natgillin/translations-raw huggingface dataset:
Ritonavir has a high affinity for several cytochrome P450 (CYP) isoforms and may inhibit oxidation with the following ranked order: CYP3A4 > CYP2D6. 
Ritonavir ima visok afinitet za nekoliko izoformi citokroma P450 (CYP) i može inhibirati oksidaciju ovim slijedom prema jačini: CYP3A4 > CYP2D6.
The protein binding of ritonavir in human plasma is approximately 98 - 99% and is constant over the concentration range of 1.0 - 100 μg/ml. 
Oko 98 - 99% ritonavira u ljudskoj plazmi veže se na proteine i to je vezanje nepromijenjeno u rasponu koncentracija od 1,0 do 100 µg /ml.
Co-administration of bosentan and ritonavir may increase steady state bosentan maximum concentrations (Cmax) and area under the curve (AUC). 
Istodobna primjena bosentana i ritonavira može povećati maksimalne koncentracije bosentana u stanju dinamičke ravnoteže (Cmax) i površinu ispod krivulje (AUC)
Cardiac and neurologic events have been reported when ritonavir has been co-administered with disopyramide, mexiletine or nefazodone. 
Prijavljeni su srčani i neurološki događaji kada se ritonavir davao istodobno s dizopiramidom, meksiletinom ili nefazodonom.
Recommended doses of Ritonavir Mylan are: 
Preporučene doze lijeka Ritonavir Mylan:
Pack sizes: 30, 90, 100 and multipack containing 90 (3 bottles of 30) film-coated tablets. 
Veličine pakiranja: 30, 90, 100 i multipakiranje od 90 (3 bočice po 30) filmom obloženih tableta.
Inhibition of HIV protease renders the enzyme incapable of processing the gag-pol polyprotein precursor which leads to the production of HIV particles with immature morphology that are unable to initiate new rounds of infection. 
Inhibicijom HIV-proteaze, taj enzim više ne može razgrađivati prekursor poliproteina gag-pol, zbog čega se stvaraju HIV-čestice nezrele morfologije, koje nisu sposobne pokretati nove cikluse infekcije.
Effects of food on oral absorption 
Učinak hrane na apsorpciju nakon oralne primjene
Contraindicated when used for the treatment of pulmonary arterial hypertension (PAH) only. 
Kontraindiciran samo kada se koristi u bolesnika s plućnom arterijskom hipertenzijom (PAH).
Relevant examples are cytomegalovirus retinitis, generalised and/or focal mycobacterial infections, and Pneumocystis jiroveci pneumonia. 
Mjerodavni primjeri su citomegalovirusni retinitis, generalizirane i/ili fokalne mikobakterijske infekcije i pneumonija koju uzrokuje
Ritonavir is principally metabolised and eliminated by the liver. 
Ritonavir se primarno metabolizira u jetri te putem nje i uklanja.
Ritonavir was not found to be mutagenic or clastogenic in a battery of in vitro and in vivo assays including the Ames bacterial reverse mutation assay using S. typhimurium and E. coli, the mouse lymphoma assay, the mouse micronucleus test and chromosomal aberration assays in human lymphocytes. 
Ritonavir se nije pokazao mutagenim ni klastogenim kompletom testova in vitro i in vivo, uključujući Amesov bakterijski test povratnih mutacija sa S. typhimurium i E. coli, test mišjeg limfoma, test mišjih mikronukleusa i testove kromosomskih aberacija ljudskih limfocita.
117 Allée des Parcs, 69800 Saint-Priest, France 
117 Allée des Parcs, 69800 Saint-Priest, Francuska
You must not take ritonavir with colchicine if you have kidney and/or liver problems (see also ‘Do not take Ritonavir Mylan' above). 
Ne smijete uzimati ritonavir s kolhicinom ako imate tegobe s bubrezima i/ili jetrom (pogledajte i dio „Nemojte uzimati Ritonavir Mylan” gore).
Autoimmune disorders (such as Graves' disease and autoimmune hepatitis) have also been reported; however, the reported time to onset is more variable and can occur many months after initiation of treatment (see section 4.4). 
Autoimuni poremećaji (kao što je Gravesova bolest i autoimuni hepatitis) su također zabilježeni; no zabilježeno je varijabilno vrijeme nastupa poremećaja koje može nastupiti i više mjeseci nakon započinjanja liječenja (vidjeti dio 4.4).
