Last update Dec. 4, 2020


Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Antiviral HIV protease inhibitor. Used and associated with lopinavir, in the treatment of HIV/AIDS.
It has been used experimentally in the treatment of the COVID-19 coronavirus (Li 2020, Lim 2020, SEFH 2020).
Oral administration in two daily doses.

Its pharmacokinetic data (moderately high molecular weight and very high percentage of protein binding) explain the negligible transfer into milk observed (Corbett 2014, Palombi 2012).

The plasma levels of infants whose mothers took it were undetectable (Corbett 2014) or very low (Gandhi 2013, Palombi 2012).

According to the policy adopted by the health authorities of each country, breastfeeding in mothers with HIV/AIDS may or may not be recommended.
With highly active antiretroviral therapy (HAART), the HIV viral load can be reduced to zero, reducing the risk of HIV transmission through breastfeeding to levels similar to those of formula feeding.

See below the information of these related products:


We do not have alternatives for Ritonavir since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Ritonavir in other languages or writings:


Ritonavir belongs to this group or family:


Main tradenames from several countries containing Ritonavir in its composition:


Variable Value Unit
Oral Bioavail. 80 %
Molecular weight 721 daltons
Protein Binding 98 - 99 %
VD 0.2 - 0.6 l/Kg
pKa 13.68 -
Tmax 2 - 4 hours
3 - 5 hours
M/P ratio 0.2 -
Theoretical Dose 0.012 - 0.036 mg/Kg/d
Relative Dose 0.36 - 0.48 %


  1. Lim J, Jeon S, Shin HY, Kim MJ, Seong YM, Lee WJ, Choe KW, Kang YM, Lee B, Park SJ. Case of the Index Patient Who Caused Tertiary Transmission of COVID-19 Infection in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Infected Pneumonia Monitored by Quantitative RT-PCR. J Korean Med Sci. 2020 Feb 17;35(6):e79. Consulted on Feb. 20, 2020 Abstract
  2. FDA. Paxlovid. Drug Summary. 2022 Full text (in our servers)
  3. EMA. Paxlovid. Ficha técnica. 2022 Full text (in our servers)
  4. Li H, Wang YM, Xu JY, Cao B. [Potential antiviral therapeutics for 2019 Novel Coronavirus]. Zhonghua Jie He He Hu Xi Za Zhi. 2020 Feb 5;43(0):E002. Abstract
  5. SEFH - Sociedad Española de Farmacia Hospitalaria. Procedimientos de farmacia hospitalaria para la gestión del tratamiento con antivirales en la enfermedad por el nuevo coronavirus sars-cov-2 (COVID-19). Recomendaciones de la Sociedad Española de Farmacia Hospitalaria. None 2020 Full text (in our servers)
  6. Puthanakit T, Thepnarong N, Chaithongwongwatthana S, Anugulruengkitt S, Anunsittichai O, Theerawit T, Ubolyam S, Pancharoen C, Phanuphak P. Intensification of antiretroviral treatment with raltegravir for pregnant women living with HIV at high risk of vertical transmission. J Virus Erad. 2018 Apr 1;4(2):61-65. Abstract Full text (link to original source) Full text (in our servers)
  7. EMA. Ombitasvir-Paritaprevir-Ritonavir. Drug Summary. 2017 Full text (in our servers)
  8. EMA. Ombitasvir-Paritaprevir-Ritonavir. Ficha técnica. 2017 Full text (in our servers)
  9. WHO - World Health Organization Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: Recommendations for a Public Health Approach. Guideline. 2016 Abstract Full text (link to original source) Full text (in our servers)
  10. CDC - Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV— United States. nPEP Guidelines Update. 2016 Full text (link to original source) Full text (in our servers)
  11. LactMed. Ombitasvir. Full Record Display. 2016 Full text (in our servers)
  12. WHO. Guidelines on post-exposure prophylaxis for HIV and the use of co-trimoxazole prophylaxis for HIV-related infections among adults, adolescents and children: recommendations for a public health approach. Guideline. 2014 Full text (link to original source) Full text (in our servers)
  13. Corbett AH, Kayira D, White NR, Davis NL, Kourtis AP, Chasela C, Martinson F, Phiri G, Musisi B, Kamwendo D, Hudgens MG, Hosseinipour MC, Nelson JA, Ellington SR, Jamieson DJ, van der Horst C, Kashuba A; BAN Study Team.. Antiretroviral pharmacokinetics in mothers and breastfeeding infants from 6 to 24 weeks post-partum: results of the BAN Study. Antivir Ther. 2014;19(6):587-95. Abstract
  14. Gandhi M, Mwesigwa J, Aweeka F, Plenty A, Charlebois E, Ruel TD, Huang Y, Clark T, Ades V, Natureeba P, Luwedde FA, Achan J, Kamya MR, Havlir DV, Cohan D; Prevention of Malaria and HIV disease in Tororo (PROMOTE) study.. Hair and plasma data show that lopinavir, ritonavir, and efavirenz all transfer from mother to infant in utero, but only efavirenz transfers via breastfeeding. J Acquir Immune Defic Syndr. 2013 Aug 15;63(5):578-84. Abstract
  15. Palombi L, Pirillo MF, Andreotti M, Liotta G, Erba F, Sagno JB, Maulidi M, Ceffa S, Jere H, Marchei E, Pichini S, Galluzzo CM, Marazzi MC, Vella S, Giuliano M. Antiretroviral prophylaxis for breastfeeding transmission in Malawi: drug concentrations, virological efficacy and safety. Antivir Ther. 2012;17(8):1511-9. Abstract

Total visits


Help us improve this entry

How to cite this entry

Do you need more information or did not found what you were looking for?

   Write us at

e-lactancia is a resource recommended by Academy of Breastfeeding Medicine - 2015 of United States of America

Would you like to recommend the use of e-lactancia? Write to us at corporate mail of APILAM