Indications
Lopinavir is an antiviral medicine used to treat HIV 1 infection in adults and children, always in combination with other HIV medicines. It is given together with a low dose of Ritonavir in the same tablet, because Ritonavir boosts Lopinavir levels in the blood. It is not a cure for HIV and does not prevent passing HIV to others.
How It Works
HIV needs an enzyme called protease to cut its proteins into the right pieces to make new infectious virus particles. Lopinavir is a protease inhibitor: it blocks this enzyme, so the virus cannot mature and multiply. This lowers the amount of virus in the blood and allows the immune system (CD4 cells) to recover.
Dosage and Administration
Take exactly as prescribed by your HIV doctor. The dose depends on age, weight, other medicines and whether the virus has resistance. Tablets can be taken with or without food and must be swallowed whole, not chewed or crushed. Take it every day at the same times and do not miss doses, because missed doses allow the virus to become resistant. Do not stop without talking to your doctor.
Interactions
Lopinavir with Ritonavir has many serious interactions. Do not take it with Simvastatin or Lovastatin, Sildenafil for lung blood pressure, Midazolam by mouth, Triazolam, Amiodarone, Ergotamine, Rifampicin, St John’s Wort, Colchicine in people with kidney or liver problems, or Salmeterol. It can change the levels of many medicines, including hormonal contraceptives, Warfarin, some heart medicines, anti seizure medicines, steroids such as Fluticasone, and erectile dysfunction medicines. Always check with your doctor or pharmacist before starting any new medicine or herbal product.
Contraindications
- Allergy to Lopinavir, Ritonavir or any ingredient.
- Severe liver disease.
- Use with the medicines listed above that must not be combined.
Side Effects
Common effects are diarrhoea, nausea, vomiting, stomach pain, headache, tiredness and rash. It can raise blood fats (cholesterol and triglycerides) and blood sugar, and change liver tests. Changes in body fat may occur over time.
Get urgent medical help if you have severe stomach pain spreading to the back with vomiting (possible pancreatitis), yellowing of the skin or eyes, a blistering or peeling rash, fainting, a very slow or irregular heartbeat, or signs of a new infection after starting treatment.
Pregnancy and Lactation
HIV medicines are important in pregnancy to protect the baby from infection. Lopinavir with Ritonavir may be used in pregnancy when prescribed; the oral solution contains alcohol and is avoided. Breastfeeding advice for mothers with HIV depends on local guidelines; discuss with your doctor.
Precautions and Warnings
Your doctor will check liver tests, blood fats, blood sugar and sometimes the heart tracing (ECG). Tell your doctor if you have hepatitis B or C, diabetes, haemophilia, heart rhythm problems or pancreatitis. Hormonal contraceptive pills may not work well; use condoms as well. The liquid form contains alcohol and propylene glycol and must not be given to premature or newborn babies.
Overdose
There is no specific antidote. Contact a doctor or hospital at once; treatment is supportive with monitoring of the heart.
Therapeutic Class
Antiretroviral; HIV protease inhibitor (boosted with Ritonavir).
Storage
Store tablets below 30°C in a dry place, away from light and out of the reach of children. Keep in the original container. Store any oral solution as directed on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.