ritonavir / Generic mfg. - LARVOL DELTA

Inflammation Unmasked: MIS-A Presenting as Status Epilepticus after COVID-19 (ACTRIMS Forum 2026) - "Despite being fully vaccinated, he had two prior COVID-19 infections, and recently completed a 3-day course of Nirmaltrelvir/Ritonavir... This case highlights the expanding spectrum of MIS-A presentations, particularly involving severe neurological manifestations without significant cardiopulmonary involvement. Persistent cortical irritability on EEG after clinical recovery highlights the potential for lasting neuroinflammatory sequelae. Recognition of MIS-A as a reversible cause of encephalopathy and seizures is critical, as timely immunomodulatory therapy may lead to full recovery."

CNS Disorders • Epilepsy • Infectious Disease • Inflammation • Novel Coronavirus Disease • Respiratory Diseases

Forecasting drug resistant HIV protease evolution. (PubMed, PLoS Comput Biol) - "Our analysis shows that the dual therapy of Atazanavir (ATV) and Ritonavir (RTV) is the multi-PI treatment regimen least likely to induce drug resistance. Interestingly, our results highlight the necessity of the amino-acid polymorphism of L63P by predicting that it is critical in developing resistance to Nelfinavir (NFV). The results validate that our framework effectively extracts and combines biological information from the distinct data sets of observed genotypes and drug resistance, while also tackling the challenge of sparsity of available sequence data compared to the large combinatorial complexity of protein evolution and changing functionality in dynamic environments."

Journal • Human Immunodeficiency Virus • Infectious Disease

A phase 2 randomized study of oral docetaxel plus ritonavir (ModraDoc006/r) in patients with metastatic castration-resistant prostate cancer (mCRPC). (ASCO 2022) - P2b | "Background: Intravenous (IV) docetaxel and oral prednisone is a standard of care regimen in patients (pts) with mCRPC...The ModraDoc006 and ritonavir combination is active in multiple docetaxel and cabazitaxel-resistant prostate cancer cell-lines The oral combination (ModraDoc006/r) was compared to IV docetaxel in a randomized phase 2b study in pts with mCRPC evaluating two doses of ModraDoc006/r (30-20/200-100 mg and 20-20/200-100 mg)...Prior therapy with enzalutamide in 8 pts, abiraterone in 10 pts... ModraDoc006/r demonstrated a favorable safety profile and comparable efficacy to IV docetaxel in pts with mCRPC, thus providing a compelling rationale for conduct of an expanded pivotal program. A key clinical program focus is the comparison of ModraDoc006/r to best available therapy in refractory mCRPC. Studies of ModraDoc006/r in other malignancies are also in active development."

Clinical • P2 data • Alopecia • Anemia • Dental Disorders • Genito-urinary Cancer • Hematological Disorders • Neutropenia • Oncology • Pain • Prostate Cancer • Solid Tumor • Stomatitis

Insights into Transport Function of the Murine Organic Anion-Transporting Polypeptide OATP1B2 by Comparison with Its Rat and Human Orthologues. (PubMed, Toxics) - "Cyclosporine A, ritonavir, odevixibat, rosuvastatin, and rifampicin markedly inhibited uptake...A comparison of the rodent data with the human orthologues revealed similar inhibition patterns but distinct substrate selectivity: hOATP1B1 showed high affinity for E1S but negligible TCA uptake, while hOATP1B3 transported TCA weakly but not E1S. This study provides insights into species-specific differences in OATP-mediated hepatic uptake and is therefore valuable for the interpretation of preclinical studies and their transfer to human pharmacology."

Journal • Preclinical

Prediction of Solvent Penetration Rate-Limited Release of Drug from Amorphous Solid Dispersion Discs of Various Geometries. (PubMed, Mol Pharm) - "The objective of this study was to predict ritonavir (RTV) and polymer release from ASDs of RTV and poly(vinylpyrrolidone-co-vinyl acetate) (PVPVA) from discs with varying geometries based solely on solvent penetration...However, predicted profiles were slightly faster than the observed profiles, indicating solvent penetration was rate-dominating, although not the only barrier to drug and polymer release. Results here indicate successful model predictions of drug release from a well-studied ASD drug/polymer pair, which has promise to aid the understanding of less well-studied ASDs."

