All you need to know about the combination of Lopinavir and Ritonavir

In the year of 2000, in the United States, the Lopinavir ritonavir was approved as a single medication for use in the medical. This fixed-dose combination medication is on the WHO's (World Health Organization's) List of Essential Medicines, the safest and most effective medicines needed in a health system.

The combination of Lopinavir and Ritonavir, both the medications are HIV protease inhibitors. Where Ritonavir mainly works by slowing down the breakdown of lopinavir.

This fixed-dose combination drug sold under the brand name Kaletra. It is basically recommended for the treatment as well as prevention of HIV/AIDS. In this combined medication, the dose of ritonavir should be low. These HIV protease inhibitors must be used with other antiretrovirals. It could be also used for prevention after a needlestick injury or other potential exposure. Till 2006, lopinavir/ritonavir was the most recommended and also most preferred fixed-dose combination medicine for Human Immunodeficiency Virus (HIV) as a first-line therapy by the U.S Department of Health and Human Services.

Apart from this as like several other Human Immunodeficiency Virus (HIV) protease inhibitors, its blood levels are greatly increased by low doses of ritonavir, a potent inhibitor of intestinal and hepatic CYP3A4, (basically an important enzyme in the body, mainly found in the liver and in the intestine. It oxidizes small foreign organic molecules (xenobiotics), such as toxins or drugs) which would otherwise reduce drug levels through catabolism.

Thus, lopinavir was only formulated and marketed as a fixed-dose combination with ritonavir.

Dosage of Lopinavir Ritonavir: 

The recommended daily dosage should be given as 800/200 mg once or twice daily. Also this combination medication can be given as once daily or twice daily regimen. The increased dose of lopinavir and ritonavir should be used when it  combines with the efavirenz, nevirapine, or nelfinavir. The combined Lopinavir and Ritonavir tablets shouldn't be recommended for once-daily dosing in pediatric patients who are younger than 18 years of age. Lopinavir 100 mg and ritonavir 25 mg tablets should be recommended only in those children who have reliably demonstrated the ability to swallow the intact tablet.

What are the Side Effects of Lopinavir Ritonavir:

The most common side effects observed with lopinavir-ritonavir tablets are as follows:

• Rash
• Diarrhea
• Nausea
• Asthenia
• Headache
• Vomiting
• Abdominal Pain
• Raised liver enzymes
• Hyperlipidemia (hypertriglyceridemia and hypercholesterolemia)

Interactions of Lopinavir and Ritonavir: 

Lopinavir and ritonavir tablets are anticipated to have varying degrees of interaction with other medications that are also CYP3A and/or P-gp substrates.
The fixed-dose combination of Lopinavir and Ritonavir should be used with caution in such patients who are with the preexisting conduction system abnormalities, structural heart disease, ischaemic heart disease, and cardiomyopathies.

Price of Lopinavir Ritonavir: 

The cost of Lopinavir and Ritonavir is quite decent. A respective patient can purchase this fixed-dose combination medication through any authorized and registered pharmaceutical company.

Note: The combination of lopinavir 200 mg and ritonavir 50 mg & lopinavir 100 mg and ritonavir 25 mg is not recommended during breastfeeding. For alternate options, talk to your healthcare provider.

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