%

(package insert)

Folliculitis <2%

(package insert)

Hypersensitivity 8%

(package insert)

Impetigo

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5712% (with fosamprenavir)

Jaundice 1%

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, lopinavir and zidovudine)

(2011): Song I+, Br J Clin Pharmacol 72(1), 103 (ocular / with atazanavir)

(2010): Squires KE+, HIV Clin Trials 11(2), 6913% (with atazanavir and abacavir/lamivudine)

Lesions

(2014): Spagnuolo V+, J Int AIDS Soc 17(4 Suppl 3), Epub (with atazanavir)

Lipodystrophy

(2016): Antinori A+, Drug Des Devel Ther 10, 1589 (with darunavir)

(2015): Putcharoen O+, Drug Des Devel Ther 9, 5763 (passim)

(2002): Reid S, Can Adv Drug Reaction Newsletter 12, 5

(2001): van der Valk M+, AIDS 15(7), 847

Peripheral edema (see also edema) 6%

(package insert)

Photosensitivity <2%

(package insert)

Pruritus (itching) 12%

(package insert)

Psoriasis <2%

(package insert)

Rash 27%

(2016): Antinori A+, Drug Des Devel Ther 10, 1589 (with darunavir)

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, lopinavir and zidovudine)

(2014): Cai J+, Chin Med J (Engl) 127(14), 263269% (with lamivudine, lopinavir and zidovudine)

(2014): Lin KY+, J Infect Chemother 20(8), 465 (with darunavir)

(2014): Nishijima T+, J Infect Chemother 20(4), 28511% (with darunavir)

(2014): Santini-Oliveira M+, Expert Opin Drug Saf 13(12), 1623 [REVIEW] (with lopinavir)

(2012): Santos JR+, PLoS One 7(5), e37442 (with darunavir)

(2012): Smith KY+, J Natl Med Assoc 104(7-8), 366 (with darunavir)

(2010): Currier J+, Ann Intern Med 153(6), 349 (with darunavir)

(2010): Squires KE+, HIV Clin Trials 11(2), 69 (with atazanavir and abacavir/lamivudine)

(2008): Borras-Blasco J+, J Antimicrob Chemother 62(5), 879 (with lopinavir)

(2005): Calista D, Eur J Dermatol 15(2), 97 (with lopinavir)

Seborrhea <2%

(package insert)

Seborrheic dermatitis

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5712% (with fosamprenavir)

Urticaria / hives 8%

(package insert)

Xanthomas

(2005): Brown CA+, J Am Acad Dermatol 52(5 Suppl 1), S86

(2004): Geyer AS+, Arch Dermatol 140(5), 617

Xerosis <2%

(package insert)

Hair

Alopecia / hair loss

(2003): Bongiovanni M+, Dermatol Online J 9(5), 28 (with lopinavir)

(2002): Ginarte M+, AIDS 16(12), 1695 (with indinavir)

Alopecia areata

(2014): Kim HS+, Infect Chemother 46(2), 103 (with atazanavir / indinavir / lopinavir)

Nails

Nail pigmentation

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, lopinavir and zidovudine)

Onychocryptosis

(2001): James CW+, Ann Pharmacother 35(7), 881 (with indinavir)

Mucosal

Cheilitis (inflammation of the lips) <2%

(2000): Bonfanti P+, J Acquir Immune Defic Syndr 23(3), 236

Gingivitis <2%

(package insert)

Macroglossia

(2005): Vritsali E+, J Oral Pathol Med 34(1), 56 (with lopinavir)

Oral candidiasis <2%

(package insert)

Oral ulceration (see also aphthous stomatitis / aphthous ulcer / aphtha) <2%

(package insert)

Oropharyngeal pain 16%

(package insert)

Sialolithiasis

(2013): Le MP+, J Antimicrob Chemother 68(3), 727

Sialorrhea (ptyalism; hypersalivation)

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, lopinavir and zidovudine)

Tonsillitis

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5717% (with fosamprenavir)

Xerostomia (dry mouth) <2%

(package insert)

Cardiovascular

Arrhythmias

(2009): Chaubey SK+, Sex Health 6 (3), 254

Arterial occlusion

(2013): Collado Borrell R+, Farm Hosp (Spanish) 37(5), 426 (with ergotamine)

