Drug interactions between Kaletra and Viramune
Results for the following 2 drugs: |
|
|---|---|
| Kaletra (lopinavir/ritonavir) | |
| Viramune (nevirapine) | |
Interactions between your selected drugs
nevirapine ⇔ lopinavir
Applies to: Viramune (nevirapine) and Kaletra (lopinavir/ritonavir)
ADJUST DOSE: Coadministration with the non-nucleoside reverse transcriptase inhibitors (NNRTIs) efavirenz or nevirapine may decrease the plasma concentrations of lopinavir, even in the presence of low-dose ritonavir as a pharmacokinetic booster. The mechanism is NNRTI induction of CYP450 3A4, the isoenzyme responsible for the metabolic clearance of lopinavir. According to the product labeling, administration of lopinavir-ritonavir (400 mg-100 mg twice a day) and nevirapine (200 mg twice a day) to HIV-infected patients for more than one year resulted in plasma trough levels of lopinavir that were approximately 50% of those observed in patients treated with lopinavir-ritonavir without nevirapine. In a pediatric population, mean lopinavir trough level in patients treated with the combination was 45% that in patients not receiving nevirapine. Efavirenz (600 mg once a day) has been reported to decrease lopinavir trough levels by approximately 40%.
MANAGEMENT: A dosage increase for lopinavir-ritonavir to 533 mg-133 mg (4 capsules or 6.5 mL of the oral solution) twice daily is recommended when used in combination with efavirenz or nevirapine. In children 12 years and under, the dosage should be increased to 13 mg-3.25 mg/kg twice daily for those weighing between 7 and 15 kg, and 11 mg-2.75 mg/kg twice daily for those 15 to 45 kg, up to a maximum of 533 mg-133 mg twice daily in children weighing more than 45 kg.
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