ritonavir / Generic mfg. - LARVOL DELTA

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

RITONAVIR-CARBAMAZEPINE INTERACTION PRESENTING AS A STROKE MIMIC WITH QTC PROLONGATION: EMPHASIZING THE IMPORTANCE OF SYSTEM LEVEL DRUG INTERACTION (CHEST 2026) - No abstract available

Cardiovascular

Giant Abdominal Haematoma and Rapid Multidrug-Resistant Infection After Low-Molecular-Weight Heparin in a Patient With COVID-19 and Rheumatoid Arthritis. (PubMed, Infect Drug Resist) - "After admission, the patient was given subcutaneous injection of LMWH (2500 IU, qd) for anticoagulation, combined with Simnotrelvir/Ritonavir for antiviral treatment...During this period, the patient received multiple rounds of anti-infective treatment with meropenem, linezolid, minocycline, etc. and underwent 5 debridements, Vacuum Sealing Drainage (VSD), and skin grafting...Under the superposition of multiple immunosuppressive factors such as COVID-19, long-term prednisone use and additional in-hospital glucocorticoid therapy, conventional-dose LMWH can induce an unusually large hematoma (15cm×15cm), with rapid disease progression (secondary infection within 1 day), which is prone to refractory MDROs infection. For such high-risk patients, clinical practice should formulate highly individualized anticoagulant treatment plans and further strengthen the monitoring of adverse reactions."

Journal • Cardiovascular • Diabetes • Hypertension • Immunology • Infectious Disease • Inflammatory Arthritis • Metabolic Disorders • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology • Type 2 Diabetes Mellitus

In vitro evaluation of water-insoluble silicates and polyvinylpyrrolidone-vinyl acetate as oral carriers for amorphous ritonavir: dissolution enhancement and the role of phosphatidylcholine. (PubMed, Int J Pharm) - "In silico results showed that silicate pore size governed RTV release, with open pores forming fewer hydrogen bonds, allowing more facile RTV release. The significant improvement in RTV dissolution with AP and FR supports the use of these carriers for poorly soluble drugs as alternatives to traditional polymers, especially for formulations with high drug loads."

Journal • Preclinical

Ursodeoxycholic Acid Reduces Angiotensin-Converting Enzyme 2 Activity and Suppresses Cytokine Storm Syndrome in Patients With Coronavirus Disease 2019. (PubMed, MedComm (2020)) - "To investigate the role of UDCA in decreasing SARS-CoV-2 infection and affecting COVID-19 cytokine levels, COVID-19 patients (n = 142, male = 72, female = 70) were divided into UDCA-free (n = 53) and UDCA (n = 89) groups and treated with nirmatasvir/ritonavir or molnupiravir for 5 days. Among the 46 cytokines analyzed, luminex profiling revealed that 21 proinflammatory cytokines, including CTACK, bFGF, G-CSF, GM-CSF, GRO-α, IL-1β, IL-1Ra, IL-2, IL-2Rα, IL-6, IL-10, IL-16, IP-10, MCP-1, MCP-3, MIG, TNF-α, TRAIL, VEGF, IL-9, and IL-18, were significantly lower with UDCA treatment (p < 0.01), whereas only eotaxin levels increased (p < 0.05). Therefore, UDCA reduces ACE2 activity, improves clinical outcomes, and suppresses cytokine storm syndrome (CSS) in COVID-19 patients."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases • ACE2 • CCL11 • CSF2 • IL10 • IL16 • IL18 • IL1B • IL1R1 • IL2 • IL6 • IL9 • TNFA

A novel therapeutic potential of the anti-hiv ritonavir against Blastocystis hominis: a dual approach in vitro and in vivo. (PubMed, J Parasit Dis) - "Moreover, there was a highly significant reduction in the serum levels of IL-1β, IL-8, and TNF-α. In conclusion, ritonavir was found to be effective against B. hominis with anti-inflammatory and immune stimulatory effects."