Bradycardia / sinus bradycardia

(2002): Kikuchi Y+, Clin Infect Dis 35(4), 488

Cardiotoxicity

(2014): Spagnuolo V+, J Int AIDS Soc 17(4 Suppl 3), Epub (with atazanavir)

(2009): McArthur MA+, Pediatr Infect Dis J 28(12), 1127 (in neonatal twins / with lopinavir)

Chest pain

(2014): Phillips M+, Int J STD AIDS 25(6), 461 (with atazanavir)

Hypertension 3%

(2006): Crane HM+, AIDS 20(7), 1019 (with lopinavir)

Hypotension 2%

(package insert)

Orthostatic hypotension 2%

(package insert)

QT interval prolonged / QT prolongation

(2011): Hunt K+, Ann Pharmacother 45(12), 1544 [REVIEW] (with saquinavir)

Sick sinus syndrome

(2013): Sasaki S+, Kansenshogaku Zasshi (Japanese) 87(5), 613 (2 cases) (with lopinavir)

Thrombophlebitis

(2000): Bonfanti P+, J Acquir Immune Defic Syndr 23(3), 236

Vasoconstriction

(2014): Ferry FR+, Rev Inst Med Trop Sao Paulo 56(3), 265 (with lopinavir and ergotamine)

Central Nervous System

Ageusia (taste loss) / taste disorder <2%

(package insert)

Anorexia

(2015): Tetteh RA+, BMC Public Health 15(1), 5736% (with lamivudine, lopinavir and zidovudine)

Confusion 3%

(package insert)

Dysgeusia (taste perversion) 16%

(package insert)

Fever (pyrexia)

(2015): Tetteh RA+, BMC Public Health 15(1), 5736% (with lamivudine, lopinavir and zidovudine)

Headache

(2017): Orrell C+, Lancet HIV 4(12), e53613% (with ataxanavir, emtricitabine and tenofovir disoproxil)

(2016): Cooper DA+, PLoS One 11(1), Epub39–40% (with tipranavir)

(2016): Fatkenheuer G+, HIV Med 17(6), 453 (with darunavir)

(2015): Molina JM+, Lancet HIV 2(4), e1275% (with darunavir)

(2015): Tetteh RA+, BMC Public Health 15(1), 57310% (with lamivudine, lopinavir and zidovudine)

(2014): Clotet B+, Lancet 383(9936), 222210% (with darunavir)

(2014): Kowdley KV+, N Engl J Med 370(3), 222 (with ABT-333, ABT-450 and ribavirin)

(2009): Arasteh K+, Antivir Ther 14(6), 8592% (with darunavir)

Hyperesthesia <2%

(package insert)

Impaired concentration 3%

(package insert)

Insomnia

(2015): Tetteh RA+, BMC Public Health 15(1), 5734% (with lamivudine, lopinavir and zidovudine)

(2014): Kowdley KV+, N Engl J Med 370(3), 222 (with ABT-333, ABT-450 and ribavirin)

Neurotoxicity

(2010): Winston A+, HIV Clin Trials 11(3), 16316% (with darunavir)

(2008): Durrieu G+, Presse Med (French) 37(6 Pt 1), 935 (55 cases)

Paresthesias 51%

(2001): Scully C+, Oral Dis 7(4), 205 [REVIEW]25% (circumoral / passim)

Parkinsonism

(2003): Clay PG+, Ann Pharmacother 37(2), 202 (with buspirone)

Parosmia <2%

(package insert)

Perioral paresthesias

(2001): McMahon D+, Antivir Ther 6(2), 105

Peripheral neuropathy 10%

(2013): Lorber M, J Int Assoc Provid AIDS Care 12(3), 162 [REVIEW] (with darunavir)

Restlessness

(2015): Tetteh RA+, BMC Public Health 15(1), 5734% (with lamivudine, lopinavir and zidovudine)

Seizures

(2003): Reuther LO+, Ugeskr Laeger 165(14), 1447 [REVIEW]

Somnolence (drowsiness)

(2015): Tetteh RA+, BMC Public Health 15(1), 5736% (with lamivudine, lopinavir and zidovudine)

Syncope / fainting 3%

(package insert)

