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lopinavir and ritonavir

J05AR10

Forms & Strengths

Tablets: 100mg/25mg, 200mg/50mg lopinavir/ritonavir
Oral solution: 80mg/20mg per mL lopinavir/ritonavir
Capsules: 100mg/25mg lopinavir/ritonavir

Adult Dosing

400mg/100mg twice daily for treatment-naive patients
600mg/150mg twice daily for treatment-experienced patients
Dose adjustments for liver dysfunction: 200mg/50mg twice daily for mild dysfunction, 100mg/25mg twice daily for moderate dysfunction
400mg/100mg twice daily with food

Pediatric Dosing

Infants ≥14 days and children: 300mg/75mg per m^2 twice daily (max 400mg/100mg twice daily)
Children >6 months to <18 years with body surface area >1.4m^2: 400mg/100mg twice daily
Children 7-15 kg: 12/3mg/kg twice daily, >15-40 kg: 10/2.5mg/kg twice daily

Indications

Treatment of HIV-1 infection in adults and pediatric patients
In combination with other antiretroviral agents for HIV-1 infection

Mechanism of Action

Lopinavir: inhibits HIV-1 protease, preventing viral replication
Ritonavir: inhibits cytochrome P450 enzyme CYP3A4, increasing lopinavir bioavailability

Contraindications

Hypersensitivity to lopinavir or ritonavir
Concurrent use of drugs that are highly dependent on CYP3A4 for metabolism
Concurrent use of potent CYP3A4 inducers that may decrease lopinavir/ritonavir efficacy

Adverse Reactions

Diarrhea, nausea, fever, asthenia
Increased liver enzymes, lipid abnormalities
Pancreatitis, hyperglycemia, insulin resistance
QT prolongation, torsades de pointes

Drug Interactions

Contraindicated with alfuzosin, amiodarone, bepridil, cisapride, dihydroergotamine, ergonovine, ergotamine, midazolam, pimozide, propafenone, quinidine, sildenafil (for pulmonary arterial hypertension), simvastatin, lovastatin, triazolam, St. John's Wort
Caution with rifampin, rifabutin, carbamazepine, phenobarbital, phenytoin, and other CYP3A4 inducers

Curated Content: Needs Vetting Before Put to Clinical Use