lopinavir and ritonavir, Kaletra
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
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
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.
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.
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