lopinavir + ritonavir at a glance
Medicine class
Boosted HIV protease inhibitor
Usual role
Part of combination antiretroviral treatment for HIV-1
Interaction risk
Many important interactions require a full medicines review
Oral solution
Take with food and measure using the supplied oral syringe
What is lopinavir + ritonavir used for?
Used in combination with other antiretroviral medicines for HIV-1 infection.
The oral solution is licensed for adults, adolescents and children aged 14 days and older.
For people previously treated with protease inhibitors, treatment history and viral resistance results should be considered.
How does lopinavir + ritonavir work?
HIV protease cuts viral proteins into components needed to form mature virus. Lopinavir blocks this enzyme, so newly produced virus remains immature and non-infectious. Ritonavir slows lopinavir breakdown by strongly inhibiting CYP3A metabolism, increasing lopinavir concentration.
lopinavir + ritonavir preparations and strengths
Oral solution
Route: Oral
Strengths: 80 mg + 20 mg
How to take lopinavir + ritonavir
Follow the specialist HIV team's instructions and continue other prescribed antiretrovirals. Do not stop treatment without discussing it with the team.
Swallow tablets whole; do not chew, break or crush them.
Tablets may be taken with or without food.
Take the oral solution with food and measure it using the supplied calibrated oral syringe.
The alcohol-containing oral solution is not recommended for polyurethane feeding tubes.
lopinavir + ritonavir side effects
Common or expected effects
- Diarrhoea and nausea
- Vomiting or abdominal discomfort
- Headache, dizziness or difficulty sleeping
- Rash or itching
- Muscle or joint pain
- Tiredness
- Raised blood fats or blood glucose
Get urgent medical advice
- Severe abdominal pain suggesting pancreatitis
- Facial swelling, breathing difficulty or another severe allergic reaction
- Blistering or peeling skin reactions
- Hepatitis or worsening liver disease, which may cause jaundice or dark urine
- Abnormal heart conduction or rhythm symptoms, such as fainting or palpitations
- Severe muscle pain or weakness, particularly with dark urine
lopinavir + ritonavir in pregnancy
Available experience, including more than 3,000 reported pregnancies, has not identified an increased pattern of birth defects. Lopinavir + ritonavir may be used when clinically needed under specialist care. The oral solution is contraindicated during pregnancy because it contains substantial propylene glycol and alcohol. Do not stop effective HIV treatment without advice.
lopinavir + ritonavir while breastfeeding
In the UK, formula feeding is the safest option because HIV can be transmitted through breast milk even when treatment is effective. Breastfeeding may sometimes be supported for a person with sustained viral suppression after detailed discussion with specialist HIV and maternity teams, with additional monitoring.
lopinavir + ritonavir interactions
Ritonavir is a strong CYP3A inhibitor. Prescription, non-prescription and herbal products must be checked before use. Important examples include:
Simvastatin or lovastatin
Contraindicated because concentrations can rise substantially, increasing myopathy and rhabdomyolysis risk.
Quetiapine
Contraindicated because markedly increased exposure can cause severe toxicity, including coma.
Common questions about lopinavir + ritonavir
Answers are fully visible for fast scanning and source review.
Is lopinavir + ritonavir a cure for HIV?
No. It suppresses HIV as part of combination treatment but does not remove the virus from the body.
Why are lopinavir and ritonavir given together?
Lopinavir blocks HIV protease. Ritonavir slows lopinavir metabolism, allowing higher and more sustained lopinavir exposure.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.