Kaletra is an antiretroviral medicine used as part of combination treatment for HIV-1 infection. It contains two medicines:

• Lopinavir: a protease inhibitor that blocks an enzyme HIV needs to produce new, infectious virus particles
• Ritonavir: a low-dose booster that slows the breakdown of lopinavir in the liver, keeping lopinavir blood levels high enough to be effective

Kaletra has a long track record in HIV treatment and is used in adults and children, including during pregnancy.

Take Kaletra twice daily with or without food, at the same times each day.

Swallow tablets whole. Do not crush, break, or chew them.

Kaletra must always be taken in combination with other antiretroviral medicines. Do not stop without speaking to your HIV doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your usual schedule. Never take a double dose.

Contact your HIV specialist or a poison control centre.

• Tablets: store below 25°C
• Oral solution: store in a refrigerator between 2°C and 8°C, or at room temperature for up to two months
• Keep out of reach of children

Very common side effects:

• Diarrhoea: one of the most common effects, often mild
• Nausea and vomiting
• Raised triglycerides and cholesterol: a fasting lipid panel should be checked regularly

Common side effects:

• Abdominal pain
• Headache
• Weakness
• Raised blood sugar levels
  

Serious side effects:

• Pancreatitis (inflammation of the pancreas): severe abdominal pain should be investigated urgently
• QT prolongation (abnormal heart rhythm): at high doses or in patients with heart disease
• Liver problems: particularly in people with hepatitis B or C

Blood tests including cholesterol, triglycerides, blood sugar, and liver enzymes are checked regularly.

Ritonavir is a very strong inhibitor of liver enzymes (CYP3A4) and has many interactions.

Important ones include:

• Statins: Kaletra significantly affects how many statins are processed, raising the risk of serious muscle side effects. Your doctor will review which statins are safe to use
• Sildenafil (for erectile dysfunction): Kaletra significantly increases sildenafil levels, which can cause a dangerous drop in blood pressure. Tell your doctor you are on Kaletra before this is prescribed
• Rifampicin: avoid, as it dramatically reduces lopinavir levels
• St John's Wort: significantly reduces lopinavir levels; avoid.

Drug interactions with Kaletra are extensive. Always check before starting any new medicine.

Why is Kaletra still used if newer HIV medicines exist?

Kaletra has been used for decades and has a well-established safety profile. It remains useful in certain situations such as some pregnancy scenarios, in children where well-studied paediatric formulations are needed, or when resistance patterns make other options less suitable. Newer integrase inhibitor-based regimens have largely replaced it as first-line therapy, but Kaletra remains an important option in specific circumstances.

Can I drink alcohol while taking Kaletra?

The oral solution form of Kaletra contains alcohol and propylene glycol, which matters more in young children or people with liver disease. For tablet users, moderate alcohol use is not specifically prohibited, but alcohol can worsen some side effects such as pancreatitis risk and liver strain. Speak to your doctor about your situation.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.