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Drug · FAERS side-effect profile with label screen

Ritonavir side effects: what 29,045 FDA adverse event reports show

Ritonavir · 1,202 reaction terms · 102,599 drug–reaction co-reports · data 2026-09-14
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Drug class

Cytochrome P450 3A Inhibitor, Protease Inhibitor

FDA label (Established Pharmacologic Class) · compare the class

Who reports

29,045 reports · 91% serious · 2,637 with death outcome · 37% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Ritonavir tablets are indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection. Ritonavir tablets are HIV protease inhibitors indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection ( 1 )

FDA label, Indications and Usage

What it is

Ritonavir is an inhibitor of HIV protease with activity against the Human Immunodeficiency Virus (HIV). Ritonavir, USP is chemically designated as 2, 4, 7, 12-Tetraazatridecan-13-oic acid,10-h.

FDA label, Description section

Boxed warning

DRUG-DRUG INTERACTIONS LEADING TO POTENTIALLY SERIOUS AND/OR LIFE THREATENING REACTIONS Co-administration of ritonavir with several classes of drugs including sedative hypnotics, antiarrhythmics, or ergot alkaloid pr.

FDA label
How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 4Labeled (related wording) 1Lab value / disease marker 3Not in label — unassessed 32
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,162 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Progressive external ophthalmoplegia1145,406.2
3,156.1–9,260.4ROR 5,427.5 · calibrated p 5e-24 ✓
569.0 EB05 486.6 · IC025 +7.1
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=114 · ♀ 0% (drug 37%) · 94% clinicianno trial data cached
Aids encephalopathy341,007.7
597.7–1,699.1ROR 1,008.9 · calibrated p 2e-15 ✓
338.0 EB05 253.0 · IC025 +5.3
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=34 · ♀ 15% (drug 37%)no trial data cached
Ultrasound antenatal screen54960.3
638.1–1,445.1ROR 962.1 · calibrated p 6e-16 ✓
357.3 EB05 284.2 · IC025 +6.0
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=54 · 100% clinicianno trial data cached
Cloacal exstrophy32843.1
505.2–1,406.8ROR 844.0 · calibrated p 9e-15 ✓
313.8 EB05 232.7 · IC025 +5.2
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=32 · 100% clinicianno trial data cached
Cd4/cd8 ratio decreased97663.5
503.2–874.7ROR 665.7 · calibrated p 8e-15 ✓
321.9 EB05 271.6 · IC025 +6.6
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Lab value / disease markerserious n=97no trial data cached
Bladder agenesis33572.5
362.1–905.3ROR 573.2 · calibrated p 2e-13 ✓
268.3 EB05 199.9 · IC025 +5.2
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=33 · 100% clinicianno trial data cached
Hiv associated nephropathy18400.1
224.6–712.8ROR 400.4 · calibrated p 2e-11 ✓
201.8 EB05 135.0 · IC025 +4.2
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=18no trial data cached
Blood hiv rna18388.0
218.5–689.0ROR 388.2 · calibrated p 3e-11 ✓
198.7 EB05 133.0 · IC025 +4.2
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=16no trial data cached
Congenital naevus43332.5
231.5–477.4ROR 333.0 · calibrated p 2e-11 ✓
206.2 EB05 159.5 · IC025 +5.5
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=43 · ♀ 100% (drug 37%)no trial data cached
Supernumerary nipple25329.3
205.0–529.0ROR 329.6 · calibrated p 4e-11 ✓
192.5 EB05 137.1 · IC025 +4.7
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=25 · ♀ 100% (drug 37%)no trial data cached
Gastrointestinal disorder congenital32311.8
205.8–472.4ROR 312.2 · calibrated p 4e-11 ✓
192.3 EB05 142.6 · IC025 +5.1
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=32 · 100% clinicianno trial data cached
Aids dementia complex18297.8
171.8–516.2ROR 298.0 · calibrated p 2e-10 ✓
172.1 EB05 115.2 · IC025 +4.2
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=18no trial data cached
Hypercorticoidism30280.8
184.0–428.4ROR 281.1 · calibrated p 1e-10 ✓
178.8 EB05 131.3 · IC025 +4.9
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=29no trial data cached
Csf hiv escape syndrome39280.2
193.5–405.8ROR 280.6 · calibrated p 8e-11 ✓
183.4 EB05 140.0 · IC025 +5.3
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=39 · 100% clinicianno trial data cached
Alpha 1 foetoprotein abnormal28276.6
178.8–428.0ROR 276.9 · calibrated p 1e-10 ✓
175.7 EB05 127.6 · IC025 +4.8
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Lab value / disease markerserious n=22no trial data cached
Genitalia external ambiguous41220.9
155.7–313.6ROR 221.3 · calibrated p 5e-10 ✓
156.6 EB05 120.4 · IC025 +5.3
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=41 · ♀ 65% (drug 37%) · 90% clinicianno trial data cached
