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Ritonavir is an antiretroviral drug classified as a protease inhibitor, primarily used in the treatment and prevention of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). It works by binding to the catalytic site of HIV protease, thereby inhibiting the cleavage of viral polyprotein precursors into mature, functional proteins required for viral replication. Ritonavir is also a potent inhibitor of cytochrome P450 3A4 (CYP3A4), which increases plasma concentrations of other co-administered protease inhibitors—a property exploited in combination therapies to "boost" their effectiveness. Initially approved at full dose for HIV therapy, it is now mainly used at low doses as a pharmacokinetic enhancer with other protease inhibitors. Ritonavir has also been repurposed in combination with nirmatrelvir (as Paxlovid) for early treatment of COVID-19 to reduce progression to severe disease[2][5][1].
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