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What is lopinavir-ritonavir?

Lopinavir and ritonavir is a combination of two antiviral medications in a group of HIV medicines called protease (PRO-tee-ayz) inhibitors. This medication prevents human immunodeficiency virus (HIV) cells from multiplying in your body.

Lopinavir and ritonavir is used to treat HIV, which causes acquired immunodeficiency syndrome (AIDS). Lopinavir and ritonavir is not a cure for HIV or AIDS.

Lopinavir and ritonavir may also be used for other purposes not listed in this medication guide.

Precautions

Instructions

Side-effects

Interactions

Precautions

Do not take lopinavir and ritonavir with astemizole (Hismanal), cisapride (Propulsid), lovastatin (Mevacor, Altocor), midazolam (Versed), pimozide (Orap), rifampin (Rifadin, Rimactane, Rifater), simvastatin (Zocor), St. John’s wort, terfenadine (Seldane), triazolam (Halcion), or an ergot medicine such as Ergomar, Cafergot, Wigraine, D.H.E. 45, Migranal, Methergine.

These drugs can cause life-threatening side effects if you take them together with lopinavir and ritonavir.

Before taking lopinavir and ritonavir, tell your doctor if you are allergic to any drugs, or if you have:

• liver disease (especially hepatitis B or C);
• diabetes;
• a bleeding disorder such as hemophilia;
• high cholesterol or triglyceride levels in your blood; or
• if you have ever used a protease inhibitor in the past.

FDA pregnancy category C. This medication may be harmful to an unborn baby. HIV can be passed to the baby if the mother is not properly treated during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Take all of your HIV medicines as directed to control your infection while you are pregnant.

Lopinavir and ritonavir can make birth control pills or patches less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking lopinavir and ritonavir.

You should not breast-feed while you are using lopinavir and ritonavir. Women with HIV or AIDS should not breast-feed at all. Even if your baby is born without HIV, you may still pass the virus to the baby in your breast milk.

Do not give this medication to a child younger than 6 months old.

If you take lopinavir and ritonavir liquid and you also take didanosine, take the didanosine at least 1 hour before or 2 hours after you take lopinavir and ritonavir liquid.

Lopinavir and ritonavir oral liquid contains a large portion of alcohol. Avoid drinking alcohol while using this medicine. Tell your doctor if you also take metronidazole (Flagyl) or disulfiram (Antabuse), which can cause severe nausea and vomiting when taken with lopinavir and ritonavir liquid.

Taking this medication will not prevent you from passing HIV to other people through unprotected sex or sharing of needles. Talk with your doctor about safe methods of preventing HIV transmission during sex, such as using a condom and spermicide. Sharing drug or medicine needles is never safe, even for a healthy person.

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Instructions

Seek emergency medical attention if you think you have used too much of this medication. An overdose of lopinavir and ritonavir oral liquid could be fatal to a child.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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Side-effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking ritonavir and call your doctor at once if you have any of these serious side effects:

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
• increased urination or extreme thirst;
• easy bruising or bleeding;
• signs of a new infection, such as fever or chills, cough, or flu symptoms;
• severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate; or
• low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• mild nausea, vomiting, diarrhea, stomach pain, bloating;
• numbness or tingling, especially around your mouth;
• headache, mood changes; or
• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Interactions

Many drugs can interact with lopinavir and ritonavir. Below is just a partial list. Tell your doctor if you are using:

• fluticasone (Advair, Flonase, Flovent);
• antibiotics such as itraconazole (Sporanox), ketoconazole (Nizoral), rifabutin (Mycobutin);
• an antidepressant such as trazodone (Desyrel) and others;
• a blood thinner such as warfarin (Coumadin);
• a calcium channel blocker such as amlodipine (Caduet, Lotrel, Norvasc), diltiazem (Tiazac, Cartia, Dilacor), felodipine (Plendil), nifedipine (Procardia, Adalat), or verapamil (Calan, Covera, Isoptin, Verelan);
• cholesterol-lowering medicine such as atorvastatin (Lipitor);
• drugs that weaken the immune system, such as cyclosporine (Gengraf, Neoral, Sandimmune), sirolimus (Rapamune), or tacrolimus (Prograf);
• heart rhythm medications such as amiodarone (Cordarone) or quinidine (Quinaglute, Quinidex);
• other HIV /AIDS medicine such as amprenavir (Agenerase), atazanavir (Reyataz), efavirenz (Sustiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), saquinavir (Invirase), and others;
• insulin or diabetes medication you take by mouth;
• medicines to treat erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra); or
• seizure medications such as carbamazepine (Carbatrol, Tegretol), phenobarbital (Luminal, Solfoton), or phenytoin (Dilantin).

This list is not complete and there are many other medicines that can interact with lopinavir and ritonavir. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

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