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Lopinavir and Ritonavir is an HIV-1 protease inhibitor indicated in combination with other antiretroviral agents for the treatment of HIV-1 infection in adults and pediatric patients (14 days and older).
Lopinavir and Ritonavir tablets may be taken with or without food, swallowed whole and not chewed, broken, or crushed.
Adult Patients:
Concomitant Therapy in Adults Patients: Dose adjustments of Lopinavir and Ritonavir may be needed when co-administering with efavirenz, nevirapine, or nelfinavir.
Do not use once daily administration of Lopinavir and Ritonavir in: HIV-1 infected patients with three or more of the following lopinavir resistance-associated substitutions: L10F/I/R/V, K20M/N/R, L24I, L33F, M36I, I47V, G48V, I54L/T/V, V82A/C/F/S/T, and I84V. Combination with efavirenz, nevirapine, nelfinavir, carbamazepine, phenobarbital, or phenytoin.
Co-administration of Lopinavir and Ritonavir is contraindicated with potent CYP3A inducers where significantly reduced lopinavir plasma concentrations may be associated with the potential for loss of virologic response and possible resistance and cross resistance. It is also contraindicated with Alpha 1 Adrenoreceptor Antagonist (Alfuzosin), Antimycobacterial (Rifampin), Ergot Derivatives ( Dihydroergotamine, ergotamine, methylergonovine), Gl Motility Agent (Cisapride), HMG-CoA Reductase Inhibitors (Lovastatin, simvastatin), PDE5 Enzyme Inhibitor (Sildenafil, when used for the treatment of pulmonary arterial hypertension), Neuroleptic (Pimozide) Sedative/Hypnotics (Triazolam; orally administered midazolam)
Lopinavir and Ritonavir is contraindicated in patients with previously demonstrated clinically significant hypersensitivity (e.g., toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, urticaria, angioedema) to any of its ingredients, including lopinavir and ritonavir.
Co-administration of Lopinavir and Ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated plasma concentrations are associated with serious and/or life-threatening reactions.
Commonly reported side effects included diarrhea, nausea, vomiting, hypertriglyceridemia and hypercholesterolemia.
Nursing Mothers: The Centers for Disease Control and Prevention recommend that HIV-1 infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV-1. Studies in rats have demonstrated that lopinavir is secreted in milk. It is not known whether lopinavir is secreted in human milk. Because of both the potential for HIV-1 transmission and the potential for serious adverse reactions in nursing infants, mothers should be instructed not to breastfeed if they are receiving this combination
Human experience of acute overdosage with this combination is limited. Treatment of overdose should consist of general supportive measures including monitoring of vital signs and observation of the clinical status of the patient. There is no specific antidote for overdose with this combination. If indicated, elimination of unabsorbed drug should be achieved by gastric lavage. Administration of activated charcoal may also be used to aid in removal of unabsorbed drug. Since lopinavir is highly protein bound, dialysis is unlikely to be beneficial in significant removal of the drug. However, dialysis can remove both alcohol and propylene glycol in the case of overdose with this combination.
Keep in a dry place & store below 30° C. Protect from light & keep out of the reach of children.
Lopinavir + Ritonavir (100mg+25mg), (200 mg+50 mg), (80 mg + 20 mg/ml),