Journal • Inflammatory Arthritis

Managing Drug-Drug Interactions Involving the Non-Prescription Opioid Loperamide Through Physiologically Based Pharmacokinetic Modeling. (PubMed, CPT Pharmacometrics Syst Pharmacol) - "The inhibitor drugs tested included quinidine (P-gp), ritonavir (CYP3A/P-gp), gemfibrozil (CYP2C8), itraconazole (CYP3A/P-gp), gemfibrozil+itraconazole, and abemaciclib (CYP1A). Predicted AUC ratios (AUC of loperamide in the presence to absence of inhibitor) were within 0.78-1.09-fold of observed ratios. This novel PBPK model for loperamide could be used to guide loperamide dosing under untested DDI scenarios when the drug is coadministered with certain CYP/transporter inhibitors to minimize toxicity risk."

Journal • PK/PD data • Addiction (Opioid and Alcohol)

Use of Rifampicin as a Cytochrome Inducer in Acute Tacrolimus Poisoning. (PubMed, Open Respir Arch) - "It is metabolized by cytochrome P450, which can cause interactions with many drugs. We present a case of acute tacrolimus poisoning in a lung transplant patient following administration of nirmaltrevir/ritonavir, as well as treatment with rifampicin, acytochrome inducer, which allowed blood levels of tacrolimus to be reduced to appropriate values."

Journal • Infectious Disease • Novel Coronavirus Disease • Transplantation

Polypharmacy and nephrotoxicity (PubMed, Inn Med (Heidelb)) - "In patients receiving calcineurin inhibitors, any additional prescriptions should be carefully reviewed for potential interactions and accompanied by dose adjustment and close therapeutic drug monitoring where appropriate. The concurrent use of several agents with structural tubular toxicity generally increases risk, whereas functional mechanisms, such as those seen with combined ACE inhibitor and sodium-glucose cotransporter 2 inhibitor (SGLT2) inhibitor therapy, are usually well tolerated. The concept of nephrotoxic burden shows promise but requires further refinement and prospective validation before it can serve as a practical tool for risk stratification in polypharmacy."

Journal • Review • Acute Kidney Injury • Nephrology • Renal Disease • CYP3A4

The Impact of the Core-Shell Fiber Composition on the Properties and Stability of the Electrospun Films. (PubMed, Nanotechnol Sci Appl) - "This study aimed to develop and evaluate core-shell electrospun orodispersible films (ODFs) containing lopinavir (LPV) and ritonavir (RTV) for pediatric HIV therapy...Core-shell electrospun ODFs with LPV in the core and RTV in the shell demonstrated more homogeneous and resistant to storage-related changes, although the release of the active ingredients was characterized by slower dissolution. These findings support the potential of co-axial electrospinning for developing pediatric-friendly antiretroviral formulations."

Journal • Human Immunodeficiency Virus • Infectious Disease • Pediatrics

GLS4 Induces the Interferon Signaling Pathway During Hepatitis B Virus (HBV) Infection. (PubMed, J Med Virol) - "Besides, combination treatment with GLS4 and ritonavir elevates the frequencies of both peripheral blood IFNγ + NK cells and liver-resident IFNγ + CD8+ T cells in the pAAV/HBV1.2 hydrodynamic injection (HDI) model. Furthermore, GLS4 partially restores innate and adaptive immunity in vivo. This signifies a potentially effective strategy for achieving a functional cure for HBV infection."

Journal • Hepatitis B • Hepatocellular Cancer • Infectious Disease • Inflammation • Oncology • Solid Tumor • CD8 • IFNG

COVID-19-induced Brugada phenocopy pattern in a patient with previous myocardial infarction: A case report. (PubMed, Medicine (Baltimore)) - "This case highlights the importance of considering fever-induced Brugada phenocopy in the differential diagnosis of ST-segment elevation in patients with coronary artery disease. Careful ECG analysis, including assessment of the β-angle and r'-wave morphology, is crucial to avoid misdiagnosis of ST-elevation myocardial infarction. Initial management should focus on controlling triggering factors such as fever with antipyretics and antivirals to prevent malignant arrhythmias."

Journal • Cardiovascular • Coronary Artery Disease • Hypertension • Infectious Disease • Myocardial Infarction • Novel Coronavirus Disease • Respiratory Diseases

A General Method to Access Sterically Hindered and Complex Ethers. (PubMed, J Org Chem) - "The reaction relies on in situ generated HCl and thiourea via anion-binding catalysis, activating carbonyls to form an oxocarbenium intermediate and enabling hydride transfer to create an ether bond. A broad substrate scope (89 substrates) and excellent functional group tolerance including complex ethers of steroids, terpenoids, peptides, and late-stage ritonavir modification have been demonstrated for this method."

