Kaletra

Written by Rachel Nall | Published on October 24, 2013
Medically Reviewed by George Krucik, MD, MBA on October 24, 2013

What Is Kaletra?

Brand Name: Kaletra
Generic Name: Lopinavir/ritonavir 

Physicians prescribe Kaletra in combination with other medications to treat HIV. The U.S. Food and Drug Administration (FDA) has approved Kaletra for use by patients aged 14 and older. Kaletra is two separate drugs, lopinavir and ritonavir, that belong to a medication class known as protease inhibitors.

Read the FDA description of Kaletra.

What Does Kaletra Do?

Kaletra works by blocking protease enzymes that are present in HIV. The lopinavir in the medication works to keep the viruses from duplicating. The ritonavir in the medication does not act against HIV, but instead works with the body to maintain steady levels of lopinavir, thus maximizing that drug’s effectiveness. Kaletra is not a cure for HIV or AIDS, but it is a way to slow HIV’s progression.

In tablet form, Kaletra can be taken with or without food. In oral suspension or capsule form, Kaletra should be taken with food.

This information is a summary. Before starting this medication, discuss questions with your healthcare provider and make sure you understand dosage instructions.

What Should I Tell My Doctor Before Starting Kaletra?

Tell your doctor before taking Kaletra if you:

  • are breastfeeding or planning on breastfeeding
  • have a heart condition, such as congenital long QT syndrome
  • have hemophilia
  • have a condition related to high blood sugar, such as hyperglycemia or diabetes
  • have hypokalemia
  • have a medication allergy to Kaletra, lopinavir, or ritonavir
  • have a liver condition such as hepatitis B or hepatitis C
  • are pregnant or are planning on becoming pregnant

What Medications May Interact with Kaletra?

Always tell your physician about any prescription medications or herbal remedies you are taking.

Medications that can adversely interact with Kaletra include:

  • disulfiram (Antabuse)
  • afuzosin (Uroxatral)
  • ergot derivatives, such as ergotamine tartrate (Cafergot, Migergot, Ergomar, Ergostat, Medihaler, Ergotamine, Wigraine, Wigrettes), dihydroergotamine mesylate (D.H.E. 45, Migranal), and methylergonovine (Methergine)
  • GI motility agents, such as cisapride (Propulsid, Quicksolv)
  • neuroleptic agents, such as pimozide (Orap)
  • rifampin (Rifadin, Rifamate, Rifater, Rimactane), a broad-spectrum antibiotic
  • non-nucleoside reverse transcriptase inhibitors (NNRTIs) used to treat HIV, including nevirapine (Viramune)
  • sildenafil (such as Viagra)
  • sedatives such as midazolam (Versed) and triazolam (Halcion)
  • statin drugs, such as lovastatin (Mevacor and Altoprev), simvastatin (Zocor), and atorvastatin (Lipitor)

Possible Side Effects of Kaletra

The following are severe and emergent side effects of these medications. Contact your medical provider immediately if you experience:

  • heart rate changes, such as the slowing of the heart rate
  • hepatotoxicity, such as acute hepatitis, that affects your liver functioning; symptoms of this condition include dark urine, decrease in appetite, fatigue, yellowing skin, nausea, and tenderness over the liver.
  • hemophilia or increased bleeding
  • hyperglycemia, including diabetic ketoacidosis where blood sugar levels can reach dangerously high levels.
  • immune reconstitution syndrome, a condition that causes an inflammatory response in viruses in the blood, such as pneumonia or tuberculosis
  • severe skin reactions that include skin changes accompanied by aching joints, fatigue, and blistering

The following side effects may occur but do not usually represent an emergency. Discuss them with your doctor or healthcare professional if they continue or are bothersome.

  • fat redistribution where body fat moves to different areas of the body, such as the back of the neck, while the legs and arms become thinner
  • abdominal pain
  • anxiety
  • diarrhea
  • facial swelling
  • flu-like symptoms
  • headache
  • increased risk for high triglyceride/cholesterol levels
  • nausea/vomiting

This list may not describe all possible side effects. Call your doctor or healthcare provider for advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Kaletra and Pregnancy

The FDA classifies Kaletra in category C, meaning the effects on an unborn baby are unknown. Always notify your physician if you are pregnant or thinking of becoming pregnant before taking Kaletra. 

Some forms of birth control pills or patches may not work as well if they are used at the same time as Kaletra. Discuss your birth control options with your doctor before taking Kaletra.

Kaletra’s manufacturer says that mothers should not breastfeed while taking Kaletra. 

Kaletra and Alcohol

Note that liquid Kaletra contains a very small amount of alcohol, which cannot be combined with the drug used to treat alcoholism known as Antabuse (disulfiram). Combining even small amounts of these two preparations can have serious side effects.

Where Should I Keep Kaletra?

Storage for Kaletra depends upon the type of preparation. For example, Kaletra tablets should be stored at room temperature, which is between 59 and 86 degrees Fahrenheit (15 to 30 degrees Celsius). However, oral solutions and capsules of Kaletra should be stored in a refrigerator between the temperatures of 36 and 46 degrees Fahrenheit (2 to 8 degrees Celsius). Once opened, the oral suspension of Kaletra should be used within two months.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

FDA Warning: Serious health problems that have been reported in premature babies receiving lopinavir/ritonavir (Kaletra) oral solution. Lopinavir/ritonavir oral solution contains the ingredients alcohol and propylene glycol. Premature babies may be at increased risk for health problems because they have a decreased ability to eliminate propylene glycol; this could lead to adverse events such as serious heart, kidney, or breathing problems. Because the consequences of using lopinavir/ritonavir oral solution in babies immediately after birth can be severe or possibly fatal, the label is being revised to include a new warning.

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Article Sources:

●      Kaletra. (n.d.). FDA Drugs Label. Retrieved October 19, 2013, from http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/021226s022lbl.pdf
●      Kaletra Drug Safety (January 2013). FDA. Retrieved October 19, 2013, from http://www.fda.gov/downloads/Drugs/DrugSafety/UCM143461.pdf
●      Lopinavir/Ritonavir. (2013, August 23). National Institutes of Health. Retrieved October 19, 2013, from http://aidsinfo.nih.gov/drugs/316/kaletra/0/patient
●      Use and Important Safety Facts. (n.d.). Kaletra.com. Retrieved October 22, 2013, from http://www.kaletra.com/

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