Vertigo / dizziness 16%

(2015): Rattanapunya S+, Malar J 14(1), 400 (with artesunate, lopinavir and mefloquine)

(2015): Tetteh RA+, BMC Public Health 15(1), 5738% (with lamivudine, lopinavir and zidovudine)

Endocrine/Metabolic

Adrenal insufficiency (hypoadrenalism)

(2012): Yoganathan K+, Int J STD AIDS 23(7), 520 (with budesonide)

Alanine aminotransferase (ALT) increased

(2016): Cooper DA+, PLoS One 11(1), Epub7–22% (grade 3 or 4) Fatal Fatal (with tipranavir)

(2011): Gallien S+, J Antimicrob Chemother 66(9), 209918% (with raltegravir and tipranavir)

(2011): Neukam K+, J Antimicrob Chemother 66(11), 26058%

Appetite decreased

(2015): Tetteh RA+, BMC Public Health 15(1), 57310% (with lamivudine, lopinavir and zidovudine)

Aspartate aminotransferase (AST) increased

(2016): Cooper DA+, PLoS One 11(1), Epub3–10% (grade 3 or 4) Fatal Fatal (with ritonavir)

Cushing's syndrome

(2013): Eeftinck Schattenkerk JK+, Ned Tijdschr Geneeskd (Dutch) 157(14), a5509 (salmeterol/fluticasone or triamcinolonacetonide with atazanavir, emtricitabine, ritonavir and tenofovir)

(2013): Hall JJ+, Int J STD AIDS 24(9), 748 (with darunavir and triamcinolone)

(2013): John G+, AIDS 27(17), 2827 (with triamcinolone)

(2012): Albert NE+, Am J Med Sci 344(1), 72 (with epidural triamcinolone)

(2012): Yoganathan K+, Int J STD AIDS 23(7), 520 (with budesonide)

(2009): Dupont C+, Rev Mal Respir 26 (7), 779 (2 cases) (with fluticasone)

(2007): Bhumbra NA+, Ann Pharmacother 41(7), 1306 (with fluticasone and lopinavir)

Diabetes mellitus

(2014): Santini-Oliveira M+, Expert Opin Drug Saf 13(12), 1623 [REVIEW] (with lopinavir)

Gynecomastia

(2001): Manfredi R+, Ann Pharmacother 35(4), 438

(2000): Bonfanti P+, J Acquir Immune Defic Syndr 23(3), 236

Hyperbilirubinemia

(2018): Fabbiani M+, J Antimicrob Chemother Apr, Epub ahead of print67% (grade 3 or 4) Fatal Fatal (with atazanavir)

(2016): Subashini D+, Indian J Pharmacol 48(5), 582 (with atazanavir)

(2015): Le MP+, Antivir Ther 20(5), 507 (grade 3 / 1 case) Fatal (with atazanavir)

(2015): Rutstein RM+, Pediatr Infect Dis J 34(2), 162 (with atazanavir)

(2015): Strehlau R+, J Int AIDS Soc 18(1), Epub9% (grade 3 or 4) Fatal Fatal (with atazanavir)

(2013): Mora-Peris B+, J Antimicrob Chemother 68(6), 1348 (with darunavir and maraviroc)

Hypercholesterolemia 3%

(2016): Cooper DA+, PLoS One 11(1), Epub6–7% (grade 3 or 4) Fatal Fatal (with tipranavir)

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5719% (with fosamprenavir)

Hyperlipidemia

(2016): Antinori A+, Drug Des Devel Ther 10, 1589 (with darunavir)

(2015): Putcharoen O+, Drug Des Devel Ther 9, 5763 (passim)

Hypertriglyceridemia (includes triglycerides increased) 9%

(2018): Fabbiani M+, J Antimicrob Chemother Apr, Epub ahead of print7% (grade 3 or 4) Fatal Fatal (with atazanavir)

(2016): Cooper DA+, PLoS One 11(1), Epub5–8% (grade 3 or 4) Fatal Fatal (with tipranavir)

(2007): Chapman SJ+, AIDS 21(4), 532 (with tipranavir)

Hypophosphatemia

(2012): Pontrelli G+, BMC Infect Dis 12, 18 (4 cases) (with tenofovir)

Miscarriage

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, lopinavir and zidovudine)

