Lopinavir/Ritonavir Oral: Dosing and Precautions
Lopinavir and ritonavir guidance for HIV treatment with age- and weight-based dosing, plus rifampicin and QT interaction precautions.
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Source reviewed
November 2022
Guide category
Oral drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Therapeutic action
Antiretrovirals, HIV protease inhibitors.
Indications
HIV infection, in combination with other antiretrovirals.
Forms and strengths
- 40 mg lopinavir/10 mg ritonavir sachet of granules.
- 100 mg lopinavir/25 mg ritonavir film coated tablet.
Dose
The daily dose is administered in 2 divided doses.
Child 2 weeks and over
- 3 to < 6 kg: 160/40 mg daily, 2 sachets 2 times daily.
- 6 to < 10 kg: 240/60 mg daily, 3 sachets 2 times daily.
- 10 to < 14 kg: 320/80 mg daily, 4 sachets 2 times daily.
- 14 to < 20 kg: 400/100 mg daily, 5 sachets 2 times daily or 2 tablets 2 times daily.
- 20 to < 25 kg: 400/100 mg daily, 2 tablets 2 times daily.
- 25 to < 35 kg: 600/150 mg daily, 3 tablets 2 times daily.
- >= 35 kg: 800/200 mg daily, 4 tablets 2 times daily.
- In children 10 to < 14 kg who can swallow tablets whole: two 100/25 mg tablets in the morning and one in the evening.
- In children on nevirapine or efavirenz: increase the dose according to manufacturer's instructions.
| Weight | Daily dose LPV/r | 40/10 mg granules | 100/25 mg tablet |
|---|---|---|---|
| 3 to < 6 kg | 160/40 mg | 2 sachets x 2 | - |
| 6 to < 10 kg | 240/60 mg | 3 sachets x 2 | - |
| 10 to < 14 kg | 320/80 mg | 4 sachets x 2 | - |
| 14 to < 20 kg | 400/100 mg | 5 sachets x 2 | 2 tab x 2 |
| 20 to < 25 kg | 400/100 mg | - | 2 tab x 2 |
| 25 to < 35 kg | 600/150 mg | - | 3 tab x 2 |
| >= 35 kg | 800/200 mg | - | 4 tab x 2 |
Adult
- 400/100 mg (4 tablets) 2 times daily, daily dose 800/200 mg.
- In adults on nevirapine or efavirenz: 500/125 mg (5 tablets) 2 times daily, daily dose 1000/250 mg.
Duration
Depending on the efficacy and tolerance of lopinavir and ritonavir.
Contra-indications, adverse effects, precautions
- Do not administer to patients with severe hepatic impairment or hypokalaemia.
- Do not combine with rifampicin; replace with rifabutin. If rifabutin is not available and LPV/r is essential, adjust the dose as recommended.
- Administer with caution and monitor use in patients with haemophilia or mild to moderate hepatic impairment.
- May cause gastrointestinal disturbances, mainly diarrhoea, skin rash, fatigue, headache, insomnia, paraesthesia, muscle pain, hyperglycaemia, conduction disorders, hyperlipidaemia, lipodystrophy, and hepatic or pancreatic disorders. In these events, stop treatment immediately.
- Administer with caution and monitor combination with drugs that prolong the QT interval.
- LPV/r reduces the efficacy of implants and oral contraceptives; use injectable medroxyprogesterone or an intrauterine device.
- Pregnancy: no contra-indication.
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
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