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Computer prediction and genetic analysis identifies retinoic acid modulation as a driver of conserved longevity pathways in genetically diverse Caenorhabditis nematodes. (PubMed, Elife) - "While 11 compounds (aldosterone, arecoline, bortezomib, dasatinib, decitabine, dexamethasone, erlotinib, everolimus, gefitinib, temsirolimus, and thalidomide) either had no effect on median lifespan or were toxic, 5 compounds (all-trans retinoic acid, berberine, fisetin, propranolol, and ritonavir) extended lifespan in Caenorhabditis elegans. While the canonical Akt-target FOXO/DAF-16 was largely dispensable, other conserved Akt-targets (Nrf2/SKN-1 and HSF1/HSF-1), as well as the conserved catalytic subunit of AMPK AAK-2, were all necessary for longevity extension by atRA. Our results highlight the potential of combining computational prediction of longevity interventions with the power of nematode functional genetics and underscore that the manipulation of a conserved metabolic regulatory circuit by co-opting endogenous signaling molecules is a powerful approach for discovering aging interventions."

Journal • AKT1 • AKT2 • AMPK • HSF1

Predicting the ritonavir crisis by revisiting the polymorph landscape with crystal structure prediction and form 4 structure solution. (PubMed, Commun Chem) - "This would have prompted additional work that could have averted the crisis. Furthermore, we determined the crystal structure of form 4 of ritonavir by three-dimensional electron diffraction, combined with in silico modeling and experimental powder X-ray diffraction, revealing a disordered motif and proving it is thermodynamically unstable."

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Application of acoustic ejection mass spectrometry for plasma protein binding assay using flux dialysis. (PubMed, Drug Metab Dispos) - "Herein, we validated this approach using 10 commercially available compounds with known fu values-imipramine, indomethacin, itraconazole, lapatinib, nicardipine, warfarin, chlorpromazine, rivastigmine, zonisamide, and ritonavir-with a wide fu range covering from very high binding (fu ≤ 0.01) to low binding (fu > 0.10) in human plasma. SIGNIFICANCE STATEMENT: This study bridges the gap between flux dialysis and acoustic ejection mass spectrometry by creating a synergistic analytical framework for plasma protein binding assays, addressing limitations of both methods and enabling high-throughput applications with improved accuracy and efficiency. The combination of flux dialysis and acoustic ejection mass spectrometry will make a positive contribution to the development of high-throughput in vitro absorption, distribution, metabolism and excretion assays in drug discovery."

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PSD04 Recurrent and persistent genital ulcers in an immunocompromised man: an uncommon presentation of herpes zoster. (PubMed, Br J Dermatol) - "He is currently on an oral daily dose of tenofovir 300 mg, lamivudine 300 mg, dolutegravir 50 mg, atazanavir 300 mg and ritonavir 100 mg...Complete resolution was obtained with a higher dose of aciclovir appropriate for VZV infection...This case was interesting because VZV as an aetiological agent for persistent genital ulcers has not previously been reported to the best of our knowledge. Clinical consideration of such a unique presentation of VZV is important for timely diagnosis and appropriate management, especially in immunocompromised individuals, to avoid possible complication of repeated treatment for HSV infection."

Journal • Cytomegalovirus Infection • Herpes Simplex • Herpes Zoster • Human Immunodeficiency Virus • Infectious Disease • Pain • Varicella Zoster • CD4

In silico screening of potential FGF2 inhibitors for cancer therapy. (PubMed, In Silico Pharmacol) - "Molecular docking study showed Elbasvir (1) to exhibit the strongest binding affinity (-8.1 kcal/mol), followed by Velpatasvir (2) (-7.6 kcal/mol), Daclatasvir (3) (-7.5 kcal/mol), Ritonavir (4) (-6.2 kcal/mol), Paliperidone Palmitate (5) (-5.9 kcal/mol), Saralasin (6) (-5.4 kcal/mol), Nystatin (8) (-5.2 kcal/mol), and Cobicistat (-5.1 kcal/mol)...Overall, the study provides mechanistic insights into the molecular interactions between FGF2 and these candidate drugs, highlighting the promising potential of compounds 1-6 and 8 for subsequent in vitro validation in cancer therapeutics. The online version contains supplementary material available at 10.1007/s40203-025-00495-2."

