Generic Hivus-LR (Lopinavir + Ritonavir 200/50 mg) guide:
What is the medication called Kaletra?
The medication sold under the brand name Kaletra is used as a part of a complex therapy of HIV and AIDS. Since March 2020, it is also approved for the treatment of the novel coronavirus COVID-19, a fast-spreading pathogen causing lungs collapse and death in a small percentage of patients. The medication is based on two active substances – Lopinavir and Ritonavir. Both of these substances are antiviral agents that together render a more potent effect than separately.
If you want to buy Kaletra for COVID-19 treatment of for HIV, you can instead opt for one of the generic versions. For instance, at our online drugstore, you can get the medication from the manufacturer Aurobindo Pharma Ltd named Hivus-LR. The generic version of the offered drug is identical to the brand drug Kaletra but costs several times less money.
How does Kaletra act?
Lopinavir is an inhibitor of HIV-1 and HIV-2 proteases. The inhibition of HIV proteases interferes with the virus proteins synthesis and prevents the splitting of polypeptide gag-pol, which leads to the formation of immature and incapable of infection virus.
Ritonavir inhibits the metabolism of Lopinavir in the liver causing its increased level in the blood plasma. Besides, this substance also inhibits HIV proteases. For the treatment of COVID-19, this medication is considered highly effective during the first 10 days of infection.
When is Kaletra used?
You can buy generic Kaletra for:
– Treatment of HIV infection in adults and kids older than 3 years (a part of a combination therapy);
– Treatment of COVID-19 infection.
When the use of Kaletra contraindicated?
Even if you have the indications for the medication use, you should not buy Lopinavir + Ritonavir and use it in the following conditions:
– Intolerance of the main or auxiliary components of the medication;
– Liver failure of the severe stage;
– Age under 3 years;
– If you use medications whose metabolism is significantly impacted by the CYP3A4 enzyme that is inhibited by Ritonavir (for instance, astemizole, blonanserin, terfenadine, midazolam, and others);
– If you undergo the therapy with other medicines (see the section “interactions” below).
The medication can be used but with caution and only if a doctor approves in:
– Hepatitis B and C;
– Decompensated liver cirrhosis;
– Non-severe liver failure;
– Hyperactive liver enzymes;
– Impaired lipids metabolism;
– Glucocorticoids used for topically (nasal sprays);
– Use of medicines that extend QT interval;
– History of heart diseases;
– Age over 65 years.
Can be Lopinavir + Ritonavir used during pregnancy and lactation?
Breastfeeding women must not use the drug or should stop breastfeeding for the term of the therapy. The medication can be used during pregnancy if the expected benefit is considered greater than the risk.
How is Kaletra used?
According to the latest treatment protocols, Lopinavir + Ritonavir for COVID-19 is used by the following scheme: 400/100 mg (= 2 tablets of 200/50 mg) for 14 days. The medication must be used in a positive test for the virus but no symptoms or mild symptoms. It should be used for moderate to severe cases only if hydroxychloroquine/chloroquine is contraindicated. Pills are taken without regard to meals.
You can follow treatment protocols approved in Italy and France for COVID-19 treatment provided in the table below if you buy Lopinavir + Ritonavir online.
For HIV, the dosage of the medication is established individually depending on the scheme of preceding and current combined therapy.
Recommended dosages for HIV treatment are:
Two 200/50 mg tablets are taken twice a day.
– Four 200/50 mg tablets taken once a day (for patients with less than three Lopinavir-associated mutations).
– For the combined therapy including efavirenz, nevirapine, amprenavir, or nelfinavir in patients who received other therapy and may be less sensitive to Lopinavir, the dosage of Kaletra should be raised to 500/125 mg (two 200/50 mg pills and one 100/25 mg pill) a day.
– Children with the body mass over 40 kg should receive the regular dosage for adults – 400/100 mg twice a day. Overdose of Lopinavir +Ritonavir There is limited data on the overdose of the medication. The recommended measures include the intake of activated carbon and induce vomiting. If severe symptoms develop, emergency help can be required.
What adverse effects can Lopinavir + Ritonavir cause?
When you buy generic Lopinavir + Ritonavir and start using it, keep in mind that there is a chance that you develop certain adverse effects:
– Allergic reactions from a skin rash to anaphylaxis;
– Development of symptoms similar to flu, middle ear inflammation, bronchitis, and other symptoms;
– Digestive disorders;
– Cellulitis, folliculitis;
– Benign and cancerous tumors occurrence;
– Blood composition disorders detected by the blood tests;
– Underactive thyroid;
– Increased appetite, weight gain, swelling, thirst, diabetes;
– Impaired lipids metabolism;
– Insomnia, mood swings, agitation, anxiety, depression, nervousness, inability to focus;
– Headaches, seizures, increased intracranial pressure;
– Vision and/or hearing impairment;
– Heart dysfunctions from mild to severe;
– Cough, asthma, lung swelling;
– Liver dysfunction, yellowing of the skin;
– Muscle or joint pain;
– Kidneys dysfunction;
– Lowered libido, erectile dysfunction (men), menstrual disorders (women).
The likelihood of severe adverse effects is lower. Overall, the risk of adverse reactions rises in a long-term high dosages use. For the complete list of adverse reactions please refer to the package insert.
Lopinavir + Ritonavir interactions
Kaletra is a potent inhibitor of CYP3A enzyme that participates in the metabolism of multiple medications. These medications must not be used with Lopinavir + Ritonavir. Some of these medications are astemizole, blonanserin, terfenadine, midazolam (when taken orally), triazolam, cisapride, pimozide, salmeterol, sildenafil, tadalafil, vardenafil, avanafil, voriconazole, ergot alkaloids, GMG-fastinvest, inhibitors of Simonoflavin, Aminoblastin, Adrenaline fusidic acid (in the treatment of skin infections), amiodarone, quetiapine.
Lopinavir + Ritonavir must not be used also with:
– Hypericum preparations;
– Ketoconazole and itraconazole in high doses (more than 200 mg/day).
If you take any other medicines besides those listed above, make sure to consult your healthcare provider before you order Kaletra and start using it to be sure that it is safe.
Special recommendations for Lopinavir + Ritonavir use
– In people with impaired liver function for whom the use of the medication is possible, there is still a risk of the medication level in the blood plasma elevation by 30%. Thus, the risk of adverse effects, overdose, and worsening of the liver function increases. In such cases, Kaletra should be used under a doctor’s supervision. If liver function deterioration is observed, the therapy must be discontinued.
– The use of the medication in people with hepatitis B or C can cause death. – In some people, the medication can cause decompensation of diabetes and hyperglycemia. To treat these conditions, in some cases it was necessary to prescribe insulin or oral hypoglycemic drugs or increase their doses. In some cases, diabetic ketoacidosis developed. In some patients, hyperglycemia persisted after discontinuation of the protease inhibitor. When using Kaletra in patients with diabetes or predisposition to diabetes, monitoring the glucose in the blood is needed.
– In progressive HIV infection, the therapy raises the risk of hypertriglyceridemia and pancreatitis. If a patient already has a history of pancreatitis, there is a risk of the disease flare-up. In the occurrence of nausea, vomiting or abdominal pain, pancreas checkup is required. In the presence of acute pancreatitis, the therapy is discontinued.
– In individuals with hemophilia type A and B, the therapy can cause bleeding. Thus, blood coagulation must be checked regularly while using Kaletra. In the normalization of blood coagulation, the therapy can be resumed.
– In individuals with heart diseases the drug must be used cautiously. If there are any signs of the heart disease worsening, the use of Kaletra is discontinued.
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