Porphyria cutanea tarda

(2007): Celesia BM+, AIDS 21(11), 1495 (with tipranavir)

Serum creatinine increased

(2016): Subashini D+, Indian J Pharmacol 48(5), 582 (with atazanavir)

Gastrointestinal/Hepatic

Abdominal pain 26%

(2016): Cooper DA+, PLoS One 11(1), Epub13–14% (with tipranavir)

(2015): Tetteh RA+, BMC Public Health 15(1), 57314% (with lamivudine, lopinavir and zidovudine)

Diarrhea 68%

(2016): Antinori A+, Drug Des Devel Ther 10, 1589 (with darunavir)

(2016): Cooper DA+, PLoS One 11(1), Epub51% (with tipranavir)

(2015): Molina JM+, Lancet HIV 2(4), e12724% (with darunavir)

(2015): Strehlau R+, J Int AIDS Soc 18(1), Epub36% (with atazanavir)

(2015): Tetteh RA+, BMC Public Health 15(1), 57365% (with lamivudine, lopinavir and zidovudine)

(2014): Clotet B+, Lancet 383(9936), 222229% (with darunavir)

(2014): Clumeck N+, AIDS 28(8), 114315% (with lopinavir)

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5754% (with fosamprenavir)

(2013): Orkin C+, HIV Med 14(1), 495–11% (with darunavir or lopinavir)

(2012): Smith KY+, J Natl Med Assoc 104(7-8), 366 (with darunavir)

(2012): Wegzyn CM+, J Int Assoc Physicians AIDS Care (Chic) 11(4), 25216% (with lopinavir)

(2010): Currier J+, Ann Intern Med 153(6), 349 (with darunavir)

(2010): Squires KE+, HIV Clin Trials 11(2), 694% (with atazanavir and abacavir/lamivudine)

(2009): Arasteh K+, Antivir Ther 14(6), 8593% (with darunavir)

Dyspepsia / functional dyspepsia / gastroparesis 12%

(package insert)

Flatulence 8%

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, lopinavir and zidovudine)

Gastritis / pangastritis / gastric irritation

(2014): Cahn P+, Lancet Infect Dis 14(7), 572 (serious / 1 case) (with lamivudine and lopinavir)

Gastroenteritis

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5736% (with fosamprenavir)

Gastroesophageal reflux 1%

(package insert)

Gastrointestinal bleeding 2%

(package insert)

Gastrointestinal disorder / discomfort

(2020): Chouchana L+, Ther Drug Monit Nov, Online ahead of print (with lopinavir)

(2016): Antinori A+, Drug Des Devel Ther 10, 1589 (with darunavir)

(2014): Zorrilla CD+, HIV Med 15(1), 5025% (with darunavir)

(2013): Ramanathan S+, J Acquir Immune Defic Syndr 64(1), 45 (with combined elvitegravir / cobicistat / emtricitabine / tenofovir)

(2012): Santos JR+, PLoS One 7(5), e37442 (with darunavir)

Hepatic (liver) disorder / hepatobiliary disorder / hepatic (liver) dysfunction

(2020): Chouchana L+, Ther Drug Monit Nov, Online ahead of print (with lopinavir)

Hepatotoxicity / liver injury / acute liver injury / drug-induced liver injury (DILI) 9%

(2021): Tang H+, Int J Clin Pharm Jul, Online ahead of print [REVIEW] (with lopinavir)

(2016): Subashini D+, Indian J Pharmacol 48(5), 582 (with atazanavir)

(2014): Cai J+, Chin Med J (Engl) 127(14), 263239% (with lamivudine, lopinavir and zidovudine)

(2012): Brunet C+, Med Mal Infect 42(9), 421 (grade 3) Fatal (maternal / with saquinavir)

(2009): Mikl J+, BMC Infect Dis 9 (with tipranavir)

(2006): Julg B+, AIDS 20(11), 1563 (with enfuvirtide and tiranavir)

Nausea 57%

(2018): Youngberg S+, J Drug Assess 7(1), 66

(2017): Orrell C+, Lancet HIV 4(12), e53620% (with atazanavir, emtricitabine and tenofovir disoproxil)

(2016): Cooper DA+, PLoS One 11(1), Epub39–40% (with tipranavir)

(2015): Molina JM+, Lancet HIV 2(4), e12714% (with darunavir)

