STD Home > Precautions and Warnings With Lopinavir and Ritonavir
There are numerous precautions and warnings with lopinavir and ritonavir to be aware of before starting treatment. For example, the medication may cause problems in people with liver disease, diabetes, or hemophilia. Precautions and warnings with lopinavir and ritonavir also include being aware of other complications that may occur with the drug, such as pancreatitis, changes in body fat distribution, and high cholesterol or triglycerides.
You should talk with your healthcare provider prior to taking lopinavir and ritonavir (Kaletra®) if you have:
- High cholesterol or high triglycerides
- Liver disease, such as liver failure, cirrhosis, or hepatitis
- An irregular heart rhythm
- Long QT syndrome
- Heart disease
- Low blood potassium (hypokalemia)
- Any allergies, including allergies to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
- Pregnant or thinking of becoming pregnant
You should also be sure to tell your healthcare provider about all other medicines you are taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Warnings and precautions to be aware of prior to taking lopinavir and ritonavir include the following:
- There have been reports of an inflamed pancreas (pancreatitis) in people who took lopinavir and ritonavir, which can be quite dangerous. Let your healthcare provider know if you have any signs of pancreatitis, such as:
- A tender or swollen abdomen
- Nausea and vomiting
- A rapid heart rate (tachycardia)
- Rapid breathing
- High triglycerides.
- Lopinavir and ritonavir can cause liver damage. Make sure to tell your healthcare provider if you already have liver disease or liver damage, as the medication may make your condition worse.
- Lopinavir and ritonavir may increase the risk of a potentially dangerous irregular heart rhythm known as heart block. This risk may be greater for people with heart disease or taking certain other medications (see Drug Interactions With Lopinavir and Ritonavir).
- Lopinavir and ritonavir may increase the risk of a potentially dangerous irregular heart rhythm known as QT prolongation. This risk may be greater for people with a condition known as long QT syndrome, who have low blood potassium, or who are taking certain other medications (see Drug Interactions With Lopinavir and Ritonavir).
- Lopinavir and ritonavir can cause high blood sugar (hyperglycemia). This can cause problems for people with diabetes, or it can even cause diabetes in individuals who are predisposed to the condition.
- The oral solution (liquid) form of this medication contains alcohol and propylene glycol, which can be dangerous to infants if too much is given. This is especially important for newborns and premature babies. Your healthcare provider should closely track the total dose of alcohol and propylene glycol your baby has received from all sources (such as from other medications) in order to avoid serious problems. In general, this medication should not be given to babies under the age of 14 days old (or even older, for premature babies).
- There have been reports of bleeding possibly due to protease inhibitors (such as lopinavir and ritonavir) in people with hemophilia. Be sure your healthcare provider knows if you have this condition.
- Lopinavir and ritonavir can increase triglyceride and cholesterol levels. Your healthcare provider should check your cholesterol and triglyceride levels while you are taking the medication.
- Lopinavir and ritonavir can change the distribution of fat on your body. You may gain fat in areas that are not typical for you, such as in the abdomen or at the back of the neck (a "buffalo hump"), and may lose weight in other areas.
- Lopinavir and ritonavir is not a cure for HIV or AIDS. If you have HIV or AIDS, you should always use safer sex practices, whether or not you are taking medications.
- As with all HIV medications, it is important that you take lopinavir and ritonavir exactly as prescribed. Missing doses may increase the chance of the virus becoming resistant to HIV medications.
- Lopinavir and ritonavir can interact with a number of different medications (see Drug Interactions With Lopinavir and Ritonavir).
- Lopinavir and ritonavir is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Kaletra and Pregnancy).
- It is not known if lopinavir and ritonavir passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Kaletra and Breastfeeding). It is important to understand that the HIV virus can be transmitted through breast milk and that breastfeeding is usually not recommended in women with HIV or AIDS.