1 May 2026Oral drugsSource update: November 2022
Lopinavir/Ritonavir = LPV/r oral
Lopinavir and ritonavir guidance for HIV treatment with age- and weight-based dosing, plus rifampicin and QT interaction precautions.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
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 reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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