Increased glucose, increased magnesium, increased alkaline phosphatase 
Manje često Povišena vrijednost glukoze, povišena vrijednost magnezija, povišena vrijednost alkalne fosfataze
Hormonal contraceptive Ethinylestradiol 
Hormonski kontraceptivi Etinilestradiol
Systemic corticosteroid effects including Cushing's syndrome and adrenal suppression (plasma cortisol levels were noted to be decreased 86% in the above study) have been reported in patients receiving ritonavir and inhaled or intranasal fluticasone propionate; similar effects could also occur with other corticosteroids metabolised by CYP3A e.g., budesonide and triamcinolone. 
Sistemni učinci kortikosteroida uključuju Cushingov sindrom i supresiju nadbubrežnih žlijezda (u gornjem se ispitivanju pokazalo da su se razine kortizola u plazmi snizile za 86%) prijavljeni su u bolesnika koji su primali ritonavir i inhalacijski ili intranazalni flutikazonpropionat; sličnih bi učinaka moglo biti i pri primjeni drugih kortikosteroida koji se metaboliziraju putem CYP3A, npr. pri primjeni budezonida i triamcinolona.
In contrast to long-term administration of ritonavir, there was no significant interaction with bupropion after short-term administration of low doses of ritonavir (200 mg twice daily for 2 days), suggesting reductions in bupropion concentrations may have onset several days after initiation of ritonavir co-administration. 
Za razliku od dugotrajne primjene ritonavira, nije bilo značajne interakcije s bupropionom pri kratkotrajnoj primjeni ritonavira u malim dozama (200 mg dva puta na dan tijekom 2 dana), što upućuje na to da su se koncentracije bupropiona počinju smanjivati nekoliko dana nakon uvođenja ritonavira.
Effect on Coadministered Medicinal Products AUC 
Utjecaj istodobno primijenjenog lijeka na AUC
The use of higher ritonavir doses might alter the safety profile of the combination and therefore is not recommended. 
Primjena ritonavira u većim dozama može promijeniti profil neškodljivosti te kombinacije i stoga se ne preporučuje.
Other medicines and Ritonavir Mylan 
Drugi lijekovi i Ritonavir Mylan
After multiple dosing of ritonavir to healthy volunteers (500 mg twice daily) and subjects with mild to moderate hepatic impairment (Child Pugh Class A and B, 400 mg twice daily) exposure to ritonavir after dose normalisation was not significantly different between the two groups. 
Nakon višekratnog doziranja ritonavira zdravim dobrovoljcima (500 mg dva puta na dan) i ispitanicima s blago do umjereno oslabljenom funkcijom jetre (Child Pugh stupanj A i B, 400 mg dva puta na dan), izloženost dviju skupina ritonaviru nije se, nakon normalizacije doze, statistički značajno razlikovala.
Tell your doctor if you feel sick (nauseous), are vomiting, or have stomach pain, because these may be signs of an inflamed pancreas. 
Recite svome liječniku ako imate mučninu ili povraćate, ili ako imate bolove u želucu, jer to mogu biti znakovi upale gušterače.
Extra vigilance is warranted in patients with chronic hepatitis B or hepatitis C co-infection, as these patients have an increased risk of hepatotoxicity. 
Poseban je nadzor nužan u bolesnika s istodobnim infekcijama hepatitisom B ili C jer je u njih povećan rizik od hepatotoksičnosti.
Ritonavir also has a high affinity for P-glycoprotein and may inhibit this transporter. 
Ritonavir ima i visok afinitet za P-glikoprotein i može ga inhibirati.
The effect of ritonavir on rifampicin is not known. 
Ne zna se utječe li ritonavir na rifampicin.
If a patient is already taking St John's wort, St John's wort should be stopped and if possible check viral levels. 
Ako bolesnik već uzima gospinu travu, njenu primjenu trebalo bi obustaviti i, ako je moguće, provjeriti broj kopija virusa.
The increased digoxin levels may lessen over time (see section 4.5). 
Povišene razine digoksina mogu se s vremenom sniziti (vidjeti dio 4.5).
Haemophilia, as there have been reports of increased bleeding in patients with haemophilia who are taking this type of medicine (protease inhibitors). 
- Hemofiliju, jer je bilo prijava pojačanog krvarenja u bolesnika s hemofilijom koji uzimaju ovu vrstu lijekova (inhibitore proteaza).
Co-administration with ritonavir may cause a large increase in the concentration of this benzodiazepine. 
