Lopinavir Ritonavir

Lopinavir Ritonavir Brand Name– Kaletra

What is Lopinavir Ritonavir

Lopinavir ritonavir is indicated for use in combination with other antiretroviral medications to treat HIV-1 infections in adults and pediatric patients 14 days and older.

Lopinavir is an antiretroviral protease inhibitor.

It is formulated with a small amount of ritonavir to increase and maintain adequate lopinavir concentrations.

Lopinavir is the active component of the lopinavir ritonavir formulation.

Indications

  1. coronavirus disease 2019 (COVID-19)
  2. human immunodeficiency virus (HIV)
  3. human immunodeficiency virus (HIV) infection
  4. human immunodeficiency virus (HIV) prophylaxis
  5. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
  6. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection

NOTE: HIV guidelines recommend consideration be given to avoiding use of lopinavir; ritonavir-containing regimens in patients at high risk for cardiovascular adverse events.

Side Effects

  1. abdominal pain
  2. alopecia
  3. amenorrhea
  4. anemia
  5. angioedema
  6. anorexia
  7. anxiety
  8. appetite stimulation
  9. arthralgia
  10. asthenia
  11. AV block
  12. back pain
  13. bleeding
  14. bradycardia
  15. breast enlargement
  16. cardiomyopathy
  17. cholangitis
  18. colitis
  19. constipation
  20. Cushingoid features
  21. diabetes mellitus
  22. diabetic ketoacidosis
  23. diarrhea
  24. dizziness
  25. dysgeusia
  26. dyspepsia
  27. elevated hepatic enzymes
  28. erythema multiforme
  29. fatigue
  30. fecal incontinence
  31. fever
  32. flatulence
  33. folliculitis
  34. furunculosis
  35. gastritis
  36. gastroesophageal reflux
  37. GI bleeding
  38. gonadal suppression
  39. gynecomastia
  40. headache
  41. hematoma
  42. hematuria
  43. hemorrhoids
  44. hepatitis
  45. hepatomegaly
  46. hyperamylasemia
  47. hyperbilirubinemia
  48. hypercholesterolemia
  49. hyperglycemia
  50. hyperlipidemia
  51. hypernatremia
  52. hypertension
  53. hypertriglyceridemia
  54. hyperuricemia
  55. hyponatremia
  56. hypophosphatemia
  57. impotence (erectile dysfunction)
  58. infection
  59. insomnia
  60. jaundice
  61. lactic acidosis
  62. leukopenia
  63. libido decrease
  64. lipodystrophy
  65. lymphadenopathy
  66. maculopapular rash
  67. menorrhagia
  68. migraine
  69. myalgia
  70. myocardial infarction
  71. nausea
  72. neutropenia
  73. night sweats
  74. oral ulceration
  75. osteonecrosis
  76. pancreatitis
  77. peptic ulcer
  78. peripheral neuropathy
  79. PR prolongation
  80. pruritus
  81. QT prolongation
  82. rash
  83. renal failure (unspecified)
  84. rhabdomyolysis
  85. seborrhea
  86. seizures
  87. steatosis
  88. Stevens-Johnson syndrome
  89. stomatitis
  90. thrombocytopenia
  91. thrombosis
  92. tinnitus
  93. torsade de pointes
  94. toxic epidermal necrolysis
  95. tremor
  96. urticaria
  97. vasculitis
  98. vertigo
  99. visual impairment
  100. vomiting
  101. weakness
  102. weight gain
  103. weight loss
  104. xerosis
  105. xerostomia

Monitoring Parameters

  • blood glucose
  • CBC with differential
  • CD4+ T cell count
  • hepatitis B serology
  • LFTs
  • plasma hepatitis C RNA
  • plasma HIV RNA
  • pregnancy testing
  • serum bilirubin (total and direct)
  • serum cholesterol
  • serum lipid profile
  • urinalysis

Contraindications

  • alcoholism
  • apheresis
  • autoimmune disease
  • AV block
  • bradycardia
  • breast-feeding
  • cardiac disease
  • cardiomyopathy
  • celiac disease
  • children
  • diabetes mellitus
  • diabetic ketoacidosis
  • females
  • fever
  • geriatric
  • Graves’ disease
  • Guillain-Barre syndrome
  • heart failure
  • hemophilia
  • hepatic disease
  • hepatitis
  • hepatitis B and HIV coinfection
  • hepatitis C and HIV coinfection
  • human immunodeficiency virus (HIV) infection
  • human immunodeficiency virus (HIV) infection resistance
  • hypercholesterolemia
  • hyperglycemia
  • hyperlipidemia
  • hyperparathyroidism
  • hypertriglyceridemia
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothermia
  • hypothyroidism
  • immune reconstitution syndrome
  • infants
  • jaundice
  • long QT syndrome
  • myocardial infarction
  • neonates
  • pancreatitis
  • pheochromocytoma
  • pregnancy
  • QT prolongation
  • rheumatoid arthritis
  • sickle cell disease
  • sleep deprivation
  • stroke
  • systemic lupus erythematosus (SLE)