Journal • Preclinical • Human Immunodeficiency Virus • Infectious Disease • CXCL8 • IL1B • TNFA

CHAPAS-5: An Adaptive Platform Trial for Evaluation of Novel Treatment Regimens in Children and Adolescents With HIV in Africa (clinicaltrials.gov) - P3 | N=800 | Not yet recruiting | Sponsor: University College, London

New P3 trial • Human Immunodeficiency Virus • Infectious Disease

DB-1303-O-1001: A Phase 1/2a Study of DB-1303/BNT323 in Advanced/Metastatic Solid Tumors (clinicaltrials.gov) - P1/2 | N=796 | Recruiting | Sponsor: DualityBio Inc. | Trial primary completion date: Apr 2026 ➔ Aug 2027

First-in-human • Trial primary completion date • Oncology • Solid Tumor • HER-2

InfoMedex: drug-drug interaction prediction via a multimodal CNN-transformer model. (PubMed, Front Drug Saf Regul) - "We investigated case studies for interactions with bupropion and ritonavir with integrated gradients and identified molecular regions associated with known CYP-mediated interaction mechanisms. InfoMedex showed strong performance for unseen drug pairs involving drugs that could have appeared elsewhere in training, but performance was substantially lower for entirely unseen drugs. Atom-level attribution analyses may support mechanistic hypothesis generation, although broader validation across molecules and interaction types is needed."

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Never Too Late: A Case Report of Severe Fanconi Syndrome Developing After More than a Decade of Silent Tenofovir Disoproxil Fumarate Exposure. (PubMed, Reports (MDPI)) - "TDF was discontinued, and her antiretroviral regimen was modified to tenofovir alafenamide fumarate (TAF), emtricitabine (FTC), darunavir, and ritonavir, combined with vitamin D supplementation. Over a 6-month follow-up period, renal function normalized, electrolyte wasting resolved, and metabolic acidosis completely reversed. This case highlights that TDF-induced proximal tubulopathy can manifest even after a decade of uneventful therapy, particularly when co-administered with a boosted protease inhibitor."

Journal • Endocrine Disorders • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Musculoskeletal Pain • Nephrology • Pain • Renal Disease • Secondary Hyperparathyroidism

Activated Sludge in the Bioremediation of Water Containing SARS-CoV-2 Antivirals. (PubMed, J Xenobiot) - "This study evaluates the removal percentages, kinetic mechanisms, and toxicity profiles of six SASs, daclatasvir (DCV), darunavir (DRV), favipiravir (FAV), lopinavir (LOP), remdesivir (REM), and ritonavir (RIT), using activated sludge. Perturbation analysis showed that all tested factors have a distinct influence on process performance. These established kinetic trends should support further investigations into advanced biological wastewater treatment methods and precise ecotoxicity profiling of emerging biotransformation products."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

DYT-TOR1A genotype alters extracellular vesicle composition in murine cell model and shows potential for biomarker discovery. (PubMed, Dystonia) - "We found that many DYT-TOR1A MEF EV differences were significantly corrected by ritonavir, a drug recently shown to correct DYT-TOR1A phenotypes in cell and mouse disease models...These results collectively show that DYT-TOR1A genotype alters EV protein composition, and these changes can be dynamically modulated by a candidate therapeutic drug and ISR activity state. These mouse model findings provide proof-of-concept that EVs may be a useful source of biomarkers in human populations and further suggest specific homologs to evaluate in cross-species validation."

Journal • Preclinical • CNS Disorders • Dystonia • Movement Disorders

Mathematical Modeling of HDV RNA, HBV DNA, and HBsAg Dynamics During Lonafarnib-Based Therapy: Insights from the LOWR HDV-1 Study. (PubMed, Bull Math Biol) - "LNF monotherapy led to a flat-partial-response (often followed by VB), while LNF combination therapy with ritonavir or pegylated interferon-α (PEG-IFN ) was associated with a biphasic HDV decline (without VB). The model explained the increase in serum HBV DNA by a median four-fold [interquartile range, IQR: 1-28] increase in HBV DNA production rate when HDV declined below an inhibitory threshold. The stability of serum HBsAg was explained by a constant number of HBsAg-producing cells."

Journal • Hepatitis B • Infectious Disease • Inflammation

Challenges in Porphyria diagnosis and management: When variegate Porphyria meets HIV. (PubMed, Mol Genet Metab) - "We present the case of a 32-year-old woman with HIV receiving antiretroviral therapy (dolutegravir, lamivudine, and ritonavir) who had generalized seizures, psychosis, and polyneuropathy, initially interpreted as secondary to infection...Despite treatment with methylprednisolone and intravenous immunoglobulins, her health worsened, requiring intensive care and extended mechanical ventilation...This case shows the complex interactions between genetic predisposition, environmental factors, and comorbidities in VP, emphasizing the importance of genetic and biochemical testing for accurate diagnosis, hemin administration during acute attacks, and careful medication review. Clinicians should remain vigilant about interactions between antiretroviral therapy and porphyria when treating HIV-positive patients with suspected or confirmed Acute Hepatic Porphyria."

