Indications & Uses
Lopinavir with Ritonavir is an HIV-1 protease inhibitor combination. It is used together with other antiretroviral medicines to treat HIV-1 infection in adults and in children aged 14 days and older.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Lopinavir and Ritonavir tablets can be taken with or without food. Swallow them whole. Don't chew, break or crush them.
For adults, the dose is 400/100 mg (two 200/50 mg tablets) twice daily. The other option is 800/200 mg (four 200/50 mg tablets) once daily, and this is only for patients with fewer than three lopinavir resistance-associated substitutions.
If an adult is also taking efavirenz, nevirapine or nelfinavir, the dose of Lopinavir and Ritonavir may need to be adjusted.
Do not use once daily administration of Lopinavir and Ritonavir in HIV-1 infected patients who have three or more of these lopinavir resistance-associated substitutions: L10F/I/R/V, K20M/N/R, L24I, L33F, M36I, I47V, G48V, I54L/T/V, V82A/C/F/S/T and I84V. Do not use it once daily in combination with efavirenz, nevirapine, nelfinavir, carbamazepine, phenobarbital or phenytoin either.
Side Effects
Commonly reported side effects include diarrhea, nausea, vomiting, and elevated triglyceride and cholesterol levels in the blood.
Cautions & Contraindications
Warnings & Precautions
Patients taking Rilovir have shown the following effects. Hepatotoxicity: those with underlying hepatitis B or C, or with marked elevations in transaminase levels before starting treatment, may be at greater risk of developing or worsening transaminase elevations or hepatic decompensation while using Rilovir. QT interval prolongation: cases of QT interval prolongation and torsade de pointes have been reported, though a causal link to Rilovir could not be established. Avoid use in patients with congenital long QT syndrome, those with hypokalemia, and those taking other drugs that prolong the QT interval. PR interval prolongation: Lopinavir plus Ritonavir prolongs the PR interval in some patients, and cases of second or third degree atrioventricular block have been reported. Rilovir should be used with caution in patients who have underlying structural heart disease, pre-existing conduction system abnormalities, ischemic heart disease, or cardiomyopathies, since these patients may be at greater risk of developing cardiac conduction abnormalities. Diabetes mellitus and hyperglycemia: new onset diabetes mellitus, worsening of pre-existing diabetes mellitus, and hyperglycemia have been reported in HIV-1 infected patients receiving protease inhibitor therapy. Some patients required either the start or a dose adjustment of insulin or oral hypoglycemic agents to treat these events, and in some cases diabetic ketoacidosis occurred. Among patients who stopped protease inhibitor therapy, hyperglycemia persisted in some cases. Lipid elevations: treatment with Lopinavir and Ritonavir has led to large increases in total cholesterol and triglyceride concentrations.
Contraindications
Lopinavir and Ritonavir should not be used in patients who have previously shown clinically significant hypersensitivity (such as toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme, urticaria, or angioedema) to any of its ingredients, including lopinavir and ritonavir. It should also not be given together with drugs that depend heavily on CYP3A for their clearance and for which raised plasma concentrations can lead to serious or life-threatening reactions.
Pregnancy & Breastfeeding
Nursing mothers: The Centers for Disease Control and Prevention recommend that mothers infected with HIV-1 do not breastfeed their babies, because of the risk of passing HIV-1 on after birth. In studies in rats, lopinavir was found in milk. It is not known whether lopinavir passes into human milk. Since there is a risk of HIV-1 transmission and also a risk of serious side effects in breastfed infants, mothers taking this combination should be told not to breastfeed.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Use in Special Populations
Lopinavir + Ritonavir has not been studied enough in children younger than 14 days. Its safety, how well it works, and how the body handles it (the pharmacokinetic profile) are not established for this age group.
Overdose
There isn't much human experience with acute overdose of Lopinavir + Ritonavir. Treatment is general supportive care, which means monitoring vital signs and watching the patient's clinical status. There is no specific antidote for an overdose of Lopinavir + Ritonavir.
If needed, gastric lavage can be used to remove drug that hasn't been absorbed yet. Activated charcoal may also help clear unabsorbed drug. Lopinavir is highly protein bound, so dialysis is unlikely to remove much of it. Dialysis can, however, remove both alcohol and propylene glycol in an overdose with Lopinavir + Ritonavir.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Lopinavir + Ritonavir in a dry place, below 30° C. Keep it away from light, and keep it out of the reach of children.
Drug Interactions
Common questions about Lopivir R 200 mg
What is Lopivir R 200 mg Tablet?
Lopivir R 200 mg Tablet is a medicine that contains Lopinavir + Ritonavir. It is made by Delta Pharma PLC. It belongs to the Drugs for HIV / Anti-retroviral drugs group of medicines.
What is Lopivir R used for?
Lopinavir with Ritonavir is an HIV-1 protease inhibitor combination. It is used together with other antiretroviral medicines to treat HIV-1 infection in adults and in children aged 14 days and older.
What are the side effects of Lopivir R?
Commonly reported side effects include diarrhea, nausea, vomiting, and elevated triglyceride and cholesterol levels in the blood.
Can I take Lopivir R during pregnancy or while breastfeeding?
Nursing mothers: The Centers for Disease Control and Prevention recommend that mothers infected with HIV-1 do not breastfeed their babies, because of the risk of passing HIV-1 on after birth. In studies in rats, lopinavir was found in milk. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Lopivir R?
There isn't much human experience with acute overdose of Lopinavir + Ritonavir. Treatment is general supportive care, which means monitoring vital signs and watching the patient's clinical status. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Lopivir R?
Store Lopinavir + Ritonavir in a dry place, below 30° C. Keep it away from light, and keep it out of the reach of children.
Can I take other medicines with Lopivir R?
Some medicines can interact with Lopinavir + Ritonavir, for example: Lovastatin, Midazolam, Alfuzosin, Sildenafil, Simvastatin, Ritonavir. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Lopivir R?
Lopivir R is a prescription (Rx) medicine. Take it as your doctor advises.