Lopinavir – Ritonavir


Lopinavir – Ritonavir | How to Use | Dosage and Side Effects

Lopinavir – Ritonavir is combination of two medicines with antivirus effect. It belongs to the antiviral medicines. This medicine is used to treat HIV (Human Immunodeficiency Virus – HIV). It is used to treat HIV in children older than 2 years of age and adults. They are usually used in combination with other antiviral medicines.


Lopinavir – Ritonavir should not be used in the following conditions:

  • Liver disorders
  • Known allergy to lopinavir or ritonavir

Caution needed in the following condition:

  • Diabetes
  • Haemophilia type A and type B. Lopinavir – Ritonavir increases the risk of bleeding, and therefore cannot be used in patients suffering from hemophilia
  • Heart disorders
  • Pancreatitis (inflammation of the pancreas)
  • Hypokalaemia (low potassium levels in the blood)

It may increase the lactic acid level in the blood. Symptoms of high levels of lactic acid are:

  1. muscle weakness of the arm,
  2. muscle weakness of the leg,
  3. nausea,
  4. vomiting,
  5. abdominal pain and shortness of breath.

Contact your doctor if you experience any of abovementioned symptoms.

Lopinavir – Ritonavir may cause high blood sugar level. Symptoms of high blood sugar level are:

  1. weight loss,
  2. fatigue,
  3. frequent urination,
  4. increased thirst.

If you experience these symptoms, contact your doctor immediately.


It may also lead to the accumulation of fat at the upper back and behind the neck (condition called “buffalo hump”). Accumulation of fat may also occur at the abdominal and chest area.

Use during pregnancy and breastfeeding

Lopinavir/ritonavir should be used during pregnancy only if the benefit to the mother outweighs the risk to the child. According to the US Agency for Food and Drug Administration, lopinavir/ritonavir belongs to the group C (FDA: Group C). This means that studies on animals have shown side effects to the fetus, but there are no studies on humans.

Women with HIV infection, should avoid breastfeeding the child, in order to avoid transmission of infection to the child.

How to use

Lopinavir/ritonavir tablets should be taken with food. Lopinavir – Ritonavir is used at dose of 400 mg + 100 mg (400 mg of lopinavir and 100 mg of ritonavir), twice daily (every 12 hours). It is commonly used in combination with other antiviral medicines. The doctor will determine the dose of lopinavir/ritonavir tablet that is suitable for you.

In children, the dose of tablet should be determined on the basis of body weight.

Lopinavir/ritonavir cannot be used in combination with alcoholic beverages because alcohol may change its effect.

You should take lopinavir/ritonavir as long as your doctor tells you to. Do not stop taking lopinavir/ritonavir tablets, even if you feel better, unless your doctor recommended.

Use with other medicines (Interactions)

Lopinavir/ritonavir should not be used in combination with the following medicines:

  • Anticonvulsants, used in the treatment of epilepsy such as:
  • Medicines used to treat bacterial infections (antibiotics) such as:
  • Medicines used to treat fungal infections such as:
    • ketoconazole,
    • itraconazole,
    • clotrimazole and others.
  • Medicines used to thin the blood such as:
  • Colchicine, used for the gout treatment (joint disorder)
  • Opioid analgesics (narcotic analgesics), used to relieve severe pain such as:
  • Corticosteroids, used in the treatment of inflammatory processes such as:
  • Statins, used to lower cholesterol level such as:
    • simvastatin,
    • rosuvastatin,
    • atorvastatin,
    • lovastatin,
    • fluvastatin and others. Red rice contains lovastatin-like substance and therefore cannot be used in combination with lopinavir/ritonavir tablets.
  • Medicines used to treat erectile dysfunction such as:
  • Benzodiazepines, medicines used for sedation such as:
  • St. John’s Wort.
  • Cisapride, used to treat gastrointestinal disorders
  • Ergot alkaloids, used for the migraine treatment such as:
    • ergotamine,
    • dihydroergotamine,
    • methyl ergometrine and others.
  • Medicines used in the treatment of autoimmune diseases such as:
    • cyclosporine,
    • tacrolimus and others.

Tell your doctor about all medications and herbal medicines you are taking.

Side effects

Lopinavir/ritonavir may cause the following side effects:

  1. upper respiratory tract infection (occurs frequently),
  2. nausea,
  3. vomiting,
  4. diarrhea,
  5. anemia,
  6. decrease in the number of white blood cells (leukopenia),
  7. high blood cholesterol,
  8. high blood triglycerides,
  9. lymphadenopathy (enlargement of the lymph glands),
  10. weight loss,
  11. insomnia,
  12. dizziness,
  13. liver damage accompanied by jaundice,
  14. hair loss (alopecia),
  15. fatigue,
  16. impotence,
  17. menstrual cycle disorders,
  18. allergy and others.

Tell your doctor if you experience any of these side effects.


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