Hemivertebra40220.6
154.7–314.4ROR 220.9 · calibrated p 5e-10 ✓
156.2 EB05 119.6 · IC025 +5.3
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=40no trial data cached
Lipodystrophy acquired460198.8
179.4–220.3ROR 202.0 · calibrated p 4e-10 ✓
154.6 EB05 143.1 · IC025 +6.9
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Labeled adverse reaction
exact term
serious n=451no trial data cached
Meconium stain33194.0
132.0–285.0ROR 194.2 · calibrated p 2e-9 ✓
140.4 EB05 104.6 · IC025 +5.0
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=34 · ♀ 100% (drug 37%) · 100% clinicianno trial data cached
Bone demineralisation215183.6
158.1–213.2ROR 185.0 · calibrated p 9e-10 ✓
144.3 EB05 128.8 · IC025 +6.5
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=202no trial data cached
Caudal regression syndrome32183.6
124.5–270.7ROR 183.8 · calibrated p 3e-9 ✓
134.6 EB05 99.8 · IC025 +4.9
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=32 · 100% clinicianno trial data cached
Ergot poisoning25177.8
114.7–275.6ROR 178.0 · calibrated p 6e-9 ✓
128.7 EB05 91.7 · IC025 +4.6
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=25 · 100% clinicianno trial data cached
Hiv-associated neurocognitive disorder22175.8
110.3–280.4ROR 176.0 · calibrated p 7e-9 ✓
126.0 EB05 87.7 · IC025 +4.4
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=22no trial data cached
Mitochondrial toxicity159173.2
145.7–205.9ROR 174.2 · calibrated p 2e-9 ✓
137.2 EB05 120.2 · IC025 +6.3
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=159 · ♀ 9% (drug 37%)no trial data cached
Acoustic stimulation tests abnormal29165.0
110.2–247.1ROR 165.2 · calibrated p 8e-9 ✓
123.4 EB05 90.1 · IC025 +4.7
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=29 · ♀ 100% (drug 37%)no trial data cached
Cushing's syndrome123152.7
125.7–185.5ROR 153.3 · calibrated p 5e-9 ✓
123.5 EB05 106.3 · IC025 +6.1
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Labeled adverse reaction
exact term
serious n=117no trial data cached
Congenital genital malformation27144.4
95.5–218.4ROR 144.5 · calibrated p 2e-8 ✓
111.0 EB05 80.1 · IC025 +4.6
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=27 · 100% clinicianno trial data cached
Cd4 lymphocytes abnormal35143.9
100.1–206.9ROR 144.1 · calibrated p 2e-8 ✓
112.6 EB05 84.7 · IC025 +4.9
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Lab value / disease markerserious n=35no trial data cached
Immune reconstitution syndrome212139.8
120.7–161.9ROR 140.8 · calibrated p 9e-9 ✓
115.8 EB05 103.3 · IC025 +6.3
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Labeled adverse reaction
exact term
serious n=209no trial data cached
Ultrasound antenatal screen abnormal35134.6
93.8–193.1ROR 134.7 · calibrated p 3e-8 ✓
106.9 EB05 80.3 · IC025 +4.9
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=30 · ♀ 100% (drug 37%) · 100% clinicianno trial data cached
Trisomy 1858128.5
97.2–170.0ROR 128.8 · calibrated p 3e-8 ✓
105.3 EB05 84.5 · IC025 +5.4
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=57 · 100% clinicianno trial data cached
Ventricular hypoplasia36121.9
85.6–173.6ROR 122.1 · calibrated p 6e-8 ✓
98.9 EB05 74.6 · IC025 +4.9
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=36no trial data cached
Tethered cord syndrome30111.7
76.0–164.2ROR 111.8 · calibrated p 1e-7 ✓
91.2 EB05 67.0 · IC025 +4.6
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=30 · 100% clinicianno trial data cached
Anogenital dysplasia19104.0
64.3–168.2ROR 104.0 · calibrated p 4e-7 ✓
83.5 EB05 56.5 · IC025 +4.0
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=19no trial data cached
Heterotaxia21103.0
65.2–162.8ROR 103.1 · calibrated p 4e-7 ✓
83.5 EB05 57.6 · IC025 +4.1
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=21 · ♀ 0% (drug 37%) · 100% clinicianno trial data cached
Congenital anomaly in offspring1698.1
58.2–165.5ROR 98.2 · calibrated p 7e-7 ✓
78.5 EB05 51.3 · IC025 +3.7
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=16no trial data cached
Adrenal suppression9793.7
75.9–115.8ROR 94.1 · calibrated p 2e-7 ✓
81.7 EB05 68.9 · IC025 +5.5
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Labeled adverse reaction
exact term
serious n=94 · 96% clinicianno trial data cached
Chordee1693.3
55.4–157.1ROR 93.3 · calibrated p 1e-6 ✓
75.4 EB05 49.2 · IC025 +3.7
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=16no trial data cached
Spine malformation3990.1
64.6–125.7ROR 90.2 · calibrated p 5e-7 ✓
77.1 EB05 58.9 · IC025 +4.8
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Not in label — unassessedserious n=39no trial data cached

Trial evidence (ClinicalTrials.gov)

Trial cross-check not yet run for this drug (ClinicalTrials.gov pull covers the 800 most-reported drugs first).