Pri njegovoj primjeni istodobno s ritonavirom moguć je velik porast koncentracije tog benzodiazepina.
25-O-desacetyl rifabutin metabolite 
25-O-dezacetil metabolit rifabutina
The following warnings apply when Ritonavir Mylan is taken as a full dose. 
Niže navedena upozorenja vrijede kada se Ritonavir Mylan uzima u punoj dozi.
Across dose groups, ritonavir oral clearance (CL/F/m2) declined with age with median values of 9.0 L/h/m2 in children less than 3 months of age, 7.8 L/h/m2 in children between 3 and 6 months of age and 4.4 L/h/m2 in children between 6 and 24 months of age. 
Usporedba skupina prema primljenim dozama pokazala je da se klirens oralno primijenjenog ritonavira (CL/F/m²) smanjivao s dobi, te su medijani vrijednosti iznosili 9,0 l/h/m² u djece mlađe od 3 mjeseca, 7,8 l/h/m² u djece u dobi od 3 do 6 mjeseci, a 4,4 l/h/m² u djece u dobi od 6 do 24 mjeseca.
Amphetamine derivatives Amphetamine 
Derivati amfetamina Amfetamin
Steroids 
Steroidi
Increased plasma concentrations of ergot derivatives leading to acute ergot toxicity, including vasospasm and ischaemia. 
Povećane koncentracije derivata ergota u plazmi, što dovodi do akutne ergotne toksičnosti, uključujući spazam krvnih žila i ishemiju.
For selected medicinal products (e.g. alprazolam) the inhibitory effects of ritonavir on CYP3A4 may decrease over time. 
Pri istodobnoj primjeni s nekim lijekovima (npr. alprazolamom), inhibicijski učinak ritonavira na CYP3A4 može s vremenom oslabiti.
Renal failure, renal impairment, elevated creatinine, hypophosphataemia and proximal tubulopathy (including Fanconi syndrome) have been reported with the use of tenofovir disoproxil fumarate (DF) in clinical practice (see section 4.8). 
Zatajenje bubrega, oštećenje funkcije bubrega, povišene razine kreatinina, hipofosfatemija i proksimalna tubulopatija (uključujući Fanconijev sindrom) zabilježeni su u kliničkoj praksi prilikom primjene tenofovirdizoproksilfumarata (DF) (vidjeti dio 4.8).
Pancreatitis has been observed in patients receiving ritonavir therapy, including those who developed hypertriglyceridemia. 
U bolesnika koji su primali ritonavir uočena je pojava pankreatitisa, uključujući bolesnike koji su razvili hipertrigliceridemiju.
Hepatitis B or C and are being treated with a combination of antiretroviral agents, as you are at a greater risk of a severe and potentially life threatening reaction because of the effect on the liver. 
- Hepatitis B ili C i liječite se kombinacijom antiretrovirusnih lijekova, jer ste izloženi većem riziku od teške i možda za život opasne reakcije zbog učinka na jetru.
Herbal preparations containing St John's wort must not be used in combination with ritonavir. 
Biljni pripravci koji sadržavaju gospinu travu ne smiju se koristiti u kombinaciji s ritonavirom.
Low doses of ritonavir have shown profound effects on the pharmacokinetics of other protease inhibitors (and other products metabolised by CYP3A4) and other protease inhibitors may influence the pharmacokinetics of ritonavir (see section 4.5). 
Pokazalo se da ritonavir u malim dozama snažno utječe na farmakokinetiku drugih inhibitora proteaza (i ostalih pripravaka koji se metaboliziraju putem CYP3A4), te da drugi inhibitori proteaza mogu utjecati na farmakokinetiku ritonavira (vidjeti dio 4.5).
Phenytoin may decrease serum levels of ritonavir. 
Fenitoin može sniziti razine ritonavira u serumu.
The inhibitory effect of ritonavir (with or without other protease inhibitors) on P-gp activity may decrease over time (e.g. digoxin and fexofenadine-see table “Ritonavir effects on non-antiretroviral medicinal products” below). 
Inhibicijski učinak ritonavira (sa ili bez drugih inhibitora proteaza) na P-gp može s vremenom oslabiti (npr. u slučaju digoksina i feksofenadina - vidjeti tablicu „Učinci ritonavira na lijekove koji nisu antiretrovirotici” u nastavku teksta).
100q12h↑ 57% ↑ 77% 
100 svakih 12 h ↑ 57% ↑ 77%
This increase is likely due to ritonavir and a more pronounced effect may be observed during prolonged co-administration. 