(2015): Rattanapunya S+, Malar J 14(1), 400 (with artesunate, lopinavir and mefloquine)

(2015): Tetteh RA+, BMC Public Health 15(1), 57371% (with lamivudine, lopinavir and zidovudine)

(2014): Clotet B+, Lancet 383(9936), 222218% (with darunavir)

(2014): Clumeck N+, AIDS 28(8), 114319% (with lopinavir)

(2014): Kowdley KV+, N Engl J Med 370(3), 222 (with ABT-333, ABT-450 and ribavirin)

(2012): Smith KY+, J Natl Med Assoc 104(7-8), 366 (with darunavir)

(2010): Currier J+, Ann Intern Med 153(6), 349 (with darunavir)

(2010): Squires KE+, HIV Clin Trials 11(2), 69 (with atazanavir and abacavir/lamivudine)

(2009): Arasteh K+, Antivir Ther 14(6), 8592% (with darunavir)

Vomiting 32%

(2016): Cooper DA+, PLoS One 11(1), Epub10–16% (with ritonavir)

(2015): Rattanapunya S+, Malar J 14(1), 400 (with artesunate, lopinavir and mefloquine)

(2015): Strehlau R+, J Int AIDS Soc 18(1), Epub29% (with atazanavir)

(2015): Tetteh RA+, BMC Public Health 15(1), 57335% (with lamivudine, lopinavir and zidovudine)

(2014): Clumeck N+, AIDS 28(8), 114313% (with lopinavir)

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5722% (with fosamprenavir)

(2009): Arasteh K+, Antivir Ther 14(6), 8593% (with darunavir)

Genitourinary

Urinary frequency 4%

(package insert)

Hematologic

Bleeding

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, lopinavir and zidovudine)

Neutropenia (neutrophils decreased)

(2014): Rudek MA+, Cancer 120(8), 1194 (3 cases) (with HAART and sunitinib)

Sepsis

(2014): Spagnuolo V+, J Int AIDS Soc 17(4 Suppl 3), Epub (triple-based therapy with atazanavir)

Neuromuscular/Skeletal

Arthralgia 19%

(package insert)

Asthenia / fatigue 46%

(2015): Tetteh RA+, BMC Public Health 15(1), 57310–27% (with lamivudine, lopinavir and zidovudine)

(2014): Cai J+, Chin Med J (Engl) 127(14), 263289% (with lamivudine, lopinavir and zidovudine)

(2014): Kowdley KV+, N Engl J Med 370(3), 222 (with ABT-333, ABT-450 and ribavirin)

Back pain 19%

(package insert)

Gouty tophi 1%

(package insert)

Myalgia/Myositis/Myopathy/Myotoxicity (see also statin-induced necrotizing autoimmune myopathy) 4–9%

(package insert)

Neck pain

(2015): Tetteh RA+, BMC Public Health 15(1), 5732% (with lamivudine, lopinavir and zidovudine)

Osteomalacia

(2013): Lucey JM+, BMJ Case Rep Jul, Epub (with emtricitabine, lopinavir and tenofovir)

Osteonecrosis / avascular necrosis

(2014): Pollett S+, Int J STD AIDS 25(6), 458 (with fluticasone)

Rhabdomyolysis

(2003): Mah Ming JB+, AIDS Patient Care STDS 17(5), 207 (with clarithromycin, atorvastatin and lopinavir)

(2002): Cheng CH+, Am J Health Syst Pharm 59(8), 728

Tendinopathy/Tendon rupture

(2014): Cresswell FV+, Int J STD AIDS 25(11), 833 (with lopinavir)

Ocular

Conjunctivitis

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5717% (with fosamprenavir)

Keratoconjunctivitis

(2017): Rainsbury PG+, Pediatr Infect Dis J 36(5), 502

Ocular icterus

(2011): Song I+, Br J Clin Pharmacol 72(1), 103 (with atazanavir and dolutegravir)

Vision blurred 6%

(package insert)

Otic

Otitis media

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5736% (with fosamprenavir)

Renal

Fanconi syndrome

(2013): Kapadia J+, Indian J Pharmacol 45(2), 191 (with tenofovir)

(2013): Lucey JM+, BMJ Case Rep Jul, Epub (with emtricitabine, lopinavir and tenofovir)

