The main usage of lopinavir and ritonavir is to treat patients with human immunodeficiency virus (HIV), specifically Type 1, the more dangerous and prevalent type of HIV. Usually, these two drugs are already combined in a tablet or in a liquid solution to make the treatment more effective. Basically, lopinavir and ritonavir act as an antivirus, preventing and reducing the production of HIV virus in the body. Patients should be informed that lopinavir and ritonavir are not used as a cure for HIV; rather, they are only used to treat and manage the condition. The combined drugs also do not prevent the virus from being transmitted from one person to another.
When taken individually, both lopinavir and ritonavir act as “protease inhibitors,” preventing viruses from infecting and spreading throughout the body. The reason behind combining the drugs is that the ritonavir increases the efficacy of lopinavir. When lopinavir is ingested, the body breaks it down at such a rapid rate that the drug becomes ineffective. What ritonavir does is delay this breakdown, letting the liponavir remain in the bloodstream for a longer period and making the body absorb it more effectively.
HIV viruses are spread and multiplied in the body when an enzyme called “protease” divides HIV-containing proteins into smaller, but functional, pieces that bind themselves to other proteins that create deoxyribonucleic acid (DNA). In this way, the HIV-containing proteins are reproduced and, thus, infect the body. As protease inhibitors, lopinavir and ritonavir target the protease, binding themselves to the protein and stopping its operation. As a result, the protease creates defective HIV proteins that have no ability to infect other cells.
Lopinavir and ritonavir are available only with a doctor’s prescription and have different dosages. For tablets, dosages of 100mg lopinavir/25mg ritonavir and 200mg lopinavir/50mg ritonavir are available and can be taken at least twice a day up to a maximum of four times, depending on the prescription. For the liquid solution, only an 80mg lopinavir/20mg ritonavir/mL is available, with an intake of 5mL two times a day, or 10mL once a day. Lopinavir/ritonavir can be taken on an empty stomach or with some food. Children under age 18 may have a different recommended dosage compared to an adult.
Side effects of lopinavir and ritonavir can include headaches, fatigue, nausea, and stomach upsets. These side effects may be more apparent during initial use and may gradually subside. The combination drugs can also raise a patient’s cholesterol levels and fat amounts in the blood and can trigger heart and hypertensive problems. Lopinavir/ritonavir can also interact with other medication that can affect the absorption of the former. Patients should inform the doctor of other medications being taken, especially those related to tuberculosis, arrhythmia, and erectile dysfunction.