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Lopinavir

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Abstract

▴ Lopinavir is a protease inhibitor with high specificity for HIV-1 protease. Ritonavir strongly inhibits lopinavir metabolism; coadministration of lopinavir and ritonavir in healthy volunteers increased the area under the lopinavir plasma concentration-time curve >100-fold.

▴ Trough plasma concentration: antiviral 50% effective concentration ratio for lopinavir was >75 for wild-type HTV at the dose used in clinical trials, compared to values of ≤4 for other commonly used protease inhibitors.

▴ Coformulated lopinavir and ritonavir (lopinavir/ ritonavir) 400/100mg twice daily for 48 weeks suppressed HIV replication in significantly more antiretroviral-naive patients than nelfinavir 750mg 3 times daily (all patients also received stavudine and lamivudine).

▴ Suppression of viral replication was observed in most protease inhibitor-experienced patients with lopinavir/ ritonavir (400/100, 400/200 or 533/133mg twice daily for 48 or 96 weeks) in combination with ≥2 nucleoside reverse transcriptase inhibitors (NRTIs) and either efavirenz or nevirapine.

▴ 48 weeks of treatment with twice daily lopinavir/ ritonavir (230/57.5 or 300/75 mg/m2 for the first 12 weeks and then 300/75 mg/m2) in combination with 1 or2NRTIs, with or without nevirapine, suppressed viral replication in the majority of antiretroviral-naive and -experienced paediatric patients (aged 6 months to 12 years).

▴ Diarrhoea, nausea and asthenia were the most frequently reported adverse effects in patients receiving lopinavir/ritonavir-based regimens. Elevated total cholesterol, triglyceride and hepatic enzyme levels were also reported.

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  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland 10, New Zealand

    Miriam Hurst & Diana Faulds

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  1. Miriam Hurst
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  2. Diana Faulds
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Correspondence to Miriam Hurst.

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Hurst, M., Faulds, D. Lopinavir. Drugs 60, 1371–1379 (2000). https://doi.org/10.2165/00003495-200060060-00009

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