BMA Concise Guide to Medicine & Drugs

Lopinavir/Ritonavir

Brand name Kaletra

Used in the following combined preparations None

QUICK REFERENCE

Drug group Drug for HIV and immune deficiency

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Lopinavir and ritonavir are both antiretroviral drugs from the same class of drugs known as protease inhibitors. Combined together as a single drug, they are used in the treatment of HIV infection. The drugs work by interfering with an enzyme used by the virus to produce genetic material.

The combination drug is prescribed with other antiretroviral drugs, usually two nucleoside analogues, which together slow down the production of HIV. The aim of this combination therapy is to reduce the damage done to the immune system by the virus.

Combination antiretroviral therapy is not a cure for HIV. Taken regularly on a long-term basis, it can reduce the level of the virus in the body and improve the outlook for the HIV patient. However, the patient will remain infectious, and will suffer a relapse if the treatment is stopped.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, liquid.

Frequency and timing of doses Every 12 hours, with food.

Adult dosage range 2 tablets, 5ml liquid.

Onset of effect Within 1 hour.

Duration of action 12 hours.

Diet advice None.

Storage Keep in original container at room temperature (tablets), or refrigerator (liquid) out of the reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next. It is very important not to miss doses on a regular basis as this can lead to the development of drug-resistant HIV.

Stopping the drug Do not stop taking the drug without consulting your doctor.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.

POSSIBLE ADVERSE EFFECTS

Gastrointestinal symptoms (such as nausea, vomiting, diarrhoea, and loss of appetite) and fatigue are the most common adverse effects. Changes in body shape, which are more likely to occur with long-term use (see ), should be discussed with your doctor. If severe abdominal pain occurs, seek prompt medical help.

INTERACTIONS

General note A wide range of drugs may interact with lopinavir and ritonavir, causing either an increase in adverse effects or a reduction in the effect of the antiretroviral drugs. Check with your doctor or pharmacist before taking any new drugs, including those from the dentist and supermarket, and herbal medicines. Ritonavir is known to interact with some recreational drugs, including ecstasy, and it is essential that you discuss the use of such drugs with your doctor or pharmacist.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have long-term liver or kidney problems.

· You have heart problems.

· You take recreational drugs.

· You are taking other medicines.

Pregnancy Safety in pregnancy not established. Discuss with your doctor.

Breast-feeding Safety in breast-feeding not established. Breast-feeding is not recommended for HIV-positive mothers as the virus may be passed to the baby.

Infants and children Not recommended in children under 2 years. Reduced dose recommended in children over 2 years.

Over 60 Reduced dose may be necessary to minimize adverse effects.

Driving and hazardous work No known problems.

Alcohol The liquid form of the drug contains a small amount of alcohol, so care should be taken if alcoholic drinks are consumed as well.

PROLONGED USE

Changes in body shape may occur, including redistribution of body fat from the arms and/or legs to the abdomen and back of the neck.

Monitoring Your doctor will take regular blood samples to check the effect of the drugs on the virus. Blood will also be checked for changes in lipids, cholesterol, and sugar levels.