Generic Name: lopinavir-ritonavir, Oral tablet

Generic Name:

lopinavir-ritonavir, Oral tablet

Kaletra

All Brands

  • Kaletra
SECTION 1 of 4

Highlights for lopinavir-ritonavir

Oral tablet
1

This is a combination drug used to treat HIV in adults and children at least 14 days old. For complete HIV treatment, it needs to be taken with at least one other drug.

2

Dosage depends on how resistant your HIV is to drug treatment. Often times, the drug is taken once or twice a day.

3

This drug has many possible drug interactions. Several of these drug interactions can slow your heart rate. Call your doctor right away if you think you might be having a drug interaction.

4

Though the drug has potential pregnancy risks, some pregnant women with HIV are given this drug. If you’re pregnant, talk to your doctor before taking it.

5

Common side effects include nausea, increased cholesterol, changes in body fat, and others.

IMPORTANT INFORMATION

Hemophilia warning

If you have hemophilia, you could have spontaneous bleeding while taking this drug. You may need additional treatment for your hemophilia.

May cause pancreatitis

Inflammation of the pancreas (pancreatitis) is a rare side effect from this drug. Signs could include:

  • stomach bloating
  • pain
  • nausea
  • vomiting
  • tenderness when touching the stomach.

If you’ve had pancreatitis before, you may be at greater risk.  

May lead to diabetes

You could develop diabetes while taking this drug. Or, if you already have diabetes, you could have an increase in blood sugar. Monitor your blood sugar carefully, especially when you start taking this drug.

Drug Features

Kaletra is a prescription drug. It is available in these forms: oral tablet and oral solution

This drug is a single treatment that's made up of multiple drug ingredients. It's important to know when you're taking a combination drug, because each of its parts might have unique traits.

This drug is used as part of a combination therapy, which means you’ll take it along with other drugs to treat HIV. In addition to lopinavir and ritonavir, a third antiretroviral drug must be added to make a complete treatment.      

Why It's Used

Kaletra is used in combination with at least one other antiretroviral drug to treat HIV. It doesn’t cure HIV, but it helps to control it.

The drug is approved to treat HIV in adults and children who are at least 14 days old.

How It Works

Lopinavir and ritonavir both belong to a class of drugs called protease inhibitors (PIs). A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

More Details

How It Works

Lopinavir and ritonavir both belong to a class of drugs called protease inhibitors (PIs). A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Protease inhibitors block the action of an enzyme called protease. The HIV virus uses protease to insert its genetic material into your cells. By blocking protease, this drug can interrupt the virus’s ability to copy itself and spread in your body.

SECTION 2 of 4

lopinavir-ritonavir Side Effects

Oral tablet

Most Common Side Effects

Some of the most common side effects that occur with Kaletra include:

  • diarrhea. This is more likely if you take the drug once a day than if you take it twice a day.

  • nausea

  • vomiting

  • high cholesterol or high triglycerides

  • changes in the distribution of body fat, such as an increasing amount of fat on the neck and back

If these effects are mild, they may disappear within a few days or a couple of weeks. If they’re more severe or don’t disappear, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • spontaneous bleeding in people with hemophilia

  • changes to your heart rhythm, especially if you have heart disease or a low potassium level in your blood. Tell your doctor and pharmacist about all drugs you’re taking, since some drugs can worsen this effect.

  • symptoms of liver toxicity, including yellowing of skin or whites of eyes, pain in the upper right part of your stomach (above the beltline), fatigue, loss of appetite, nausea, rash, dark urine, weight loss, and others. Your risk is higher if you already have liver disease, including hepatitis B and hepatitis C. Liver toxicity has been fatal in some cases.

  • inflammation of the pancreas (pancreatitis). This is a rare side effect. Signs could include:

    • stomach bloating
    • pain
    • nausea
    • vomiting
    • tenderness when touching the stomach

    If you’ve had pancreatitis before, you may be at greater risk.

  • symptoms of infection, including fungal infection, pneumonia, or tuberculosis. These may indicate immune reconstitution syndrome (IRS). In IRS, your improved immune system makes infections you have had in the past come back again. Your doctor may need to treat the old infection if this happens.

