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Norvir Advisory

Tips for Taking Ritonavir Liquid by Mike Royal, BS, RPh

Dose

# Capsules

# ml Liquid

# Teaspoonful Liquid

100mg

1

1.25ml

1/4 tsp

200mg

2

2.50ml

tsp

300mg

3

3.75ml

3/4 tsp

400mg

4

5.00ml

1 tsp

500mg

5

6.25ml

1 & 1/4 tsp

600mg

6

7.50ml

1 & tsp

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 a substitute 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 water based liquids such as Kool Aid, water, juices, carbonated beverages, etc. Avoid using anything that has a mint, caramel or butter taster. 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 a liquid or pudding and are less effective.

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 & 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 half the pudding. Take RTV. Slowly eat remaining pudding.

Chocolate Ice Cream

(1/2 cup, softened)

Use sugar free variety

Take Lactaid, DairyEse 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.

Slowly eat half the cottage cheese. Take RTV. Slowly eat remaining cottage cheese.

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. Gargle with 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.

Posted 9/2/98

Notice: This is an IAPAC initiative that is under the sole direction of the IAPAC Norvir Advisory Committee. Contents of the Norvir Advisory section of the IAPAC Web site are subject to the approval of the chair of the advisory committee and will reflect the recommendations of the committee members. Abbott Laboratories has no input in the content of the Norvir Advisory section of the IAPAC Web site.