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Tips for Taking Ritonavir Liquid

 Dose

 # Capsules

 # ml Liquid

 # Teaspoonful Liquid

 100 mg

 1

 1.25 ml

1/4 tsp

 200 mg

2

2.50 ml

1/2 tsp

 300 mg

3

 3.75 ml

3/4 tsp

400 mg

4

 5.00 ml

 1 tsp

500 mg

5

 6.25 ml

 1 & 1/4 tsp

600 mg

6

 7.50 ml

 1 & 1/2 tsp

Do not stop taking Ritonavir without talking to your physician first. If you are having trouble tolerating liquid Norvir, it is important to speak to your doctor about it immediately. Do not discontinue taking the liquid until speaking with your doctor.

 

It is important to measure the appropriate dose. It is therefore preferable to use the dosing cup your pharmacist gives you that comes with the liquid Norvir. Do not fill the cup to the top. On the dosing cup are lines indicating how much Norvir liquid to use.

Regardless of what you use to measure your dose, rinse the cup or spoon well and dry it before putting it away. If you do not use the measuring cup provided with the RTV, use a cooking measuring spoon. Do not use a regular teaspoon that you would use to add sugar to your coffee, tea, etc. These spoons vary in size from one brand to another. You can not accurately measure a dose. Do not use a plastic medicine spoon.

Avoid getting liquid on lips. This can extend the aftertaste plus numb the lips. For best results, tip the head back and pour the dose into your mouth so that the liquid hits the back of the mouth instead of the front of the mouth.

Take each dose with food. If you take your dose with one of the recommendations on the following page, you must do this after eating a balanced meal that is high in fat and protein. None of the recommendations are substitutes for a meal when taking RTV. Take your dose after eating, not before eating. This will help reduce the upset stomach that some patients have reported.

Do not mix the RTV with liquids. Drink some liquid first, take the RTV, then finish drinking the liquid. Mixing the RTV only dilutes it and extends the time that RTV is in the mouth.

Do not use anything that has a caramel or butter taste. These will accentuate the taste of RTV. Do not use an alcohol based product.

Chew gum afterwards. Big Red Cinnamon Gum works well. Gargle with a cinnamon flavored alcohol-free mouthwash.

 

 Recommendations

What works for one person may not work for another. Trial and error is the only way to find out which works best. Other foods may also work. Similar/generic products may also be used. For best results, use something that is soft, smooth, creamy and has some fat content. Solid foods such as cream filled cupcakes or donuts, etc, can be used but they do not coat the mouth as well as liquid or pudding and are less effective. These recommendations come from the Adult AIDS Clinical Trial Group (ACTG).

 

 No Diet Restrictions.

 Diabetics

 Lactose Intolerant

 Comments

Chocolate Milk

(6 to 8 ounces)

2% milk + Sugar Free

Carnation Instant Breakfast

Lactose free milk + chocolate syrup or add Lactaid, DairyEse, etc to Chocolate milk USE REGULAR CHOCOLATE MILK, NOT REDUCED FAT, SKIM OR NONFAT VARIETY. Drink half the milk in small sips to get mouth coated. Take RTV. Gargle and swallow remaining milk in several portions. 

Peanut Butter

(1 tablespoonful)

Use a "natural" brand to reduce sugar intake. Diet controlled diabetics may need to adjust daily fat exchanges. No restrictions. Place half of the peanut butter in mouth. Work around mouth with tongue to coat mouth. Take RTV. Eat the other half of the peanut butter.
Peanut Butter and Jelly Sandwich Same as peanut butter. Use sugar free jelly or "whole fruit" preserves to reduce sugar intake. No restrictions. Eat half the sandwich in small bites. Take RTV. Eat the other half of the sandwich in small bites.

Peanut Butter cups

(2 full size or 6 miniature)

Not advisable. No substitutes. No restrictions. Slowly eat one full size or 3 miniature peanut butter cups. Take RTV. Slowly eat remaining peanut butter cup(s).

Chocolate Pudding

(4 oz. Pudding cup/serving).

Use sugar free brand. Take Lactaid, DairyEse, or other product. DO NOT USE A LOW-FAT OR FAT-FREE BRAND. Slowly eat remaining pudding.

Chocolate Ice Cream

(1/2 cup, softened)

Use sugar free variety Take Lactaid, DariyEse or other product. DO NOT USE A LOW-FAT OR FAT-FREE PRODUCT. Slowly eat half the ice cream. Take RTV. Slowly eat remaining ice cream.

Soft Brick Cheese

(1 ounce)

Diet controlled patients should adjust food exchanges as needed. Take Lactaid, DairyEse, or other product. Take RTV. Slowly eat cheese. Use mild flavored cheese such as colby, longhorn, mozzarella, or Velveeta. Avoid sharp flavored cheeses like swiss or cheddar. These can accentuate the RTV taste. DO NOT USE "PROCESSED AMERICAN CHEESE" PRODUCTS.

Cottage Cheese

(1/2 Cup)

Diet controlled patients should adjust food exchanges as needed. Take Lactaid, DairyEse, or other product. USE REGULAR COTTAGE CHEESE, NOT THE LOW FAT OR NO FAT VARIETY.

Regular Yogurt

(4 oz serving)

Diet controlled patients should adjust food exchanges as needed. Take Lactaid, DairyEse, or other product. USE REGULAR YOGURT, NOT THE LOW FAT OR NO FAT VARIETY. Slowly eat half the yogurt. Take RTV. Slowly eat remaining yogurt. A banana flavor yogurt works best. Avoid citrus flavors such as orange or lemon.
Chocolate Ensure, Advera, or Sustacal (1 can).

Check with physician or nutritionist before using any food

supplement.

No restrictions.  Drink half the can in small sips. Take RTV. Drink remaining can in small sips. Best if chilled before drinking. French vanilla flavor can be used but does not work as well. Avoid all other flavors for this purpose.
 Chocolate Ensure Bar Check with physician or nutritionist before using any food supplement. No restrictions. Take RTV. Slowly eat bar.

 Suggestions for taking the liquid formulation of ritonavir

The AIDS Clinical Trials Group has compiled a list of administration suggestions from their pediatric sites.
Some of these ideas have worked for only one or two patients and some have worked for more.
Taste is an individual experience, so the list contains all the suggestions received.

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