Kaletra® (Lopinavir/Ritonavir)

Who should take this?

Kaletra is approved to treat HIV infection in adults and children six months of age or older.

It may be harmful to an unborn baby.  A woman who is pregnant or planning to become pregnant should discuss this with her doctor before taking Kaletra.

How is it taken? / Dosage

Kaletra comes in a tablet or a liquid to be taken by mouth.  The liquid form should be taken with food to help the body absorb the medicine. It is usually taken twice a day. The tablets can be taken with or without food.  The tablets should be swallowed whole, not chewed or crushed.

Regular tests of how well the liver is working should be done to prevent liver damage.

People who are also taking didanosine (ddI or Videx®), should take it one hour before or two hours after Kaletra.

To make Kaletra as effective as possible, it should be taken exactly as prescribed by the doctor. Missing doses may make it more likely that the HIV will become resistant to the drug. If a dose is missed, it should be taken as soon as possible.  If it is time for the next dose, the missed dose should be skipped and the regular schedule followed. Don’t double the dose.

Side Effects

People taking Kaletra have a greater risk of the following:

• High blood sugar or diabetes. The signs of this are dry mouth, dry skin, flushing, frequent urination, loss of appetite, thirst, tiredness and trouble breathing. If these appear, a doctor should be called right away.
• High levels of cholesterol and other fats (triglycerides) in the blood. This can lead to heart disease or stroke.
• Pancreatitis, an inflamed pancreas. The signs of this are nausea, vomiting and abdominal pain.
• Liver problems
• Changes in the distribution of fat on the body.  This includes a build up of fat behind the neck (buffalo hump), the breasts and the belly with a loss of fat on the arms, face and legs. 

The drugs in Kaletra are powerful and may cause side effects. These include:

• Diarrhea or abnormal stools
• Difficulty falling asleep or staying asleep
• Dizziness
• Headache
• Heartburn
• Nausea
• Skin rash
• Tiredness
• Weakness

Some side effects go away on their own as the body gets used to Kaletra.  Others can be serious. In rare cases, the following symptoms may occur.  If they do, a doctor should be called right away:

• Extreme tiredness
• Flu-like symptoms
• Loss of appetite
• Pain in the upper right part of the stomach
• Stomach pain
• Unusual bleeding or bruising
• Upset stomach
• Vomiting
• Yellowing of the skin or eyes

You should stop taking Kaletra and seek emergency medical attention if you experience an allergic reaction. Signs of an allergic reaction are difficulty breathing, closing of the throat, swelling of the lips tongue or face, and hives.

Drug Interactions

Resistance

As HIV copies itself and multiplies, changes sometimes happen in the new HIV copies.  These are called mutations.  When the virus changes, it is sometimes able to resist certain antiretroviral drugs. This is called drug resistance. Sometimes when the virus develops a resistance to one drug, it will also resist other antiretroviral drugs.  This is called cross-resistance.

Protease inhibitors are slightly less likely to be resisted by the HIV compared to non-nucleoside analog drugs.

The best way to prevent drug resistance is to take antiretroviral drugs regularly as the doctor has prescribed. This will make opportunistic infections less likely.  It will also improve quality and length of life.