Fact Sheet Number 446
- WHAT IS LOPINAVIR?
- WHO SHOULD TAKE IT?
- WHAT ABOUT DRUG RESISTANCE?
- HOW IS IT TAKEN?
- WHAT ARE THE SIDE EFFECTS?
- HOW DOES IT REACT WITH OTHER DRUGS?
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PrintLopinavir is a drug used for antiviral therapy. Lopinavir used
to be called ABT-378. It is manufactured by Abbott Laboratories.
Lopinavir is a protease inhibitor. The amount of Lopinavir in
the blood stream stays much higher if it is taken with a small
amount of ritonavir, another protease inhibitor. See Fact
Sheet 442 for more information on ritonavir. Kaletra®
is a combination of lopinavir and ritonavir in the same capsule.
Protease inhibitors prevent the protease enzyme from working.
HIV protease acts like a chemical scissors. It cuts the raw material
for HIV into specific pieces needed to build a new virus. Protease
inhibitors “gum up” these scissors.
KALETRA?
Kaletra was approved as an antiviral drug for people with HIV
infection. There are no absolute rules about when to start antiviral
drugs. You and your doctor should consider your T-cell
count, your viral load,
any symptoms you are having, and your attitude about taking HIV
medications. Fact Sheet 411
has more information about guidelines
for the use of antiviral medications.
If you take Kaletra with other antiviral drugs, you can reduce
your viral load to extremely low levels, and increase your T-cell
counts. This should mean staying healthier longer.
RESISTANCE?
Many new copies of HIV are mutations. They are slightly different
from the original virus. Some mutations can keep multiplying even
when you are taking an antiviral drug. When this happens, the
drug will stop working. This is called “developing resistance”
to the drug. See Fact Sheet 414
for more information on resistance.
Sometimes, if your virus develops resistance to one drug, it
will also have resistance to other antiviral drugs. This is called
“cross-resistance”.
Kaletra provides blood levels that are high enough to control
HIV that has already developed some resistance to other protease
inhibitors.
Resistance can develop quickly. It is very important to
take antiviral medications according to instructions, on schedule,
and not to skip or reduce doses.
TAKEN?
Kaletra is taken by mouth as a capsule. Each capsule contains
133 milligrams (mg) of lopinavir and 33 mg of ritonavir. The normal
dose is three capsules twice a day. It is also available in liquid
form. The normal adult dose is 5 milliliters (ml) twice a day.
Kaletra should be taken with food.
Different doses are used in some combinations. Be sure you
know how much Kaletra your doctor has prescribed for you, and
when and how to take each dose.
Kaletra is approved for use by children. Their dosage is based
on their body weight.
Your pharmacist should keep Kaletra refrigerated. When you
take it home, you can refrigerate it, or else keep it below 77º
F or 25º C and use it within two months.
WHAT ARE THE SIDE EFFECTS?
The most common side effects of Kaletra are diarrhea, fatigue,
headache, and nausea. None of these side effects seem to be very
serious. Kaletra can increase the amount of fat (cholesterol and
triglycerides) in your blood. High levels of blood fats can increase
your risk of problems with your heart or pancreas.
REACT WITH OTHER DRUGS?
Kaletra is broken down by the liver and can interact with other
drugs that also use the liver. Combining these drugs can change
the amount of each drug in your bloodstream and cause an under-
or overdose. Drugs to watch out for include Viagra, several antihistamines,
sedatives, drugs to lower cholesterol and anti-fungal drugs. Make
sure that your doctor knows about ALL drugs you are taking.
If you are taking Kaletra and ddI,
you should take ddI one hour before or two hours after Kaletra.
You should also take Kaletra one hour apart from antacids.
Some birth control pills may not work if you are taking Kaletra.
Talk to your doctor about how to prevent an unwanted pregnancy.
The herb St. John’s Wort (See
Fact Sheet 729) lowers the blood levels of some protease inhibitors.
Tell your doctor about any herbs or other supplements that you
use.
Revised August 16, 2002
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New Mexico AIDS Education and Training Center
and the New Mexico Department of Health