Ovo povišenje se vjerojatno događa zbog ritonavira i moguć je izraženiji učinak tijekom produljene primjene.
If a side effect is preventing you from taking Ritonavir Mylan as directed, tell your doctor straight away. 
Bude li Vas koja nuspojava sprječavala da uzimate Ritonavir Mylan prema uputi, odmah to recite svom liječniku.
Antidepressants Amitriptyline, fluoxetine, imipramine, nortriptyline, paroxetine, sertraline 
Antidepresivi Amitriptilin, fluoksetin, imipramin, nortriptilin, paroksetin, sertralin
• swelling of the hands and feet 
• oticanje dlanova i stopala
Based on data for other CYP3A4 inhibitors, plasma concentrations of midazolam are expected to be significantly higher when midazolam is given orally. 
Na temelju podataka o drugim inhibitorima CYP3A4, očekuje se da bi koncentracije midazolama u plazmi bile značajno veće pri njegovoj oralnoj primjeni.
If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, contact your doctor, pharmacist, Accident and Emergency department or if it is urgent get immediate medical help. 
Pogorša li se bilo koja nuspojava, ili ako zamijetite nuspojavu koja nije navedena u ovoj uputi, molimo javite se svome liječniku, ljekarniku ili hitnoj službi, a ako je riječ o hitnom slučaju, odmah potražite liječničku pomoć.
The pharmacokinetic parameters observed with various dosing schemes of ritonavir alone are shown in the table below. 
Farmakokinetički pokazatelji praćeni pri različitim shemama doziranja ritonavira samog prikazani su u tablici niže.
6.6 Special precautions for disposal No special requirements. 
6.6 Posebne mjere za zbrinjavanje i druga rukovanja lijekom Nema posebnih zahtjeva.
Increased risk of tumor lysis syndrome at the dose initiation and during the dose-titration phase (see section 4.5). 
Povećan rizik od sindroma tumorske lize pri uvođenju liječenja i tijekom razdoblja titracije doze (vidjeti dio 4.5).
Adverse reactions from clinical trials and post-marketing experience in adult patients The most frequently reported adverse drug reactions among patients receiving ritonavir alone or in combination with other antiretroviral drugs were gastrointestinal (including diarrhoea, nausea, vomiting, abdominal pain (upper and lower)), neurological disturbances (including paraesthesia and oral paraesthesia) and fatigue/asthenia. 
Nuspojave iz kliničkih ispitivanja i iz postmarketinškog praćenja kod odraslih bolesnika Najčešće zabilježene nuspojave među bolesnicima koji su uzimali ritonavir sam ili u kombinaciji s drugim antiretrovirusnim lijekovima bili su poremećaji probavnog sustava (uključujući proljev, mučninu, povraćanje, bol u gornjem i donjem abdomenu, neurološki poremećaji (uključujući paresteziju i oralnu paresteziju) i umor/astenija.
Plasma concentrations of ritonavir after administration of a single 100 mg dose tablet are similar to the 100 mg soft gelatin capsule under fed conditions. 
Koncentracije ritonavira u plazmi nakon primjene jednokratne doze u tableti od 100 mg bile su slične onima nakon primjene doze od 100 mg u mekoj želatinskoj kapsuli, uzetima s hranom.
Anorexia, flatulence, mouth ulcer, gastrointestinal haemorrhage, gastroesophageal reflux disease, pancreatitis 
Anoreksija, flatulencija, ulceracija usne šupljine, gastrointestinalno krvarenje, gastroezofagealna refluksna bolest, pankreatitis
The mean changes from baseline in PR interval ranged from 11.0 to 24.0 msec in the 12 hour interval post dose. 
Srednje vrijednosti promjena PR-intervala u odnosu na početne kretale su se u rasponu od 11,0 do 24,0 msec tijekom razdoblja od 12 sati nakon uzimanja doze.
Ritonavir can pass into breast milk. 
Ritonavir se može izlučiti u majčino mlijeko.
The tablets should be swallowed whole and not chewed, broken or crushed. 
Tablete se moraju progutati cijele i ne smiju se žvakati, lomiti ni drobiti.
Patients with impaired liver function 
Bolesnici s oštećenom funkcijom jetre
LIST OF EXCIPIENTS High in sodium - see leaflet for further information. 
POPIS POMOĆNIH TVARI Visoki sadržaj natrija - za dodatne informacije vidjeti uputu o lijeku.
