Lopinavir and Ritonavir (Systemic)

Brand Names : Kaletra

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For lopinavir and ritonavir, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to lopinavir or ritonavir. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Lopinavir and ritonavir has not been studied in pregnant women. However, it has been found to cause birth defects and other problems in animals at doses many times the human dose. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding - It is not known whether lopinavir and ritonavir pass into breast milk. However, because of the possibility that this medicine could cause unwanted effects in nursing babies and the risk of passing HIV on to the infant, breast-feeding is usually not recommended.

Children - This medicine has been tested in children 6 months of age and older and, in effective doses, has not been shown to cause different side effects or problems than it does in adults.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of lopinavir and ritonavir in the elderly with use in other age groups.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking lopinavir and ritonavir, it is especially important that your health care professional knows if you are taking any of the following:

• Amiodarone (e.g., Cordarone) or
• Bepridil (e.g., Vascor) or
• Quinidine (e.g., Quinidex) - Levels of these medicines in the body may be increased and cause toxic effects to the heart.

• Astemizole (e.g. Hismanal) or
• Cisapride (e.g., Propulsid) or
• Flecainide (e.g., Tambocor) or
• Pimozide (e.g., Orap) or
• Propafenone (e.g., Rythmol) or
• Terfenadine (e.g., Seldane) - These medicines should not be taken with lopinavir and ritonavir due to the chance of serious heart rhythm problems.

• Atorvastatin (e.g., Lipitor) or
• Lovastatin (e.g., Mevacor) or
• Simvastatin (e.g., Zocor) - Simvastatin and lovastatin should not be taken with lopinavir and ritonavir due to the risk of serious effects on muscle tissue; atorvastatin dose should be as low as possible to avoid adverse effects

• Carbamazepine (e.g., Tegretol) or
• Dexamethasone (e.g., Decadron) or
• Phenobarbital (e.g., Luminal) or
• Phenytoin (e.g., Dilantin) - These medicines may reduce the effectiveness of lopinavir and ritonavir by lowering the amount of lopinavir present in the body.

• Clarithromycin (e.g., Biaxin) - Use of lopinavir and ritonavir may increase the amount of clarithromycin in the body; patients with abnormal kidney function may need to have their dose adjusted

• Cyclosporine (e.g., Sandimmune, Neoral) or
• Felodipine (e.g., Plendil) or
• Nicardipine (e.g., Cardene) or
• Nifedipine (e.g., Procardia) or
• Sirolimus (e.g., Rapamune) or
• Tacrolimus (e.g., Prograf) - Use of lopinavir and ritonavir may increase the amount of these medicines in the body, which may lead to increased side effects

• Dihydroergotamine (e.g. D.H.E., Migranal) or
• Ergonovine (e.g., Ergotrate) or
• Ergotamine (e.g., Ergostat) or
• Methylergonovine (e.g., Methergine) or
• Midazolam (e.g., Versed) or
• Triazolam (e.g., Halcion) - These medicines should not be taken with lopinavir and ritonavir because serious side effects could occur

• Efavirenz (e.g., Sustiva) or
• Nevirapine (e.g., Viramune) - The dose of lopinavir and ritonavir might need to be increased when taken with these medicines.

• Ethinyl estradiol - Lopinavir and ritonavir may cause this medicine to be less effective; therefore, alternative or additional birth control methods should be used when birth control pills containing ethinyl estradiol are taken with lopinavir and ritonavir.

• Ketoconazole (e.g., Nizoral) or
• Itraconazole (e.g., Sporonox) - High doses are not recommended when taken with lopinavir and ritonavir

• Rifabutin (e.g., Mycobutin) - Doses of this medicine should be decreased and patients should be monitored more closely when this medicine is taken with lopinavir and ritonavir.

• Rifampin (e.g., Rifadin) or
• St. John's wort - Lopinavir and ritonavir may not work properly if taken with these medicines

• Sildenafil (e.g., Viagra) - Use of lopinavir and ritonavir may increase the amount of this medicine in the body, which may lead to increased side effects; your doctor may decrease your sildenafil dose

• Warfarin (e.g., Coumadin) - The amount of warfarin in the blood may be affected; bleeding times should be closely watched by your doctor

Other medical problems - The presence of other medical problems may affect the use of lopinavir and ritonavir. Make sure you tell your doctor if you have any other medical problems, especially:

• Diabetes mellitus (sugar diabetes) - Lopinavir and ritonavir may increase blood sugar; it may be necessary to adjust your dose of insulin or oral diabetes medicine

• Hemophilia - Lopinavir and ritonavir may increase the risk of major bleeding.

• Liver problems or
• Hepatitis B or
• Hepatitis C - Effects of lopinavir and ritonavir may be increased because of slower removal of the medicines from the body

• Pancreatitis (history of) - The chance that this condition will return is increased