Journal • Acute Myelogenous Leukemia • Brain Cancer • Breast Cancer • Gastric Cancer • Glioblastoma • Hematological Malignancies • Leukemia • Lung Cancer • Nasopharyngeal Carcinoma • Non Small Cell Lung Cancer • Oncology • Solid Tumor • FGF2 • FGFR

DB-1311-O-1001: A Phase 1/2a Study of DB-1311/BNT324 in Advanced/Metastatic Solid Tumors (clinicaltrials.gov) - P1/2 | N=862 | Recruiting | Sponsor: DualityBio Inc. | Trial completion date: Jan 2028 ➔ May 2028 | Trial primary completion date: Sep 2027 ➔ Dec 2027

First-in-human • Trial completion date • Trial primary completion date • Esophageal Cancer • Esophageal Squamous Cell Carcinoma • Lung Cancer • Melanoma • Non Small Cell Lung Cancer • Oncology • Prostate Adenocarcinoma • Prostate Cancer • Small Cell Lung Cancer • Solid Tumor • Squamous Cell Carcinoma of Head and Neck • ALK • BRAF • CD276 • EGFR • KRAS • MET • NTRK1 • NTRK2 • NTRK3 • ROS1

Trace-level quantitation of N-((2-isopropylthiazol-4-yl)methyl)-N-methylnitrous amide by liquid chromatography-tandem mass spectrometry. (PubMed, J Pharm Biomed Anal) - "Recently, the potential occurrence of the nitrosamine drug substance-related impurity, N-((2-isopropylthiazol-4-yl)methyl)-N-methylnitrous amide (NITMA), also known as N-nitroso-2,4-thiazole amine (NNTA), has been reported in some finished drug products containing ritonavir...The validated quantitation limit (0.0225 ng/mL) aligns with current regulatory requirements for NITMA. Overall, the newly developed method was found suitable to support risk assessment strategies and regulatory compliance."

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A case report of drug-drug interaction between voriconazole and simnotrelvir/ritonavir. (PubMed, Front Antibiot) - "This case indicates that the trough concentration of voriconazole increased significantly during co-administration with simnotrelvir/ritonavir. Moreover, the interaction persisted even after discontinuation of simnotrelvir/ritonavir, necessitating dynamic dose adjustments guided by therapeutic drug monitoring."

Journal • Infectious Disease • Novel Coronavirus Disease • Pulmonary Disease • Respiratory Diseases

Model-Informed Evidence for Rifapentine Use in Chinese HIV-Positive Adults with Latent Tuberculosis: Assessing Ethnic PK Differences and Interactions with Ritonavir. (PubMed, Int J Infect Dis) - P4 | "The integrated modeling strategy indicated that there are no clinically significant ethnic differences in the PK of rifapentine between Chinese and non-Chinese populations, and that dose adjustment of ritonavir is not necessary when co-administered with rifapentine."

Journal • Human Immunodeficiency Virus • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Tenofovir Alafenamide Fumarate-Associated Fanconi Syndrome (KIDNEY WEEK 2025) - "The patient had been stable on darunavir, ritonavir, and raltegravir, but this was changed to a combined bictegravir-emtricitabine-tenofovir alafenamide for simplicity just prior to his presentation. His development of acute and severe electrolyte disturbances after initiation of TAF is concerning for acute worsening of preexisting Fanconi syndrome. This case highlights that while TAF is generally considered safer, there is still risk of renal toxicity, particularly when renal tubular dysfunction is already present."

Chronic Kidney Disease • Fatigue • Human Immunodeficiency Virus • Infectious Disease • Musculoskeletal Diseases • Nephrology • Orthopedics • Renal Disease

Co-Treatment with Ritonavir or Sertraline Enhances Itraconazole Efficacy Against Azole-Resistant Trichophyton indotineae Isolates. (PubMed, J Fungi (Basel)) - "The increasing prevalence of antifungal resistance is a growing global health concern. These findings suggest that sertraline holds considerable potential as an adjunctive therapy for the treatment of dermatomycoses."

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The Effects of Ritonavir on the Pharmacokinetics of Tofacitinib in Rats. (PubMed, Pharmaceuticals (Basel)) - "These results suggest the need for dose adjustments of TOF during co-administration with RTV in clinical settings. Further clinical research is needed to confirm these findings."

Journal • PK/PD data • Preclinical • Immunology • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology

Hydrophobic drug particles adopt a complex biomolecular corona in ex vivo gastrointestinal fluids. (PubMed, J Control Release) - "Furthermore, the PIF corona was drug-particle specific, with distinct compositions observed between CMZ and ritonavir (RTV) (both weak bases with logP values above 5) compared to the corona composition on crystalline indomethacin (IND). All investigated corona compositions showed enrichment of low-abundance proteins not detectable in the original GI fluid. In conclusion, this study provides insights into the issue of how the identity and solid state of drug particles influences the adsorption of biomolecules onto drug particles in ex vivo GI fluids, and that exposure to the different fluids reveals that certain protein components specific to intestinal fluids can dominate the composition of the corona after sequential exposure."

Journal • Preclinical • Gastrointestinal Disorder