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug interaction2,55611.8
11.4–12.3ROR 12.8 · calibrated p 0.013 ✓
11.6 EB05 11.2 · IC025 +3.5
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: PRR 38.3 (33.0–44.5)
Reporting / coding artifactserious PRR 8.0 · 91% clinicianno trial data cached
Foetal exposure during pregnancy2,39021.9
21.0–22.7ROR 23.7 · calibrated p 9e-4 ✓
21.2 EB05 20.5 · IC025 +4.3
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: PRR 53.2 (44.4–63.7)
Reporting / coding artifactserious PRR 13.4no trial data cached
Anxiety1,6224.1
3.9–4.3ROR 4.3 · calibrated p 0.325
4.1 EB05 3.9 · IC025 +2.0
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: PRR 10.9 (9.8–12.1)
Not in label — unassessedserious PRR 3.7no trial data cached
Pain1,5731.8
1.8–1.9ROR 1.9 · calibrated p 0.886
1.8 EB05 1.8 · IC025 +0.8
vs other Cytochrome P450 3A Inhibitors: PRR 9.7 (8.7–10.8)
Labeled adverse reaction
exact term
serious PRR 1.8no trial data cached
Emotional distress1,3888.3
7.9–8.8ROR 8.7 · calibrated p 0.051
8.2 EB05 7.9 · IC025 +3.0
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: PRR 8.8 (7.9–9.8)
Not in label — unassessedserious PRR 5.7 · 100% consumerno trial data cached
Maternal exposure during pregnancy1,23910.3
9.7–10.9ROR 10.7 · calibrated p 0.026 ✓
10.1 EB05 9.7 · IC025 +3.2
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: only this drug
Reporting / coding artifactserious PRR 6.8 · ♀ 99% (drug 37%)no trial data cached
Anhedonia1,23535.3
33.4–37.3ROR 36.8 · calibrated p 9e-5 ✓
33.6 EB05 32.1 · IC025 +5.0
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: PRR 8.4 (7.5–9.4)
Not in label — unassessedserious PRR 22.7 · 100% consumerno trial data cached
Nausea1,0561.0
0.9–1.0ROR 1.0 · calibrated p 0.284
1.0 EB05 0.9 · IC025 -0.2
PRR-only: not supported by EBGM or IC
vs other Cytochrome P450 3A Inhibitors: only this drug
Labeled adverse reaction
exact term
serious PRR 1.0no trial data cached
Diarrhoea (diarrhea)1,0221.1
1.1–1.2ROR 1.2 · calibrated p 0.408
1.1 EB05 1.1 · IC025 +0.1
vs other Cytochrome P450 3A Inhibitors: only this drug
Labeled adverse reaction
exact term
serious PRR 1.1no trial data cached
Exposure during pregnancy1,01111.9
11.2–12.7ROR 12.3 · calibrated p 0.015 ✓
11.7 EB05 11.1 · IC025 +3.4
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: PRR 94.6 (65.4–136.8)
Reporting / coding artifactserious PRR 9.9 · ♀ 99% (drug 37%)no trial data cached
Renal failure (kidney failure)9505.2
4.8–5.5ROR 5.3 · calibrated p 0.205
5.1 EB05 4.8 · IC025 +2.2
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: PRR 15.2 (12.9–17.8)
Labeled adverse reaction
exact term
serious PRR 3.3no trial data cached
Fatigue (tiredness)9060.8
0.8–0.9ROR 0.8 · calibrated p 0.205
0.8 EB05 0.8 · IC025 -0.4
PRR-only: not supported by EBGM or IC
vs other Cytochrome P450 3A Inhibitors: only this drug
Labeled adverse reaction
exact term
serious PRR 0.9no trial data cached
Chronic kidney disease8978.5
8.0–9.1ROR 8.8 · calibrated p 0.050 ✓
8.4 EB05 8.0 · IC025 +3.0
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: PRR 9.5 (8.3–10.9)
Not in label — unassessedserious PRR 5.4no trial data cached
Depression8682.7
2.6–2.9ROR 2.8 · calibrated p 0.694
2.7 EB05 2.6 · IC025 +1.3
3/3 methods agree
vs other Cytochrome P450 3A Inhibitors: PRR 16.0 (13.5–19.1)
Labeled adverse reaction
exact term
serious PRR 2.3no trial data cached

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Nirmatrelvir/ritonavir (Paxlovid) ↔ COVID-19 recurrence ("Paxlovid rebound").

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Ritonavir?

In FDA FAERS, the most frequently co-reported reaction terms for Ritonavir are anxiety, pain, emotional distress, anhedonia, nausea, diarrhoea. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Ritonavir have an FDA boxed warning?

Yes. The current FDA label carries a boxed warning: DRUG-DRUG INTERACTIONS LEADING TO POTENTIALLY SERIOUS AND/OR LIFE THREATENING REACTIONS Co-administration of ritonavir with several classes of drugs including sedative hypnotics, antiarrhythmics, or ergot alkaloid pr.

Do FAERS signals prove that Ritonavir causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.