Pharmacist's Advice
Healthline Pharmacist Editorial Team

Kaletra does not cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

lopinavir-ritonavir May Interact with Other Medications

Oral tablet

This drug has many possible drug interactions. It can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Medications That Might Interact with This Drug

Antibiotics and other drugs to treat infections
  • artemether and lumefantrine (Coartem) for malaria
  • atovaquone (Mepron)
  • clarithromycin (Biaxin)
  • colchicine (Colcrys)
  • metronidazole ( Flagyl)
  • rifabutin (Mycobutin)
  • rifampin (Rifadin)

Antidepressants
  • bupropion (Wellbutrin)
  • paroxetine (Paxil)
  • sertraline (Zoloft)
  • trazodone (Desyrel)

Antifungal drugs
  • ketoconazole (Nizoral)
  • itraconazole (Sporonox)
  • voriconazole (Vfend, IV drug)

Antiretroviral (HIV) drugs

These include:

  • abacavir (Ziagen)
  • atazanavir (Reyataz)
  • delavirdine (Rescriptor)
  • didanosine (Videx)
  • efavirenz (Sustiva)
  • fosamprenavir (Lexiva)
  • indinavir (Crixivan)
  • maraviroc (Selzentry)
  • nelfinavir (Viracept)
  • nevirapine (Viramune)
  • ritonavir (Norvir)
  • saquinavir (Invirase)
  • tenofovir (Viread)
  • tipranavir (Aptivus)
  • zidovudine (Retrovir)

Asthma, allergy, and other respiratory drugs
  • bosentan (Tracleer)
  • budesonide (Pulmocort)
  • fluticasone (Flonase)
  • salmeterol (Serevent Diskus)

Blood thinner, anticoagulants
  • rivaroxaban (Xarelto)
  • warfarin (Coumadin)

Benign prostate enlargement (BPH)
  • alfuzosin (Uroxatral)

Chemotherapy
  • vincristine
  • vinblastine
  • nilotinib (Tasigna)

Cholesterol-lowering drugs
  • atorvastatin (Lipitor)
  • rosuvastatin (Crestor)

Epilepsy drugs
  • carbamazepine (Tegretol)
  • phenobarbital
  • phenytoin (Dilantin)

Erectile dysfunction drugs
  • avanafil (Stendra)
  • sildenafil (Viagra)
  • tadalafil (Cialis, Adcirca)
  • vardenafil (Levitra)

Heart drugs, calcium channel blockers, heart arrhythmia drugs
  • amiodarone (Cordarone)
  • digoxin (Lanoxin)
  • diltiazem (Cardizem)
  • lidocaine
  • nicardipine (Cardene)
  • nifedipine (Procardia, Adalat)
  • quinidine
  • verapamil (Calan, Verelan, Isoptin)

Hepatitis drugs
  • boceprevir (Victrelis) for hepatitis C
  • telaprevir (Incivek) for hepatitis C

Migraine drugs with ergotamine
  • dihydroergotamine (D.H.E. 45, Embolex, Migranal)
  • ergotamine (Cafergot, Ergomar)
  • methylergonovine

Oral contraceptives/hormones
  • ethinyl estradiol 
  • norethindrone

Pain drugs

These include:

  • fentanyl (Duragesic, Actiq and others)
  • buprenorphine/naloxone
  • methadone

Post-transplant drugs (immunosuppressants)
  • cyclosporine (Gengraf, Neoral)
  • tacrolimus (Prograf)
  • sirolimus (rapamycin)

Sedative medications

These include:

  • midazolam (Versed)
  • triazolam (Halcion)

Steroids
  • dexamethasone
  • prednisone

Tourette’s syndrome drugs
  • pimozide (Orap)

Herbs
  • St. John’s wort

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with hemophilia

If you have hemophilia, you could have spontaneous bleeding while taking this drug. You may need additional treatment for your hemophilia.

People with liver disease

Having liver disease, including hepatitis B and hepatitis C, increases your risk for liver toxicity from this drug. Your doctor should monitor your liver function before treatment and periodically during treatment. Liver toxicity has been fatal in some cases.

People with diabetes

If you have diabetes, your blood sugar could go up while taking Kaletra. Monitor your blood sugar carefully, especially when you begin treatment.

Pregnant women

This is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain about the risk to your baby.

Despite risks, this drug combination is sometimes used to treat pregnant women. Your doctor may decide that the benefit of taking this drug outweighs the risk.

If you’re pregnant or plan to become pregnant, talk to your doctor before taking this drug.

Women who are nursing

The U.S. Department of Health and Human Services states that HIV can be passed through breast milk and advises women with HIV not to breastfeed.

You should not breastfeed while taking this drug combination. Animal studies have shown that lopinavir, one of this drug’s ingredients, is passed through breast milk. If the drug reaches a baby through breast milk, the child could have serious side effects.

For Children

The oral solution is recommended for children 14 days to 12 years of age who weigh less than 40 kg, as well as for children who can’t swallow tablets.

Infants: This drug can be toxic in premature babies or in babies under 14 days old.

When to call the doctor

Call your doctor right away if you think you’re experiencing worsening HIV symptoms. These include:

  • fever
  • weakness
  • chills
  • night sweats
  • sore throat
  • joint pain

If you experience worsening symptoms, you may need a different treatment.

SECTION 4 of 4

How to Take lopinavir-ritonavir (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

Your dosage of Kaletra may depend on how resistant (or powerful) your HIV virus is. Your doctor will do a blood test to determine the virus’s resistance.