(2011): Kuijper A+, Ned Tijdschr Geneeskd 155, A2249 (with HAART / tenofovir)

(2008): Gupta SK, AIDS Patient Care STDS 22(2), 99 [REVIEW] (with tenofovir)

Nephrolithiasis

(2014): Izzedine H+, Clin Kidney J 7(2), 121 [REVIEW]

(2014): Spagnuolo V+, J Int AIDS Soc 17(4 Suppl 3), Epub (with atazanavir)

(2004): Doco-Lecompte T+, AIDS 18(4), 705 (with lopinavir)

Nephrotoxicity / kidney injury / acute kidney injury (AKI) / drug-induced kidney injury

(2015): Chughlay MF+, AIDS 29(4), 503 (with lopinavir)

(2014): Santini-Oliveira M+, Expert Opin Drug Saf 13(12), 1623 [REVIEW] (with lopinavir)

(1998): Deray G+, Presse Med 27(35), 180113%

Renal failure

(2014): Krishna MM+, Indian J Pharmacol 46(2), 230 (delayed / with emtricitabine, lopinavir and tenofovir)

(2014): Spagnuolo V+, J Int AIDS Soc 17(4 Suppl 3), Epub (triple-based therapy with atazanavir)

Respiratory

Bronchitis

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5712% (with fosamprenavir)

Cough 22%

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5717% (with fosamprenavir)

Nasopharyngitis

(2016): Cooper DA+, PLoS One 11(1), Epub13–17% (with tipranavir)

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5729% (with fosamprenavir)

Pharyngitis

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5729% (with fosamprenavir)

Pneumonia

(2014): Spagnuolo V+, J Int AIDS Soc 17(4 Suppl 3), Epub (with atazanavir)

Pulmonary embolism

(2013): John G+, AIDS 27(17), 2827 (with triamcinolone)

Rhinitis

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5725% (with fosamprenavir)

Upper respiratory tract infection

(2015): Strehlau R+, J Int AIDS Soc 18(1), Epub36% (with atazanavir)

(2014): Cotton M+, Pediatr Infect Dis J 33(1), 5736% (with fosamprenavir)

Other

Adverse effects / adverse reactions

(2019): Klimova EA+, Ter Arkh (Russian) 91(8), 67-7443% (with narlaprevir and daclatasvir)

(2015): Putcharoen O+, Drug Des Devel Ther 9, 5763 (gastrointestinal / passim)

(2014): Cai J+, Chin Med J (Engl) 127(14), 2632 (gastrointestinal / with lamivudine, lopinavir and zidovudine)

(2014): Gazzola L+, HIV Clin Trials 15(4), 140 (with darunavir and etravirine)

(2014): Judd A+, Pharmacoepidemiol Drug Saf 23(3), 321 (with fosamprenavir)

(2014): Macias J+, HIV Med 15(7), 417 (with darunavir and maraviroc)

(2014): Podzamczer D+, J Antimicrob Chemother 69(9), 253610% (with abacavir, darunavir and lamivudine)

(2014): Salazar JC+, Pediatr Infect Dis J 33(4), 39655–65% (with tripranavir)

(2012): Moyle GJ+, Antivir Ther 17(4), 6894%

(2011): Elgadi MM+, Drugs R D 11(4), 29521–25% (with tripranavir or darunavir)

Allergic reactions <2%

(package insert)

Infection

(2014): Zorrilla CD+, HIV Med 15(1), 5044% (with darunavir)

Preterm birth/labor

(2014): Zorrilla CD+, HIV Med 15(1), 5025% (with darunavir)

Adverse reactions attributed to entire drug class Antiretroviral

Hematologic

Adverse reactions attributed to entire drug class HIV-1 protease inhibitor

Skin

Eczema / eczematous reaction / eczematous eruption

(2015): Descamps V+, Br J Dermatol 173(1), 311

Xerosis

(2015): Descamps V+, Br J Dermatol 173(1), 311

Page last updated 08/01/2022

Symbol key

Incidence

<1%
1-5%
5-10%
10-15%
15-20%
20-30%
>30%

Seriousness

Hospitalization possible
Life threatening
Fatal

Warnings in other populations

Breast feeding
Geriatric
Pediatric

^ Back to top