Journal • CNS Disorders • Critical care • Epilepsy • Genetic Disorders • Hematological Disorders • Human Immunodeficiency Virus • Immunology • Infectious Disease • Metabolic Disorders • Pain • Psychiatry • PPOX

Impact of mixing method on amorphous solid dispersions fabricated via vacuum compression molding: dissolution and degree of fusion. (PubMed, Int J Pharm) - "This study evaluated the impact of mixing methods on dissolution performance of ritonavir (RTV)/poly(vinylpyrrolidone-co-vinyl acetate) (PVPVA) ASD discs fabricated by VCM, comparing physical blending (PB) and CM...ATR- FTIR further revealed that PB led to localized amorphous drug-rich domains, whereas CM promoted more uniform dispersion. Collectively, these findings highlight that effective ASD performance was governed not only by powder mixing, but also by the extent of microstructural fusion achieved during molding as a result of improved spatial proximity between drug and polymer within pre-VCM powder."

Journal

Clinical pharmacokinetics of afatinib: A systematic review. (PubMed, Curr Opin Pharmacol) - "This systematic review provides an updated synthesis of clinical PK evidence on afatinib. Afatinib exposure is influenced by dose, repeated administration, renal impairment, diarrhea associated toxicity, and P-glycoprotein mediated drug interactions. These findings may support individualized dosing, toxicity-guided dose adjustment, and future development of PK models for afatinib."

Journal • PK/PD data • Review • Lung Cancer • Non Small Cell Lung Cancer • Oncology • Renal Disease • Solid Tumor

Affordability of antiretrovirals: have productive development partnerships for local production and technology transfer contributed to the sustainability of Brazil’s universal access policy? (AIDS 2026) - " Ten active PDPs (4 in Phase III; 6 in Phase IV) for 7 ARVs (atazanavir, darunavir, dolutegravir, emtricitabine/lamivudine, ritonavir, tenofovir, and tenofovir/lamivudine) were identified, involving 12 laboratories (5 public, 5 private national and 2 international). While local production is vital for health sovereignty, PDPs did not consistently contribute to ARV affordability from 2015-2025. Competition appears to remain a key driver for price reduction. Recent policy updates might correct existing distortions to ensure greater affordability gains."

Human Immunodeficiency Virus • Infectious Disease

Antiretroviral treatment trajectories and post-listing outcomes in people living with HIV or AIDS listed for kidney or liver transplantation: a national cohort study in Brazil (AIDS 2026) - "Longer cumulative exposure to multiple antiretrovirals—including lamivudine, zidovudine, efavirenz, darunavir, dolutegravir, lopinavir, nevirapine, ritonavir, and tenofovir disoproxil fumarate—was consistently associated with lower post-listing mortality (Spearman ? In this nationwide study, longer cumulative exposure to widely used antiretrovirals was associated with lower mortality after listing, even for drugs traditionally described as hepatotoxic or nephrotoxic. This suggests, in this context, cumulative ART exposure primarily reflects sustained engagement in care, rather than a direct pharmacological toxicity effect on mortality. This first national linkage of transplant and HIV information systems provides evidence to inform the integration of HIV care and transplant services, and supports future evaluations of equity and outcomes among aging populations living with HIV."

Human Immunodeficiency Virus • Infectious Disease • Solid Organ Transplantation • Transplantation

COMBINED SECOND HARMONIC AND LINEAR LIGHT SCATTERING AS A TOOL FOR SOLUBILITY AND AGGREGATION SCREENING. (PubMed, Eur J Pharm Sci) - "LLS, which reports on particle size/number, detected precipitation onsets typically close to or below HPLC values and could resolve particle formation down to ∼0.1 µM for pimozide, substantially exceeding the sensitivity of standard nephelometric methods. SHS, which is sensitive to interfacial asymmetry and nonlinear susceptibility, often showed onsets and complex peak-drop-rise patterns that deviated from LLS, particularly for lopinavir, loratadine, and ritonavir, indicating structurally distinct, largely centrosymmetric drug-rich assemblies above the solubility limit. Orthogonal characterization by scanning electron microscopy, Capflex (capillary flow with a hydrophobic fluorescent tracer), and confocal fluorescence microscopy provided independent evidence for droplet-like or amorphous drug-rich domains that preceded bulk precipitation. Together, the results showed that combined SHS-LLS enabled highly sensitive detection of precipitation, while revealing..."

