LOPINAVIR/RITONAVIR = LPV/r oral

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    Last updated: November 2022

     

    Prescription under medical supervision

     

    Therapeutic action

    • Antiretrovirals, HIV protease inhibitors

    Indications

    • HIV infection, in combination with other antiretrovirals

    Forms and strengths

    • 40 mg lopinavir/10 mg ritonavir sachet of granules
    • 100 mg lopinavir/25 mg ritonavir film coated tablet

    Dosage

    The daily dose is administered in 2 divided doses.

    • Child 2 weeks and over:

     

    Weight

     Daily dose

    LPV/r

    40/10 mg granules

    100/25 mg tablet

    3 to < 6 kg

    160/40 mg 

    2 sachets x 2

    –

    6 to < 10 kg

    240/60 mg 

    3 sachets x 2

    –

    10 to < 14 kg

    320/80 mg 

    4 sachets x 2

    –

    14 to < 20 kg

    400/100 mg 

    5 sachets x 2

    2 tab x 2

    20 to < 25 kg

    400/100 mg 

    –

    2 tab x 2

    25 to < 35 kg

    600/150 mg 

    –

    3 tab x 2

    ≥ 35 kg

    800/200 mg 

    –

    4 tab x 2

     

    • In children 10 to < 14 kg who can swallow the tablets whole, administer two 100/25 mg tablets in the morning and one 100/25 mg tablet in the evening (daily dose: 300/75 mg).
    • In children on nevirapine or efavirenz: increase the dose of LPV/r according to manufacturer's instructions.

     

    • Adult:
      • 400/100 mg (4 tablets) 2 times daily (daily dose: 800/200 mg)
      • In adult on nevirapine or efavirenz: 500/125 mg (5 tablets) 2 times daily (daily dose: 1000/250 mg)

    Duration

    • Depending on the efficacy and tolerance of lopinavir and ritonavir.

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with severe hepatic impairment or hypokalaemia.
    • Do not combine with rifampicin, replace with rifabutin. If rifabutin is not available and LPV/r is essential, adjust the dose:
      • child: increase the dose of RTV to obtain a one-to-one (1:1) LPV/r ratio;
      • adult: double the dose (800/200 mg 2 times daily).
    • Administer with caution and monitor use in patients with haemophilia (increased bleeding) or mild to moderate hepatic impairment.
    • May cause:
      • gastrointestinal disturbances (mainly diarrhoea), skin rash, fatigue, headache, insomnia, paraesthesia, muscle pain hyperglycaemia, conduction disorders, hyperlipidaemia, lipodystrophy;
      • hepatic and pancreatic disorders; in this event, stop treatment immediately.
    • Administer with caution and monitor combination with drugs that prolong the QT interval (amiodarone, co-artemether, mefloquine, quinine, haloperidol, etc.).
    • LPV/r reduces the efficacy of implants and oral contraceptives: use injectable medroxyprogesterone or an intrauterine device. 
    • Pregnancy: no contra-indication

    Remarks

    • Do not cut, crush or chew tablets. 
    • Pour granules into a small amount of breast milk, water or soft foods and administer immediately (within 2 hours of preparation max.).

    Storage

     
    –  
     
    –  Below 25 °C 
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