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Kaletra

Generic name: Lopinavir, Ritonavir
Brand names: Kaletra

Why is Kaletra prescribed?

Kaletra combats the human immunodeficiency virus (HIV). HIV is the deadly virus that undermines the infection-fighting capacity of the body"s immune system, eventually leading to AIDS.

Kaletra is a combination of two drugs, lopinavir and ritonavir (Norvir), both of which fall into the drug category known as protease inhibitors. When taken along with other HIV drugs, Kaletra lowers the amount of the virus circulating in the bloodstream. However, it does not completely eradicate the virus, and you may continue to develop the rare infections that attack when the immune system weakens. It"s also important to remember that Kaletra does not eliminate the danger of transmitting the virus to others.

Most important fact about Kaletra

Combining Kaletra with certain other medications can cause serious, even life-threatening, reactions. Never take Kaletra with the following:

Flecainide (Tambocor)
Midazolam (Versed)
Migraine remedies based on ergot, including Cafergot, D.H.E. 45, Methergine, Migranal, and Wigraine
Pimozide (Orap)
Propafenone (Rythmol)
Triazolam (Halcion)

How should you take Kaletra?

Kaletra is used in combination with other HIV drugs. It should be taken twice a day, in the morning and evening, with food. Do not change the dose or discontinue therapy without consulting your doctor first.

If your doctor has also prescribed Videx (didanosine), you must take Kaletra one hour before or two hours after Videx.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and return to your normal schedule. Never double a dose.

--Storage instructions...

If Kaletra capsules and Kaletra oral solution are kept in the refrigerator, they can be used until the expiration date imprinted on the bottle. If they are stored at room temperature, they should be used within 2 months of opening. Avoid exposing the medication to excessive heat.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Kaletra.

• More common side effects may include:
  Abdominal pain, diarrhea, headache, nausea, rash, vomiting, weakness

Why should Kaletra not be prescribed?

You will not be able to use Kaletra if you prove to be allergic to either lopinavir or ritonavir. Remember, too, that Kaletra must never be combined with drugs listed under "The most important fact about Kaletra."

Special warnings about Kaletra

In some patients Kaletra causes a substantial increase in cholesterol and triglyceride levels, so the doctor will check yours periodically. High triglycerides can lead to a serious condition called pancreatitis. Call your doctor if you develop symptoms of this problem, such as nausea, vomiting, and abdominal pain.

Kaletra has been known to raise blood sugar levels, and can even cause diabetes. If you already have diabetes, be sure to monitor your blood sugar carefully and to notify your doctor if your blood sugar becomes difficult to control.

Liver failure, including some fatalities, has been reported among patients on Kaletra. Be sure your doctor knows if you have a history of liver disease, including hepatitis. You will need to be monitored carefully.

Some patients taking HIV medications find that their body fat gets redistributed. They may develop a fatty "buffalo hump" on their upper back, suffer breast enlargement, and gain weight in the abdomen. At the same time, they often lose weight in the face, arms, and legs.

During treatment with drugs similar to Kaletra, some patients with hemophilia have experienced increased bleeding.

Possible food and drug interactions when taking Kaletra

Kaletra interacts with a wide variety of other medications. Be careful to avoid combining it with any of the drugs listed under "Most important fact about Kaletra." Also be especially careful when taking Viagra. Kaletra can increase Kaletra"s side effects, and has been known to cause potentially damaging erections that last for more than 4 hours. If this happens to you, call your doctor immediately.

Kaletra also decreases the effectiveness of birth control pills. Check with your doctor about additional contraceptive measures you may want to take while using Kaletra.

Listed below are some of the other drugs that may interact with Kaletra. However, because interactions are so likely, it"s best to check with your doctor before combining Kaletra with any medication, including over-the-counter products and herbal remedies.

Anticonvulsants such as Dilantin, Phenobarbital, Tegretol
Antifungals such as Nizoral and Sporanox
Atovaquone (Mepron)
Certain cholesterol-lowering agents, including Lipitor, Mevacor, and Zocor
Certain HIV drugs such as Sustiva, Videx, Viramune
Clarithromycin (Biaxin)
Dexamethasone (Decadron)
Disulfuram (Antabuse)
Drugs used to treat heart arrhythmias, such as Cordarone, Lidocaine, Quinidex, Rhythmol
Drugs used to treat tuberculosis, such as Mycobutin, Rifadin, Rifater
Heart medications such as Adalat, Cardene, Plendil, Procardia
Immunosuppressants such as Neoral and Prograf
Methadone
Metronidazole (Flagyl)
St. John"s wort (also called hypericum perforatum)
Warfarin (Coumadin)

Special information if you are pregnant or breastfeeding

Kaletra has not been studied in pregnant women and should be used only if the potential benefit to the mother outweighs the possible risk to the developing baby.

HIV can be passed to your baby in breast milk, so breastfeeding is not advised.

Recommended dosage

ADULTS

Kaletra Capsules

The usual dose is 3 capsules twice daily with food. The dose may be increased to 4 capsules twice daily if Kaletra is used in conjunction with Sustiva or Viramune.

Kaletra Oral Solution

Take 5 milliliters (1 teaspoonful) twice daily with food. The dose may be increased to 6.5 milliliters twice daily if Kaletra is used in conjunction with Sustiva or Viramune.

CHILDREN

Aged 6 Months to 12 Years

The dose of Kaletra for children is based on body weight. It should be taken twice a day with food and should be administered using a calibrated dosing syringe. The dose may be increased if the child is also taking Sustiva or Viramune.

Overdosage

Little is known about Kaletra overdose. Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

Kaletra oral solution contains a high percentage of alcohol, which could be dangerous to a young child. If a child swallows more than the recommended dose, contact your local poison control center immediately.