ritonavir / Generic mfg. - LARVOL DELTA

Predictive modeling of influenza strain drugs using temperature-based topological indices and regression analysis via multi-criteria decision making techniques. (PubMed, Sci Rep) - "Moreover, the multi-criteria decision-making methods (WSM and WPM) reported Azithromycin (81.25), Ritonavir (77.46), and Indinavir (72.82) as the best ranked ones. The presented solution will offer a cost-effective, interpretable, and reliable instrument of antiviral drug prioritization."

Journal • Infectious Disease • Influenza • Respiratory Diseases

Lonafarnib/ritonavir and peg-Interferon alfa drive histological improvement and inflammation resolution in chronic hepatitis D: results of the multicenter phase 3 D-LIVR study (EASL 2026) - No abstract available

Clinical • P3 data • Hepatology • Inflammation

Lonafarnib/ritonavir with or without peginterferon achieves rapid, durable responses in a chronic hepatitis D: extended analyses from the phase 3 D-LIVR trial (EASL 2026) - No abstract available

P3 data • Hepatology • Inflammation

Role of Dissolution Medium pH in the Release Behavior of Basic Drug-Copovidone Amorphous Solid Dispersions. (PubMed, Mol Pharm) - "Loratadine (LRD) and ritonavir (RTV) were used as model basic drugs. In contrast, for low DL ASDs where the polymer controls the release, pH is anticipated to have less impact on release. This study contributes additional understanding of the release mechanisms of PVPVA-based ASDs."

Journal

Atorvastatin suppresses HIV/antiretroviral drug-induced cardiac fibrosis and dysfunction in mice by blocking platelet TGFβ1 signaling. (PubMed, JCI Insight) - "In the REPRIEVE trial, pitavastatin reduces atherosclerotic CVD risk to a magnitude inconsistent with pitavastatin's impact solely on LDL-cholesterol and inflammation...ART drugs used in REPRIEVE, including a nucleoside/nucleotide, integrase inhibitor-based regimen (tenofovir (TDF), emtricitabine (FTC), and dolutegravir (DTG)), and the protease inhibitors ritonavir (RTV) and darunavir (DRV), and the impact of atorvastatin, were examined in two HIV mouse models: transgenic HIV-Tg26 mice and HIV-PDX mice engrafted with T cells isolated from PWH...Administration of TDF-FTC-DTG or RTV, but not DRV, resulted in a further ~2-fold increase in fibrosis (p<0.01)...Our results indicate that certain ART regimens accelerate HIV-associated CVD characterized by HFpEF via platelet TGFβ1-dependent processes, which were mitigated by atorvastatin. We postulate that our findings provide a potential mechanism for the pleiotropic effects of statins in HIV/ART-linked CVD which could be..."

Journal • Preclinical • Atherosclerosis • Cardiovascular • Congestive Heart Failure • Fibrosis • Heart Failure • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation

FAERS DATABASE ANALYSIS REVEALS ANENCEPHALY ASSOCIATED WITH ANTIRETROVIRAL DRUG EXPOSURE (ISPOR 2026) - "Emtricitabine had the highest number of reports (n=51), followed by Ritonavir (n=32) and Tenofovir (n=28)...Tipranavir showed the strongest signal (551.688; 343.42-886.26), followed by Etravirine (97.723; 50.453-189.28) and Enfuvirtide (97.684; 48.489-196.789). Among FDCs, Lamivudine and Zidovudine (87.799; 50.529-152.56) had the highest signal... This study highlights a potential safety concern regarding the association between antiretroviral agents and anencephaly. Continued pharmacovigilance and targeted epidemiological studies are warranted to further investigate and mitigate these risks in vulnerable populations."

