Drug reference
HIV infection in combination with other antiretroviral drugs ▶BY MOUTH USING TABLETS ▶Adult: 400/100 mg twice daily, alternatively 800/200 mg once daily, once daily dose to be used only in adults with a HIV strain that has less than 3 mutations to protease inhibitors ▶BY MOUTH USING ORAL SOLUTION ▶Adult: 5 mL twice daily DOSE EQUIVALENCE AND CONVERSION ▶Oral solution contains 400 mg lopinavir, 100 mg ritonavir/5 mL (or 80 mg lopinavir, 20 mg ritonavir/mL).
PDF page 718
Cardiac conduction disorders. pancreatitis. patients at high risk of cardiovascular disease. structural heart disease
PDF page 718
For oral solution, manufacturer advises high alcohol (42 % v/v) and propylene glycol content—consider total amounts from all medicines that are to be given to infants in order to avoid toxicity; caution in patients for which consumption may be harmful.
PDF page 718
Scottish Medicines Consortium (SMC) decisions SMC No. 326/06 The Scottish Medicines Consortium has advised (November 2006) that lopinavir with ritonavir tablet (Kaletra ®) is accepted for use within NHS Scotland in combination with other antiretrovirals for the treatment of HIV-1 infected adults and children above the age of 2 years.
PDF page 718
→Appendix 1: HIV-protease inhibitors
PDF page 718
▶Common or very common Increased risk of infection. leucopenia. lymphadenopathy. menstrual cycle irregularities. migraine. muscle weakness. myopathy. night sweats. pain. sexual dysfunction ▶Uncommon Atherosclerosis. atrioventricular block. cholangitis. constipation. deep vein thrombosis. haemorrhage. hyperbilirubinaemia. hypogonadism. myocardial infarction. nephritis. stomatitis. stroke. tinnitus. tremor. tricuspid valve incompetence. vasculitis . vertigo. visual impairment SIDE-EFFECTS, FURTHER INFORMATION Signs and symptoms suggestive of pancreatitis (including raised serum lipase) should be evaluated—discontinue if pancreatitis diagnosed.
PDF page 718
For tablets, manufacturer advises only use if potential benefit outweighs risk—toxicity in animal studies (recommendation also supported by specialist sources). Avoid oral solution due to high alcohol and propylene glycol content.
PDF page 718
For oral solution, manufacturer advises avoid due to propylene glycol content (risk of toxicity). For tablets, manufacturer advises avoid in severe impairment (no information available).
PDF page 718
Avoid oral solution due to high propylene glycol content.
PDF page 718
▶Manufacturer advises monitor liver function before and during treatment. ▶For oral solution, manufacturer advises monitor for signs of alcohol and propylene glycol toxicity (particularly in infants).
PDF page 718
There can be variation in the licensing of different medicines containing the same drug. Oral solution CAUTIONARY AND ADVISORY LABELS 21 EXCIPIENTS: May contain Alcohol, propylene glycol ▶Kaletra (AbbVie Ltd) Ritonavir 20 mg per 1 ml, Lopinavir 80 mg per 1 ml Kaletra 80mg/20mg/1ml oral solution | 120 ml P £122.96 | 300 ml P £307.39 Tablet CAUTIONARY AND ADVISORY LABELS 25 ▶Lopinavir with ritonavir (Non-proprietary) Ritonavir 50 mg, Lopinavir 200 mg Lopinavir 200mg / Ritonavir 50mg tablets | 120 tablet P £285.40 (Hospital only) | 120 tablet P £242.60–£285.40 ▶Kaletra (AbbVie Ltd) Ritonavir 25 mg, Lopinavir 100 mg Kaletra 100mg/25mg tablets | 60 tablet P £76.85 Ritonavir 50 mg, Lopinavir 200 mg Kaletra 200mg/50mg tablets | 120 tablet P £285.41 eiiii F 693
PDF page 718
Oral solution tastes bitter.
PDF page 718
400/100 mg twice daily, alternatively
First-line fragment. Read the complete Indications and Dose section above.
PDF page 718
5 mL twice daily
First-line fragment. Read the complete Indications and Dose section above.
PDF page 718
