lopinavir and ritonavir, Kaletra (cont.)

Pharmacy Author:

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.

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Medical and Pharmacy Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Kaletra may also prevent the break down of lovastatin (Mevacor), simvastatin (Zocor), rosuvastatin (Crestor) and atorvastatin (Lipitor), causing their levels in the body to rise. This may increase the occurrence of muscle breakdown (rhabdomyolysis), which is a side effect of these drugs. Therefore, lovastatin and simvastatin should not be combined with Kaletra; the dose of rosuvastatin should not exceed 10 mg/day and the lowest dose of atorvastatin should be used. The blood concentration of rifabutin (Mycobutin) and sildenafil (Viagra) can be increased by Kaletra. Therefore, the doses of rifabutin and sildenafil should be reduced.

The oral solution contains alcohol, which causes severe side effects when combined with metronidazole (Flagyl) or disulfiram (Antabuse).

Kaletra can reduce the effectiveness of oral contraceptives.

Rifampin (Rifadin), St. John's wort, efavirenz (Sustiva) and nevirapine (Viramune) decrease the blood levels of Kaletra and this can reduce the effectiveness of Kaletra.

PREGNANCY: Use of Kaletra during pregnancy has not been adequately evaluated.

NURSING MOTHERS: It is not known whether Kaletra is excreted in breast milk. Nevertheless, HIV-infected mothers should not breastfeed because of the potential risk of transmitting HIV to an infant that is not infected.

SIDE EFFECTS: The most common side effects of Kaletra are abdominal pain, weakness, nausea, diarrhea, vomiting, headache and insomnia. Kaletra may cause liver failure and failure of the pancreas. Like other protease inhibitors use of Kaletra may be associated with redistribution or accumulation of body fat, increased cholesterol and worsening of diabetes. Kaletra may cause abnormal heart rhythms. It should be used cautiously in patients with pre-existing heart conditions.

Reference: FDA Prescribing Information

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