lopinavir and ritonavir, Kaletra

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GENERIC NAME: lopinavir and ritonavir

BRAND NAME: Kaletra

DRUG CLASS AND MECHANISM: Kaletra is an oral medication that is a combination of lopinavir and ritonavir. It is used for treating infections with the human immunodeficiency virus (HIV). It is in a class of drugs called protease inhibitors which, among others, includes ritonavir (Norvir), nelfinavir (Viracept) and saquinavir (Invirase, Fortovase). Although both lopinavir and ritonavir inhibit the HIV virus, they are combined in Kaletra because ritonavir increases the concentration of lopinavir in the body. In fact, the activity of Kaletra against HIV is due to the lopinavir because the amount of ritonavir in Kaletra is not enough to inhibit the HIV virus. During infection with HIV, the HIV virus multiplies within the body's cells. Viruses are released from the cells and spread throughout the body where they infect other cells. In this manner, HIV infection is perpetuated among new cells that the body produces continually. During the production of the viruses, new proteins for the viruses are made. Some of the proteins are structural proteins, that, is, proteins that form the body of the virus. Other proteins are enzymes which manufacture DNA and other components for the new viruses. Protease is the enzyme that forms the new structural proteins and enzymes. The lopinavir in Kaletra blocks the action of protease and results in the formation of defective viruses that are unable to infect the body's cells. As a result, the number of viruses in the body (the viral load) decreases. Nevertheless, Kaletra does not prevent the transmission of HIV among individuals, and it does not cure HIV infections or AIDS. Kaletra was approved by the FDA in September 2000.

GENERIC AVAILABLE: No

PRESCRIPTION: Yes

PREPARATIONS: Tablets (mg lopinavir/mg ritonavir): 100/25 and 200/50. Oral solution: 80/20 per mL. Capsules: 133/33.3.

STORAGE: Capsules and solution should be refrigerated at 2 C to 8 C (36 F to 46 F). If stored at room temperature, the capsules and solution should be used within 2 months. Tablets should be stored at 15 C to30 C (59 F to 86 F).

PRESCRIBED FOR: Kaletra is used for the treatment of HIV infection.

DOSING: Kaletra tablets may be administered with or without food. Oral solution and capsules should be administered with food. There are several dosing regimens depending on the formulation used, age of the patient, previous exposure to lopinavir, or use of other drugs. Here are some examples.

  • Therapy-naive adult patients: 400/100 tablets (3 capsules) twice daily or 800/200 (6 capsules) once daily; Oral solution, 5 mL twice daily or 10 mL once daily with food.
  • Therapy-experienced adult patients: 200/50 tablets, two twice daily or 3 capsules twice daily; Oral solution 5 mL twice daily. Once daily administration of Kaletra is not recommended.
  • Children between 6 months and 18 years of age: The recommended dose is 230/57.5/m2 of the oral solution given twice daily and not to exceed the recommended adult dose. Kaletra should not be administered once daily in patients less than 18 years of age.
  • Children between 14 days and 6 months of age: The recommended dose is 16/4/kg or 300/75/m2 of the oral solution given twice daily.
  • In combination with efavirenz (Sustiva), nevirapine (Viramune), fosamprenavir (Lexiva) or nelfinavir (Viracept): Once daily administration is not recommended when combined with efavirenz, nevirapine, fosamprenavir or nelfinavir. For adults, the recommended dose is two 200/50 tablets and one 100/25 tablet twice daily; Oral solution, 6.5 mL twice daily. For children, the recommended dose is 300/75/m2 not to exceed the adult dose.

DRUG INTERACTIONS: Kaletra interacts with many drugs. Some of the important interactions are mentioned below. Patients should consult their healthcare provider before combining any drug with Kaletra.

Kaletra should not be used together with amiodarone (Cordarone), quinidine (Quinaglute, Cardioquin), triazolam (Halcion), midazolam (Versed), pimozide (Orap), ergotamine derivatives (for example, Ergostat), propafenone (Rythmol) and flecainide (Tambocor) because Kaletra increases the levels of these drugs in the body and as a result may lead to serious adverse effects of these drugs.

Medically Reviewed by a Doctor on 3/6/2013



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