Lopinavir + Ritonavir Farmoz (Lopinavir, Ritonavir)

Lopinavir/ritonavir is a protease inhibitor used in the management of HIV-1 infection.

• Adults with HIV-1 infection: reduces viral load and improves immune function.
• Children with HIV-1 infection: helps achieve viral suppression and supports growth.
• Pregnant women with HIV-1 infection: part of combination therapy to lower the risk of mother‑to‑child transmission.

• Lopinavir and ritonavir inhibit the HIV‑1 protease enzyme, preventing the cleavage of viral polyprotein precursors into functional proteins. This blockade halts the maturation of viral particles, thereby suppressing replication of the virus within host cells.

Lopinavir + Ritonavir may cause a range of adverse reactions.

Common Side Effects

• Diarrhea: frequent loose stools.
• Nausea: feeling of sickness or urge to vomit.
• Vomiting: expulsion of stomach contents.
• Abdominal pain: discomfort in the stomach area.
• Headache: mild to moderate head pain.
• Elevated lipids: increase in cholesterol or triglycerides.

Serious or Rare Side Effects

• Hepatotoxicity: liver enzyme elevations or liver injury.
• Pancreatitis: inflammation of the pancreas, presenting with severe abdominal pain.
• Severe allergic reactions: rash, swelling, or anaphylaxis.
• QT prolongation: potential heart rhythm disturbances.
• Stevens‑Johnson syndrome: severe skin and mucous membrane reaction.

Before initiating therapy, several safety considerations are recommended.

• Monitor liver function: perform baseline and periodic hepatic enzyme tests.
• Assess lipid profile: watch for hyperlipidaemia and manage accordingly.
• Evaluate for drug resistance: review prior antiretroviral exposure.
• Avoid in patients with known hypersensitivity to lopinavir, ritonavir, or excipients.
• Store at room temperature: keep in the original container, protect from moisture and heat.

Lopinavir/ritonavir interacts with several medication classes and requires careful management.

Major Interactions (Avoid)

• CYP3A4 substrates such as simvastatin or lovastatin: risk of severe toxicity.
• Strong CYP3A4 inducers like rifampicin: markedly reduces lopinavir exposure.
• Certain antiarrhythmics (e.g., amiodarone): may cause dangerous cardiac effects.

Moderate Interactions (Monitor Closely)

• Anticoagulants (e.g., warfarin): may require INR monitoring and dose adjustment.
• Oral hypoglycemics (e.g., sulfonylureas): increased risk of hypoglycaemia.
• Other protease inhibitors: potential for additive toxicity and altered drug levels.