Lopinavir/ritonavir
Tablets/Liquid
(Kaletra®)

Please read this factsheet carefully together with the patient information leaflet before taking your medicine. If you have any questions or are unsure about anything, ask your doctor or pharmacist.

Lopinavir/ritonavir, also known as Kaletra® belongs to a class of drugs called protease inhibitors (PIs). Protease Inhibitors are used for the treatment of HIV infection in combination with other anti-HIV drugs. Please speak to your clinic doctor or pharmacist if you would like more information about how these drugs work.

Before taking Kaletra
Tell your doctor about:

* About all other drugs that you are taking, including any that you buy over the counter in a
community pharmacy and herbal medicines;
* Previous allergy to any medicines;
* If you have ever had any liver disease;
* If you are diabetic;
* If you are pregnant or thinking about becoming pregnant;

Taking your Kaletra

* Kaletra tablets are a new formulation of the previously available capsules. They are available as yellow film coated tablet (embossed with the Abbot Logo and “KA”). The tablet contains both lopinavir (200mg) and ritonavir (50mg). The ritonavir acts to boost the levels of lopinavir in the body, making it more effective. It is also available as a liquid. Each 5ml of liquid contains 400mg lopinavir and 100mg of ritonavir;
* The recommended dose is 2 tablets or 5ml twice each day. Your doctor may prescribe a different dose depending on your individual circumstances e.g. other medications you may be taking;
* The doses should be divided equally throughout the day: try to take doses as close as possible to twelve hours apart and at the same times each day;
* Kaletra tablets can be taken with or without food, swallowed whole and not chewed, broken or crushed. Kaletra liquid should be taken with food or just after food;
* Kaletra, like all other protease inhibitors, works best if there is a constant amount in your bloodstream. It is therefore very important to take the medication regularly. If you forget a dose take it as soon as you remember. If it is almost time for your next dose anyway, forget about the missed dose. Wait and take the next dose at the regular time. Do not double the next dose.;

Do not run out of Kaletra. If you are going on holiday and need additional supplies, tell your doctor. When receiving a supply from pharmacy, ensure that you have an adequate supply to last until your next appointment.

Other drugs and Kaletra
Kaletra is metabolised (processed in the body) by the liver. Some other drugs are metabolised in the same way. This is why it is important to tell your doctor about all the medicines that you take even if you only take them occasionally, including herbal and recreational drugs. Examples of some drugs that are metabolised in the same way as Kaletra and should NOT be taken are rifampicin, phenytoin, simvastatin, ergotamine, certain benzodiazepines and St. Johns Wort.

Other examples of drugs that are metabolised in the same way as Kaletra include rifabutin, fluticasone, warfarin, methadone, drugs for erectile dysfunction (e.g. Viagra®), NNRTIs and other protease inhibitors. Your doctor may alter your doses if you are taking one of these drugs.

Kaletra can stop certain hormonal contraceptives from working effectively, so you must use an alternative or additional form of contraception, e.g. barrier methods. Kaletra liquid contains a small amount of alcohol. You should not take the antibiotics metronidazole or tinidazole whilst on kaletra liquid.

Side effects
Kaletra, like all other medicines has some side effects. The most common ones (incidence of more than 1 in 100 patients) are:

* Diarrhoea;
* Headache;
* Nausea and vomiting;
* Dry mouth;
* Fatigue (lack of energy);
* Rash;

Combination regimes containing protease inhibitors have been associated with redistribution of body fat in some patients. They are also associated with metabolic abnormalities such as raised cholesterol, increased risk of diabetes and heart disease. Your clinic doctor will monitor you for all of these.

Whilst many of the side-effects are transient, if you experience any of these side effects or any other new symptoms after you start Kaletra, tell your doctor who will advise you what to do. Do NOT stop taking your Kaletra without consulting your doctor first. It is important that you tell your doctor so that he or she can discuss other treatment options with you.

Admission to hospital
If you are admitted to hospital please bring all your medicines with you. This is especially important for anti-HIV drugs, as they have to be taken regularly. Thomas Macaulay Ward operates a self medication programme. Some people are able to self administer their own medicines to enable them to stick to the routine they have been used to at home.

Storing your Kaletra
Kaletra tablets should be stored at room temperature. The liquid preparation has to be stored in a fridge but can be stored at room temperature for up to 6 weeks.