CNS Disorders

Synthetic Tetrahydrocannabinol (THC) is a Safe Adjunct to the Treatment of Postoperative Pain after Arthroscopic Knee Surgery: A Pilot Randomized Safety Trial (AAOS 2026) - "Exclusion criteria included patients under the age of 18, patients unable to provide consent, patients who are pregnant, breastfeeding, or trying to become pregnant, patients with an allergy to any of the study drugs, patients undergoing revision surgery or open surgery, patients with a history of mania, depression, or schizophrenia, patients currently diagnosed with alcohol or drug abuse, patients who cannot or will not abide by the medication regimen, or patients taking any of the following drugs: anticholinergic agents, benzodiazepines, central nervous system depressants, droperidol, hydroxyzine, levomepromazine, methotrimeprazine, monoamine oxidase inhibitors, ritonavir, selective serotonin reuptake inhibitors, sympathomimetics, St...Primary outcome for this pilot study was safety of the test drug with the secondary outcome being pain control and number of opioid tablets (hydrocodone-acetaminophen 5-325mg) consumed at 3 different time intervals: 24 hours, 48 hours,..."

Clinical • Surgery • Addiction (Opioid and Alcohol) • Bipolar Disorder • Depression • Immunology • Orthopedics • Pain • Schizophrenia • Xerostomia

Evaluation of co-amorphous systems containing ritonavir and coformers: An experimental and molecular simulation study. (PubMed, J Pharm Sci) - "RDF analysis confirmed that RTV-SAC and RTV-NIC formed more compact and stable molecular arrangements across both formulation methods. These findings suggest that co-former selection and preparation methods significantly impact the final stability of pharmaceutical formulations."

Journal

Optimized Milling Approaches for Scalable Production of Ritonavir Nanocrystals: from Process Design to Bioperformance Evaluation. (PubMed, ACS Omega) - "Biochemical analyses suggested formulation-dependent hepatic stress, reflected by increased GGT for the nanosuspension, and alterations in carbohydrate metabolism, including elevated glucose and amylase levels, for the nanocrystal formulation. Overall, ritonavir nanocrystals significantly improved dissolution, and the optimized milling and spray-drying approach represents a robust and scalable strategy to enhance the performance of Class II or IV drugs."

Journal

Effects of Ritonavir, Lopinavir, and Alcohol on ABC Transporters and Secretion of Bile Acid and Bilirubin in Senescent Hepatocytes. (PubMed, Int J Mol Sci) - "In this study, the toxic effects of ritonavir, lopinavir, and alcohol on hepatocyte transporters and the secretion of bile acids and bilirubin were investigated in hydrogen peroxide-induced senescent HepG2 and doxorubicin-induced senescent primary human hepatocytes. Further, anti-cholestasis agents, ursodeoxycholic acid and glycyrrhizin, significantly ameliorated the impaired secretions of bile acids and bilirubin as well as reducing intracellular lipid accumulation and cell death caused by ritonavir, lopinavir, and alcohol in the primary hepatocytes with ABCC6 knockdown. These results indicate that senescence moderately impairs the ABC transporters of hepatocytes and secretion of bile acids or bilirubin, which become worse in the presence of the drugs and alcohol but could be improved by anti-cholestasis agents."

Journal • Addiction (Opioid and Alcohol) • Cholestasis • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Liver Failure • ABCB1 • ABCB4 • ABCC1 • ABCC2 • ABCC3 • ABCC6 • ABCD3 • LMNA • UGT1A1

Metabolic dysfunction-associated steatotic liver disease linked to antiretroviral exposure in cohort of people with HIV. (PubMed, AIDS) - "Our findings suggest that commonly used antiretrovirals may contribute to the development of MASLD. Prospective studies examining the possible causal effects of these therapies on MASLD development and progression are warranted."

Journal • Diabetes • Hepatology • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease

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

Functional Nanofiber Scaffolds Enabling Local Immunomodulation and Inhibition of Ectopic Bone Formation. (PubMed, ACS Appl Mater Interfaces) - "Collectively, this work establishes localized ritonavir delivery as a multifunctional strategy integrating lineage control, bone remodeling regulation, and immunomodulation for HO prevention. This multifunctional therapeutic approach offers a clinically translatable solution for preventing aberrant bone formation and improving outcomes in trauma and orthopedic patients at risk of HO."

Journal • Immunology • Orthopedics • Pain • COL1A1 • COL2A1 • IL6 • SOX9 • TNFA

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."

Journal

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