Across dose groups, ritonavir oral clearance (CL/F/m2) was approximately 1.5 to 1.7 times faster in paediatric patients above 2 years of age than in adult subjects. 
Usporedba skupina prema primljenim dozama pokazala je da je klirens oralno primijenjenog ritonavira (CL/F/m²) bio oko 1,5 do 1,7 puta brži u pedijatrijskih bolesnika starijih od 2 godine negoli u odraslih ispitanika.
117 Allée des Parcs, Saint-Priest, 69800, France 
117 Allée des Parcs, Saint-Priest, 69800, Francuska
Herbal preparations containing St John's wort (Hypericum perforatum) due to the risk of decreased plasma concentrations and reduced clinical effects of ritonavir (see section 4.5). 
Biljni pripravci koji sadržavaju gospinu travu (Hypericum perforatum), zbog rizika od smanjenih koncentracija u plazmi i slabijih kliničkih učinaka ritonavira (vidjeti dio 4.5).
Ritonavir is not a cure for HIV infection or AIDS. 
- Ritonavir nije lijek za izlječenje HIV-infekcije ni AIDS-a.
Tissue to plasma ratios of approximately 1 measured in rat lymph nodes suggests that ritonavir distributes into lymphatic tissues. 
Omjer tkivo: plazma od oko 1, izmjeren u limfnim čvorovima štakora, upućuje na to da se ritonavir distribuira u limfna tkiva.
Co-administration of delamanid with a strong inhibitor of CYP3A (ritonavir) may increase exposure to delamanid metabolite, which has been associated with QTc prolongation. 
Istodobna primjena delamanida sa snažnim inhibitorom CYP3A (ritonavirom) može povisiti izloženost metabolitu delamanida, koji je povezan s produljenjem QTc intervala.
In HIV-infected patients with severe immune deficiency at the time of institution of combination antiretroviral therapy (CART), an inflammatory reaction to asymtomatic or residual opportunistic pathogens may arise and cause serious clinical conditions, or aggravation of symptoms. 
U bolesnika s HIV-infekcijom i teškom imunodeficijencijom u vrijeme uvođenja kombiniranog antiretrovirusnog liječenja (CART, engl. combination antiretroviral therapy) može se javiti upalna reakcija na asimptomatske ili rezidualne oportunističke patogene i prouzročiti ozbiljna klinička stanja ili pogoršati simptome.
Digoxin levels should be monitored more intensively than usual during this period, with dose adjustments made, as necessary, based on clinical, electrocardiographic and digoxin level findings. 
Razine digoksina treba tijekom tog razdoblja provjeravati češće nego inače, a dozu prilagođavati prema potrebi, ovisno o kliničkom i elektrokardiografskom nalazu te o razinama digoksina.
HCV Direct Acting Antiviral Glecaprevir/pibrentasvir 
Direktno djelujući antivirotici za liječenje HCV-a Glekaprevir/pibrentasvir
Saquinavir/ritonavir should not be given together with rifampicin, due to the risk of severe hepatotoxicity (presenting as increased hepatic transaminases) if the three medicines are given together (see section 4.5). 
Sakvinavir/ritonavir se ne smiju davati istodobno s rifampicinom zbog rizika od teške hepatotoksičnosti (koja se očituje porastom vrijednosti jetrenih transaminaza) ako se ta tri lijeka daju istodobno (vidjeti dio 4.5).
These data indicate no increase in the rate of birth defects compared to rates observed in population-based birth defect surveillance systems. 
Prema tim podacima, stopa porođajnih defekata nije bila veća od one zabilježene u općoj populaciji.
Increased fexofenadine levels may lessen over time as induction develops. 
Povišene razine feksofenadina mogu se s vremenom, s razvojem indukcije, sniziti.
Ritonavir is an orally active peptidomimetic inhibitor of the HIV-1 and HIV-2 aspartyl proteases. 
Ritonavir je oralno djelatni peptidomimetički inhibitor aspartil-proteaza virusa HIV-1 i HIV-2.
Proton pump inhibitors and H2-receptor antagonists Proton pump inhibitors and H2-receptor antagonists (e.g. omeprazole or ranitidine) may reduce concentrations for co-administered protease inhibitors. 
Inhibitori protonske crpke i antagonisti H2-receptora Inhibitori protonske crpke i antagonisti H2-receptora (npr. omeprazol i ranitidin) mogu smanjiti koncentracije istodobno primijenjenih inhibitora proteaza.
