Kaletra Capsules and Oral Solution
The following drug information is obtained from various newswires, published
medical journal articles, and medical conference presentations.
For the treatment of HIV-1 infection in adults and pediatric patients age six months and older
General Information
Kaletra is an HIV protease inhibitor approved for the treatment
of HIV-1 infection. It consists of two components: lopinavir and
ritonavir. Lopinavir is an inhibitor of the HIV protease, which is
a chemical necessary for HIV to multiply. Ritonavir inhibits the
(CYP3A-mediated) metabolism of lopinavir, thereby increasing levels
of lopinavir in the blood. The FDA has granted accelerated approval
to Kaletra based on favorable results in reducing HIV viral load
and on CD4 T-cell counts.
Clinical Results
Patients Who Have Not Received Prior Antiretroviral
Therapy
Study 863 is an ongoing, randomized, double-blind, multicenter
trial comparing treatment with Kaletra versus nelfinavir. Both
products were administered with stavudine and lamivudine - two
nucleoside reverse transcriptase inhibitors (NRTI) - to 653
patients new to HIV therapy. Through 24 weeks of therapy, the
proportion of patients with HIV RNA <50 copies/ mL was 65% in
the group receiving Kaletra, and 60% in the nelfinavir group.
Additionally, the mean increase from baseline in CD4 cell count was
154 cells/ mm3 for the Kaletra group and 150 cells/ mm3 for the
nelfinavir group.
Study 720 is an ongoing, randomized, blinded, multicenter trial
evaluating treatment with Kaletra at three dose levels (plus
lamivudine and stavudine) in 100 patients. Through 72 weeks of
treatment, the proportion of patients with undetectable levels of
the virus (HIV RNA <400 copies/ mL) was 80% and the mean
increase from baseline in CD4 cell count was 256 cells/ mm3 for the
51 patients originally receiving a 400/ 100 mg dose of Kaletra.
Patients Who Have Received Prior Antiretroviral
Therapy
Study 765 is an ongoing, randomized, blinded, multicenter trial
evaluating treatment with Kaletra at two dose levels plus
nevirapine and two NRTIs. The treatment group consisted of 70
patients who had not previously taken a non-nucleoside reverse
transcriptase inhibitor (NNRTI) but were single protease inhibitor
experienced. Through 72 weeks of treatment, the proportion of
patients with HIV RNA <400 copies/ mL was 75% and the mean
increase from baseline in CD4 cell count was 174 cells/ mm3 for the
36 patients receiving the 400/ 100 mg dose of Kaletra. (from FDA
Label)
Side Effects
Possible side effects of Kaletra include (but are not limited
to) the following:
- Abnormal bowel movements
- Diarrhea
- Feeling weak/ tired
- Headache
- Nausea
- Abdominal pain
Additionally, some patients taking Kaletra can develop serious
problems with their pancreas. Patients should immediately inform
their doctor if nausea, vomiting, or abdominal pain occurs, as
these may be signs of pancreatitis.
Mechanism of Action
Lopinavir, an inhibitor of the HIV protease, prevents cleavage
of the Gag-Pol polyprotein, resulting in the production of
immature, non-infectious viral particles. (from FDA label)
Additional Information