50mg ritonavir - Microboosting of Atazanavir 300 mg With 50 mg Versus 100mg Ritonavir Daily in HIV-infected Patients: a Pharmacokinetic Study
Lopimune tablets /50mg contain a fixed dose combination of two antiretroviral drugs lopinavir and ritonavir, which are used to treat HIV infection.
HIV-1 infection, in combination with other antiretroviral agents. Swallow tabs whole; take oral soln with food. Concomitant efavirenz, nevirapine, or nelfinavir: Take oral soln with food. Do not administer with efavirenz, nevirapine, or nelfinavir. John's wort, lovastatin, simvastatin, sildenafil [as Revatio for PAH], oral midazolam, triazolam. Suspend if pancreatitis occurs. History of, or risk factors for, pancreatitis eg, elevated triglycerides, 50mg ritonavir.
Monitor LFTs at baseline and during treatment esp.
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Avoid in congenital long QT syndrome or hypokalemia. Underlying structural heart disease. Pre-existing conduction system abnormalities. Obtain baseline triglyceride, cholesterol; monitor periodically. Toxicity in preterm neonates see full labeling. Avoid oral soln with metronidazole, disulfiram. Potentiates statins metabolized by CYP3A; use atorvastatin with caution and at the lowest necessary doses; do not exceed ritonavir 10mg daily.
Potentiates sildenafil, vardenafil, tadalafil reduce 50mg of these ; avanafil, fluticasone avoid. Potentiates fentanyl, 50mg ritonavir, parenteral midazolam; monitor.
Potentiates anticancer agents eg, 50mg, vinblastine, dasatinib, nilotinib ; may need dose adjustment see full labeling. Risk of tumor ritonavir syndrome with venetoclax. Concomitant colchicine see full labeling, 50mg ritonavir.
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Potentiates bosentan see full labeling. Increases levels of antiarrhythmics eg, amiodarone, ritonavir, systemic lidocaine, quinidinedihydropyridine CCBs, immunosuppressants monitor ; ketoconazole, ritonavir avoid high dosesisavuconazonium sulfate caution ; bedaquiline use only if benefit 50mg the risk ; rifabutin reduce rifabutin dose and monitor ; clarithromycin reduce clarithromycin dose in renal dysfunctiontrazodone reduce trazodone dose50mg ritonavir, maraviroc give max maraviroc mg twice dailyquetiapine reduce dose.
Monitor other antiretrovirals, warfarin. Avoid concomitant rivaroxaban; increased bleeding risk. Decrease levels of atovaquone, 50mg ritonavir, methadone, bupropion, estrogen-containing 50mg contraceptives use other or back-up contraception50mg ritonavir, voriconazole avoid and use alternatives. Lopinavir levels decreased by 50mg eg, carbamazepine, phenobarbital, phenytoinbudesonide, dexamethasone, prednisone, efavirenz, nevirapine. Lopinavir levels may be increased by delavirdine, CYP3A ritonavir.
Antagonized by corticosteroids eg, oral dexamethasone, 50mg ritonavir, betamethasone, budesonide ; consider alternatives. May decrease lamotrigine, valproate, zidovudine or abacavir levels.
Give didanosine 1 hour before or 2 hours after. 50mg concomitant with ritonavir drugs that prolong the QT interval.