Interactions

  • Abacavir
  • Abacavir; Dolutegravir; Lamivudine
  • Abacavir; Lamivudine, 3TC
  • Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
  • Abemaciclib
  • Acalabrutinib
  • Acarbose
  • Acebutolol
  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
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  • Aliskiren; Valsartan
  • Almotriptan
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  • Chlorpheniramine; Codeine
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  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
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  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Emtricitabine; Rilpivirine; Tenofovir alafenamide
  • Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
  • Emtricitabine; Tenofovir alafenamide
  • Emtricitabine; Tenofovir disoproxil fumarate
  • Enalapril; Felodipine
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  • Estropipate
  • Eszopiclone
  • Ethanol
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Desogestrel
  • Ethinyl Estradiol; Ethynodiol Diacetate
  • Ethinyl Estradiol; Etonogestrel
  • Ethinyl Estradiol; Levonorgestrel
  • Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
  • Ethinyl Estradiol; Norethindrone; Ferrous fumarate
  • Ethinyl Estradiol; Norgestimate
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  • Fentanyl
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  • Fingolimod
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  • Flibanserin
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  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Fluticasone
  • Fluticasone; Salmeterol
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  • Fluvastatin
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  • food
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  • Glipizide; Metformin
  • Glyburide; Metformin
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  • Goserelin
  • Granisetron
  • grapefruit juice
  • Griseofulvin
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guanfacine
  • Halofantrine
  • Halogenated Anesthetics
  • Haloperidol
  • Histrelin
  • Homatropine; Hydrocodone
  • Hydantoins
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydroxychloroquine
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  • Hydroxyzine
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  • Ibuprofen; Oxycodone
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  • Perphenazine; Amitriptyline
  • Pexidartinib
  • Phenobarbital
  • Phentermine; Topiramate
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimavanserin
  • Pimozide
  • Pindolol
  • Pirbuterol
  • Pirfenidone
  • Pitolisant
  • Polatuzumab Vedotin
  • Pomalidomide
  • Ponatinib
  • Posaconazole
  • Pramlintide
  • Praziquantel
  • Prednisolone
  • Prednisone
  • Primaquine
  • Primidone
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Propofol
  • Propoxyphene
  • Propranolol
  • Protriptyline
  • Quazepam
  • Quetiapine
  • Quinidine
  • Quinine
  • Rabeprazole
  • Ramelteon
  • Ranolazine
  • Red Yeast Rice
  • Regorafenib
  • Remifentanil
  • Repaglinide
  • Retapamulin
  • Revefenacin
  • Ribavirin
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Rilpivirine
  • Riluzole
  • Rimegepant
  • Riociguat
  • Ripretinib
  • Risperidone
  • Rivaroxaban
  • Rocuronium
  • Roflumilast
  • Romidepsin
  • Rosuvastatin
  • Ruxolitinib
  • Sacituzumab Govitecan
  • Sacubitril; Valsartan
  • Salmeterol
  • Sapropterin
  • Saquinavir
  • Saxagliptin
  • Secobarbital
  • Segesterone Acetate; Ethinyl Estradiol
  • Selexipag
  • Selpercatinib
  • Selumetinib
  • Sertraline
  • Short-acting beta-agonists
  • Sibutramine
  • Sildenafil
  • Silodosin
  • Simeprevir
  • Simvastatin
  • Simvastatin; Sitagliptin
  • Siponimod
  • Sirolimus
  • Sitagliptin
  • Sodium Bicarbonate
  • Sodium Oxybate
  • Sofosbuvir; Velpatasvir; Voxilaprevir
  • Solifenacin
  • Somatropin, rh-GH
  • Sonidegib
  • Sorafenib
  • Sotalol
  • St. John’s Wort, Hypericum perforatum
  • Sufentanil
  • Sulfonylureas
  • Sunitinib
  • Suvorexant
  • Tacrolimus
  • Tadalafil
  • Talazoparib
  • Tamoxifen
  • Tamsulosin
  • Tasimelteon
  • Tazemetostat
  • Telaprevir
  • Telavancin
  • Telithromycin
  • Telotristat Ethyl
  • Temsirolimus
  • Teniposide
  • Tenofovir Alafenamide
  • Tenofovir Alafenamide
  • Tenofovir, PMPA
  • Terbinafine
  • Terbutaline
  • Terfenadine
  • Tesamorelin
  • Testosterone
  • Tetrabenazine
  • Tezacaftor; Ivacaftor
  • Theophylline, Aminophylline
  • Thiazolidinediones
  • Thiopental
  • Thioridazine
  • Thiotepa
  • Tiagabine
  • Ticagrelor
  • Timolol
  • Tinidazole
  • Tiotropium; Olodaterol
  • Tofacitinib
  • Tolterodine
  • Tolvaptan
  • Topiramate
  • Topotecan
  • Toremifene
  • Trabectedin
  • Tramadol
  • Trandolapril; Verapamil
  • Trazodone
  • Triamcinolone
  • Triazolam
  • Triclabendazole
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimetrexate
  • Trimipramine
  • Triptorelin
  • Tucatinib
  • Ubrogepant
  • Ulipristal
  • Umeclidinium; Vilanterol
  • Upadacitinib
  • Valbenazine
  • Valproic Acid, Divalproex Sodium
  • Valsartan
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venetoclax
  • Venlafaxine
  • Verapamil
  • Vilazodone
  • Vinblastine
  • Vincristine
  • Vincristine Liposomal
  • Vinorelbine
  • Vorapaxar
  • Voriconazole
  • Vorinostat
  • Voxelotor
  • Warfarin
  • Yohimbine
  • Zafirlukast
  • Zalcitabine, ddC
  • Zaleplon
  • Zanubrutinib
  • Zidovudine, ZDV
  • Zileuton
  • Ziprasidone
  • Zolmitriptan
  • Zolpidem
  • Zonisamide