All possible dosages may not be included here.

What Are You Taking This Medication For?

Human immunodeficiency virus (HIV) infection

Brand: Kaletra

Form: Oral solution
Strength: 80 mg lopinavir and 20 mg ritonavir per milliliter
Form: Oral tablet
Strengths: 
  • 200 mg lopinavir and 50 mg ritonavir
  • 100 mg lopinavir and 25 mg ritonavir
Adult Dosage (ages 18 years and older)
  • Take two 200/50 mg tablets two times per day.
  • Take four 200/50 mg tablets once per day if your HIV virus has less than three substitutions due to resistance to lopinavir.
Child Dosage (ages 14 days-17 years)

Your doctor will provide a dose based on your child’s specific weight (dose should not be higher than the adult dose).

Child Dosage (ages 0-13 days)

This medicine has not been studied, and should not be used, in children under the age of 14 days.

Special Considerations

Children: Children who weigh at least 88 pounds (40 kg) can take the tablet form of this drug. For children at least 14 days old and up to age 12, and for children who can’t swallow tablets, an oral solution form is available. Your doctor will provide the correct dose based on your child’s size.

Seniors: If you are aged 65 years and older, your body may process this drug more slowly. Your doctor may start you on a lowered dose so that too much of this drug does not build up in your body. Too much of the drug in your body can be toxic.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Keeping HIV under control requires long-term treatment and long-term effort. There can be very serious health consequences if you don’t take this drug exactly how your doctor tells you.

If You Stop Taking It or Miss Doses

If you stop taking this medication or miss doses, your HIV can become worse. You may have many more serious infections and HIV-related problems.

If You Don’t Take It on Schedule

Taking your drug at the same time every day increases your ability to keep the virus under control. If you don’t, you risk worsened infection.

If You Miss a Dose

If you forget to take your dose, take it as soon as you remember. If it's just a few hours until your next dose, wait and take a single dose at the usual time.

Take just one dose at a time. Never try to catch up by taking two tablets at once. This could result in toxic side effects.

How Can I Tell if the Drug is Working?

To see how well your treatment is working, your doctor will check your:

  • symptoms
  • HIV virus count. A virus count measures the number of copies of the HIV virus in your body.

CD4 count. A CD4 count measures the amount of CD4 cells in your body. CD4 cells are white blood cells that fight infection. An increased CD4 count is a sign that your HIV treatment is working.

Kaletra is a long-term drug treatment.

You can take the tablet form of the drug with or without food

The oral solution must be taken with food.

Do not crush or cut the tablet form of this drug

If you need a different dose, or if you can’t swallow the tablets, ask your doctor or pharmacist about the oral solution.

Store the tablet form of this drug at room temperature: 68 – 77°F (20 – 25°C)

The tablets can be in temperatures as low as 59°F (15°C) and as high as 86°F (30°C) for short periods of time.

Keep the tablets in their original container and away from light and heat. If the tablets are exposed to high humidity for more than two weeks, they could lose some effectiveness. 

Store the oral solution in the refrigerator: 36 – 46°F (2 – 8°C). This will keep the solution fresh until its expiration date. If you store the solution at room temperature, make sure you use it within two months.

Note: Be careful of moist environments, including bathrooms. To keep drugs away from moisture, store them somewhere other than your bathroom and any other damp location.

Self-Management

This drug can cause blood sugar levels to rise. If you have diabetes or experience increased blood sugar, you may need to monitor your blood sugar.

Clinical Monitoring

Before you begin this treatment, and periodically while you’re on it, your doctor may check your:

  • liver function
  • blood sugar
  • cholesterol

To check your progress, your doctor may check your:

  • HIV viral load or count. A viral load test measures how many copies of the HIV virus are in your blood. A decreased number is a sign the drug is working.
  • CD4 count. A CD4 test measures the amount of CD4 cells in your body. These are white blood cells that fight infection. An increased number of CD4 cells is a sign the drug is working.

This drug can increase your blood sugar levels. Your doctor may check your blood sugar more often while you take it. You may need to learn to check your own blood sugar, too.

Not every pharmacy stocks this drug, so call ahead

If you only need a few tablets, you should call and ask if your pharmacy dispenses only a small number of tablets. Some pharmacies can't dispense only part of a bottle.

This drug is often available from specialty pharmacies through your insurance plan. These pharmacies operate like mail order pharmacies and ship the drug to you.

In larger cities, there will often be HIV pharmacies where you can have your prescriptions filled. Ask your doctor if there's an HIV pharmacy in your area.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for this drug. Your doctor may need to do paperwork for you, which could take a week more.

Are There Any Alternatives?

There are other drugs and combinations that can treat HIV infection. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

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Content developed in collaboration with Susan J. Bliss, RPh, MBA

Medically reviewed by Alan Carter, PharmD and Stacey Boudreaux, PharmD on February 20, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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