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Sustained undetectable intact reservoir in early treated infants in Africa (AIDS 2026) - "Lopinavir and ritonavir (LPV/r) levels were measured concomitantly with reservoir and VL. Early-treated infants, particularly with protective HLA can achieve durable undetectable intact proviral DNA, suggesting extremely small or absent intact reservoir. Those infants are strong candidates for ATI studies. Additionally, undetectable total HIV-DNA by ddPCR reliably identified infants with absent or minimal intact provirus by IPDA, supporting ddPCR as an effective initial screening tool for cure-related studies."

Human Immunodeficiency Virus • Infectious Disease • CD4

Multivariate control charts based on Mahalanobis distance for bivariate quality monitoring in petrochemical and pharmaceutical analyses. (PubMed, Anal Bioanal Chem) - "One ritonavir-lopinavir dataset provided an illustrative action-level exceedance, suggesting how a covariance-adjusted statistic may flag localized joint deviations; however, this single event should not be interpreted as definitive validation of fault-detection capability. A permutation-based resampling strategy was used to examine the variability of control thresholds and signal probabilities across alternative historical-monitoring partitions. Overall, the results support the feasibility, interpretability, and reproducibility of the proposed bivariate workflow as a complementary tool for routine analytical monitoring, while indicating that more rigorous validation with independent datasets containing known deviations is required before broader claims regarding fault-detection performance can be made."

Journal

Management of ritonavir shortage in people with long-standing HIV infection: A single-centre experience. (PubMed, HIV Med) - No abstract available

Journal • Human Immunodeficiency Virus • Infectious Disease

Pharmacokinetics, safety, and dose optimization of GST-HG171 in renal impairment: insights from physiologically based pharmacokinetic modeling. (PubMed, Antimicrob Agents Chemother) - P=N/A | "GST-HG171 was generally tolerated across all groups, but adverse reactions related to hypertriglyceridemia should be monitored. Physiologically based PK modeling supported dose reductions for patients with renal impairment, recommending GST-HG171/ritonavir 100/100 mg twice daily for mild impairment and 50/100 mg twice daily for moderate impairment, administered for 5 days.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as NCT06106126."

Journal • PK/PD data • Dyslipidemia • Hypertriglyceridemia • Infectious Disease • Novel Coronavirus Disease • Renal Disease

Reversible HIV-Associated Nephropathy and Concomitant Encephalomyelopathy as the Initial Presentation of Advanced, Untreated HIV. (PubMed, Cureus) - "The patient was initiated on regular haemodialysis and an intensive antiretroviral regimen consisting of dolutegravir/lamivudine, darunavir, and ritonavir, alongside co-trimoxazole prophylaxis until her CD4 count was over 200 cells/mm3. This case underscores that advanced HIVAN requiring renal replacement therapy and extensive HIV-related central nervous system pathology can be profoundly reversed with timely, potent antiretroviral therapy. Clinicians must maintain a high index of suspicion for HIV in patients presenting with unexplained concurrent multiorgan dysfunction, as early intervention can avert permanent end-stage organ failure and severe neurological disability."

Journal • Acute Kidney Injury • Chronic Kidney Disease • CNS Disorders • Glomerulonephritis • Human Immunodeficiency Virus • Infectious Disease • Nephrology • Renal Disease • CD4

Ethanol-assisted fabrication of Casein-Ritonavir amorphous dispersions. (PubMed, Food Hydrocoll Health) - "Zeta potential measurements showed a consistent increase in negative surface charge (-45 mV to -60 mV) with increasing ethanol content during complex fabrication, indicating changes in surface charge characteristics and electrostatic dispersion stability. Therefore, these findings support the formation of stable, amorphous casein-ritonavir complexes with improved solubility and potential for oral delivery applications."

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