Meds and you

27 September 2013

Lopinavir

Lopinavir is an anti-retroviral. Anti-retrovirals are drugs that suppress the activity or replication of retro-viruses such as HIV.

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Lopinavir is not available as a product on its own. It is however one of the active ingredients found in Aluvia tablets (Nappi code: 710028-001), Kaletra soft capsules (Nappi code: 700922-003) and Kaletra oral solution (Nappi code:700924-019).

General information
Lopinavir is an anti-retroviral. Anti-retrovirals are drugs that suppress the activity or replication of retro-viruses such as HIV.

This specific anti-viral is classified as a protease inhibitor, meaning that it blocks an enzyme which plays an essential role in viral multiplication - it interferes with the ability of the virus to make copies of itself.

In South Africa lopinavir is registered for the treatment of infection with the human immunodeficiency virus (HIV), often in combination with other anti-retroviral drugs.

If not treated, HIV will advance to weaken the body's immune system, gradually chipping away to create grounds for other infections, against which the body will find more and more difficult to protect itself. HIV develops into acquired immune deficiency syndrome (Aids) when your immune system has been severely weakened.

For lopinavir to be effective, it has to be taken regularly. By skipping even a few doses the risk for treatment failure increases substantially. Try to ensure that you take all your doses, and at the correct time.

It should be understood that lopinavir is not a cure for HIV or Aids, but is one of a variety of drugs that only restricts the advance of the virus, keeping the immune system up and running. It is used in combination with other anti-retroviral drugs and should not be prescribed on its own.

Lopinavir does not reduce transmission of HIV; you can still infect another person with the virus and the use of appropriate precautions to prevent spread to other persons is highly recommended.

How does lopinavir work?
After a human T-cell is infected with HIV, the virus needs to multiply to spread to other cells. A crucial part of HIV multiplication is the production of an enzyme called protease, which is essential for the assembly of new viral copies. This drug interferes with the working of this enzyme, thereby leaving the new copies of the virus immature and non-infectious.

Fast facts

Drug schedule: schedule 4
What does it do? Lopinavir is an anti-viral drug
Overdose risk:v medium
Dependence risk: low
Is lopinavir available on prescription only? yes

User information

Dietary advice: lopinavir should be taken with or after a meal; at least 1.5 litres of water should be consumed daily while being treated with this drug to reduce the risk of kidney stones.
Stopping this medicine: do not stop taking this drug without consulting your doctor.
Prolonged use: side effects may develop with long-term use; frequent blood tests may be required with prolonged therapy to prevent serious blood disorders and to determine liver function.

Special precautions
Consult your doctor before using this drug if:

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. Not only can HIV infection be passed to your baby through breast milk, but lopinavir is also present and transmitted in breast milk.
Porphyria: avoid. This medication may cause serious adverse effects. Consult your doctor before use.
The elderly: caution is advised in the elderly as side effects may be more severe.
Infants and children: this medication is not intended for use in children under the age of 2 years.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness or light-headedness. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effect

Side Effect
Frequency
Consult your doctor

Common
Rare
Only if severe
In all cases
diarrhoea
X

X

constipation

X
X

nausea/vomiting

X
X

abdominal pain

X
X

taste disturbance

X
X

dizziness

X
X

headache

X
X

yellow tinge to eyes/skin

X

X
palpitations

X

X
anxiety/mood changes

X

X
confusion

X

X
visual disturbance

X

X
abnormal body fat distribution

X

X
skin rash

X

X
muscle weakness

X

X
muscle/joint pain

X

X

Interactions

carbamazepine, phenytoin, phenobarbitone reduced effect of lopinavir
ketoconazole increased risk of lopinavir toxicity
dexamethasone reduced effect of lopinavir
didanosine take the 2 drugs at least 2 hours apart
benzodiazepines increased risk of toxicity
sildenafil increased risk of toxicity
rifampicin/ St John's wort reduced effect of lopinavir
cyclosporine/tacrolimus increased risk of toxicity
astemizole/cisapride/ pimozide/ terfenadine increased risk of cardiac toxicity
simvastatin and other similar cholesterol-lowering drugs increased risk of muscle wasting

Many other medicines may interact with lopinavir and you should always consult your doctor before taking any other medicine.

Disease interactions
Contact your doctor in case of liver/kidney disease, if you have porphyria or diabetes, or if you have been diagnosed with a condition that increases your risk of bleeding.

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

 
 

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