Rare reports of 2nd or 3rd degree atrioventricular block in patients with underlying structural heart disease and pre-existing conduction system abnormalities or in patients receiving medicinal products known to prolong the PR interval (such as verapamil or atazanavir) have been reported in patients receiving ritonavir. 
Bilo je rijetkih prijava atrioventrikularnog bloka 2. i 3. stupnja u bolesnika sa strukturnom bolešću srca u podlozi i u onih s već prisutnim nenormalnostima provodnog sustava, te u bolesnika koji su primali lijekove za koje se zna da produžuju PR-interval (npr. verapamil i atazanavir), a primali su ritonavir.
Caution should be exercised in administering afatinib with ritonavir (refer to the afatinib SmPC). 
Potreban je oprez kada se afatinib primjenjuje zajedno s ritonavirom (vidjeti Sažetak opisa svojstava lijeka za afatinib).
Clinical investigation in humans has revealed no clinically significant alteration in thyroid function tests. 
Klinička ispitivanja u ljudi nisu pokazala klinički značajne promjene nalaza funkcijskih pretraga štitnjače.
Clarithromycin doses greater than 1 g per day should not be co-administered with ritonavir dosed as an antiretroviral agent or as a pharmacokinetic enhancer. 
Klaritromicin u dozama većima od 1 g na dan ne treba davati istodobno s ritonavirom doziranim kao antiretrovirusnim lijekom ni kao farmakokinetičkim pojačivačem.
The maximum mean (95% upper confidence bound) difference in QTcF from placebo was 5.5 (7.6) for 400 mg twice daily ritonavir. 
Maksimalna razlika srednje vrijednosti (gornja granica 95%tnog intervala pouzdanosti) QTcF-a u odnosu na placebo iznosila je 5,5 (7,6) pri dozi ritonavira od
Developmental toxicity observed in rats (embryolethality, decreased foetal body weight and ossification delays and visceral changes, including delayed testicular descent) occurred mainly at a maternally toxic dosage. 
Razvojna toksičnost u štakora (embrioletalnost, smanjena tjelesna težina fetusa, odgođeno okoštavanje i visceralne promjene, uključujući odgođeno spuštanje testisa) zamijećena je uglavnom pri maternalno toksičnim dozama.
MARKETING AUTHORISATION NUMBER(S) EU/1/17/1242/004 
12. BROJ(EVI) ODOBRENJA ZA STAVLJANJE LIJEKA U PROMET EU/1/17/1242/004
Concomitant use of ritonavir and fluticasone or other glucocorticoids that are metabolised by CYP3A4 is not recommended unless the potential benefit of treatment outweighs the risk of systemic corticosteroid effects, including Cushing's syndrome and adrenal suppression (see section 4.5). 
Istodobna primjena ritonavira s flutikazonom ili ostalim glukokortikoidima koji se metaboliziraju putem CYP3A4 se ne preporučuje, osim ako očekivana korist od liječenja ne nadmašuje rizik os sistemnih učinaka kortikosteroida, uključujući Cushingov sindrom i supresiju nadbubrežnih žlijezda (vidjeti dio 4.5).
Patients should not remain on 300 mg twice daily for more than 3 days. 
Bolesnika se na dozi od 300 mg na dan ne smije ostaviti duže od tri dana.
Ritonavir was noted to be extensively metabolised by the hepatic cytochrome P450 system, primarily by the CYP3A isozyme family and to a lesser extent by the CYP2D6 isoform. 
Zabilježeno je da se ritonavir opsežno metabolizira sustavom jetrenog citokroma P450, prvenstveno skupinom izoenzima CYP3A, a u manjem stupnju izoformom CYP2D6.
Increased urination, renal impairment (e.g. oliguria, elevated creatinine) 
Povećano mokrenje, oštećenje bubrega (npr. oligurija, povišen kreatinin)
Elevated norpethidine concentrations may increase the risk of CNS effects (e.g., seizures), see section 4.3. 
Povećane koncentracije norpetidina mogu povećati rizik od učinaka na CNS (npr. od napadaja); vidjeti dio 4.3.
Ritonavir should be used with caution in such patients (see section 5.1). 
Tim bolesnicima ritonavir treba davati oprezno (vidjeti dio 5.1).
Hypersensitivity including urticaria, and face oedema 
Preosjetljivost, uključujući urtikariju i edem lica.