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Lopinavir + Ritonavir: Brands, Price & Uses in Bangladesh
Lopinavir + Ritonavir is a fixed-dose combination of an HIV-1 protease inhibitor (lopinavir) with a pharmacokinetic booster (ritonavir) and more.
About Lopinavir + Ritonavir
Indications of Lopinavir + Ritonavir
Lopinavir + Ritonavir is a fixed-dose combination of an HIV-1 protease inhibitor (lopinavir) with a pharmacokinetic booster (ritonavir), indicated for the treatment of HIV-1 infection in adults and pediatric patients (14 days of age and older).
- Established/approved use: Lopinavir + Ritonavir is indicated, always in combination with other antiretroviral agents, for the treatment of HIV-1 infection in treatment-naive and treatment-experienced adults and children.
- Guideline-supported use: Recommended by WHO and national HIV treatment guidelines as an alternative boosted-protease-inhibitor-based regimen, including for infants, young children, and pregnant women where integrase-inhibitor-based regimens are not suitable or available.
- Combination therapy requirement: Lopinavir + Ritonavir must always be prescribed with at least two other active antiretroviral agents as part of a complete regimen; it is never used as monotherapy.
Use of Lopinavir + Ritonavir must always be directed by a physician experienced in HIV management, with regular monitoring of viral load, CD4 count, hepatic function, lipids, and treatment adherence.
Dosage & Administration of Lopinavir + Ritonavir
Lopinavir + Ritonavir must always be prescribed as part of a combination antiretroviral regimen; it should never be used alone.
| Population | Recommended Dose |
|---|---|
| Adults and adolescents | 400 mg/100 mg (two 200 mg/50 mg tablets) twice daily with food; an alternative once-daily dose of 800 mg/200 mg may be used in select patients without certain resistance-associated substitutions, but is not recommended in pregnancy or with once-daily efavirenz, nevirapine, nelfinavir, or in patients dosed less than twice daily with other interacting agents, per physician judgment |
| Pediatric patients (14 days of age and older) | Weight- or body-surface-area-based twice-daily dosing using the oral solution or age/weight-appropriate tablet strength, per current pediatric ART weight-band tables; not recommended in neonates before 14 days of postnatal age |
| Hepatic impairment | Use with caution in mild-to-moderate hepatic impairment with close monitoring; not recommended in patients with severe hepatic impairment |
See Dosage and Administration sections below for further detail, and Use in Special Populations for hepatic and pediatric/neonatal considerations.
Side Effects of Lopinavir + Ritonavir
Common side effects
- Diarrhea (very common) and other gastrointestinal upset
- Nausea, vomiting, abdominal pain
- Headache
- Asthenia (weakness) and fatigue
- Insomnia and other sleep disturbances
- Rash
Serious side effects
- Pancreatitis, including fatal cases, particularly in patients with markedly elevated triglycerides or a history of pancreatitis; seek immediate care for severe abdominal pain, nausea, or vomiting.
- Hepatotoxicity, including hepatic transaminase elevations and, rarely, hepatic failure, especially in patients with underlying liver disease or hepatitis B/C co-infection.
- QT and PR interval prolongation, which can lead to cardiac arrhythmias in susceptible patients.
- Lipid abnormalities — significant elevations in triglycerides and cholesterol.
- Hyperglycemia and new-onset diabetes mellitus, or worsening of pre-existing diabetes.
- Redistribution/accumulation of body fat (lipodystrophy) with long-term antiretroviral therapy.
- Immune reconstitution inflammatory syndrome (IRIS) after starting therapy.
- Increased bleeding episodes have been reported in patients with hemophilia.
Contraindications of Lopinavir + Ritonavir
Lopinavir + Ritonavir is contraindicated in:
- Patients with known hypersensitivity to lopinavir, ritonavir, or any excipient of the formulation.
- Co-administration with drugs that are highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious or life-threatening events, including certain ergot derivatives (e.g., dihydroergotamine, ergotamine, methylergonovine), oral midazolam, triazolam, pimozide, cisapride, lovastatin, simvastatin, ranolazine, dronedarone, lurasidone, alfuzosin, rifampin, and sildenafil when used for pulmonary arterial hypertension.
Frequently Asked Questions about Lopinavir + Ritonavir
What is Lopinavir + Ritonavir used for?
Lopinavir + Ritonavir is a boosted protease-inhibitor antiretroviral medicine used, together with other antiretroviral drugs, to treat HIV-1 infection in adults and children (14 days of age and older) as part of combination antiretroviral therapy.
Can I take Lopinavir + Ritonavir on its own?
No. Lopinavir + Ritonavir must always be used in combination with at least two other active antiretroviral agents as part of a complete regimen prescribed by a physician; using it alone can lead to treatment failure and drug resistance.
Should Lopinavir + Ritonavir be taken with food?
Yes. Lopinavir + Ritonavir tablets are generally taken with food to help absorption, and the oral solution must always be taken with food. Follow your physician's or pharmacist's specific instructions.
What happens if I miss a dose of Lopinavir + Ritonavir?
Take the missed dose as soon as you remember unless it is close to the time of your next dose, in which case skip the missed dose and continue your regular schedule. Do not take a double dose. Missing doses regularly can promote HIV drug resistance, so try to take Lopinavir + Ritonavir at the same times every day.
Is Lopinavir + Ritonavir safe during pregnancy?
Lopinavir + Ritonavir has been used during pregnancy as part of guideline-directed combination antiretroviral therapy to treat the mother and reduce the risk of passing HIV to the baby, but it should only be used under a physician's guidance, who will select the most appropriate regimen and dosing schedule. Do not start or stop this medicine during pregnancy without medical advice.
What serious warning signs should I watch for while taking Lopinavir + Ritonavir?
Seek immediate medical attention for severe abdominal pain, nausea, or vomiting (possible pancreatitis), signs of liver problems (yellowing of skin/eyes, dark urine, severe fatigue), irregular heartbeat or fainting (possible heart rhythm effects), or any signs of a severe allergic reaction.
Can I stop taking Lopinavir + Ritonavir if I feel better?
No. Do not stop, skip doses, or share Lopinavir + Ritonavir with others without consulting your physician. Stopping treatment can cause the virus to rebound and increases the risk of the virus becoming resistant to treatment.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.