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HIV Protease Inhibitor (Boosted) — Antiretroviral Therapy

Lopinavir / Ritonavir

Brand names: Kaletra

Lopinavir with ritonavir is a co-formulated HIV protease inhibitor combination used as part of antiretroviral therapy for HIV infection.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

Lopinavir inhibits the HIV protease enzyme, preventing cleavage of viral polyproteins into functional units and producing immature, non-infectious virions; low-dose ritonavir acts as a pharmacokinetic booster by inhibiting CYP3A-mediated metabolism of lopinavir.

Prescribing in practice

  • The ritonavir-mediated CYP3A inhibition causes numerous and potentially serious drug interactions, so all co-medication must be checked against current prescribing references before and during treatment.
  • It is associated with metabolic disturbance including dyslipidaemia and effects on glucose, and may prolong the PR and QT intervals in susceptible individuals.
  • Gastrointestinal upset, particularly diarrhoea, is common and may affect tolerability and adherence.

Monitoring

Monitor HIV viral load and CD4 count alongside lipids and glucose, and review for relevant drug interactions.

Counselling the patient

  • Take every dose to keep the virus controlled and reduce the risk of resistance.
  • Always check with your team or pharmacist before starting any new medicine, including over-the-counter products.
  • Tell your team if you get troublesome diarrhoea or other persistent side effects.

Evidence & guidelines

Boosted protease inhibitors are established components of combination antiretroviral therapy supported by extensive clinical trial experience.

Reference: BHIVA HIV Treatment Guidelines 2019; WHO Consolidated HIV Guidelines 2021; PENTA Paediatric HIV Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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