Last update Dec. 4, 2020

Lopinavir

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Antiviral HIV protease inhibitor. Used and associated with ritonavir, in the treatment of HIV/AIDS.
It has been used experimentally in the treatment of the COVID-19 coronavirus (Li 2020, Lim 2020, SEFH 2020).
Oral administration in two daily doses.

Its pharmacokinetic data (moderately high molecular weight and very high percentage of protein binding) explain the negligible transfer into milk observed (Oumar 2018, Corbett 2014, Shapiro 2013, Palombi 2012).

The plasma levels of infants whose mothers took it were undetectable (Oumar 2018, Corbett 2014, Gandhi 2013, Shapiro 2013) or very low (Gandhi 2013, Shapiro 2013, Palombi 2012).

According to the policy adopted by the health authorities of each country, breastfeeding in mothers with HIV/AIDS may or may not be recommended.
With highly active antiretroviral therapy (HAART), the HIV viral load can be reduced to zero, reducing the risk of HIV transmission through breastfeeding to levels similar to those of formula feeding.


See below the information of these related products:

Alternatives

We do not have alternatives for Lopinavir since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.
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Other names

Lopinavir in other languages or writings:

Group

Lopinavir belongs to this group or family:

Tradenames

Main tradenames from several countries containing Lopinavir in its composition:

List of 10 tradenames
  • Aluvia™. Contains other elements than Lopinavir in its composition
  • Aluvia (Алувиа)™. Contains other elements than Lopinavir in its composition
  • Aluvia (克力芝)™. Contains other elements than Lopinavir in its composition
  • Emletra ™. Contains other elements than Lopinavir in its composition
  • Kaletra™. Contains other elements than Lopinavir in its composition
  • Kaletra (Калетра)™. Contains other elements than Lopinavir in its composition
  • Kalmeltrex ™. Contains other elements than Lopinavir in its composition
  • Lopimune ™. Contains other elements than Lopinavir in its composition
  • Rilopravir™. Contains other elements than Lopinavir in its composition
  • Ritomax-L™. Contains other elements than Lopinavir in its composition

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 25 %
Molecular weight 629 daltons
Protein Binding 98 - 99 %
VD 0.9 - 1.8 l/Kg
pKa 13.39 -
Tmax 4.4 hours
T½ 5 - 6 hours
M/P ratio 0.2 - 0.4 -
Theoretical Dose 0.1 - 0.28 mg/Kg/d
Relative Dose 0.23 - 2.1 %

References

  1. SEFH - Sociedad Española de Farmacia Hospitalaria. Procedimientos de farmacia hospitalaria para la gestión del tratamiento con antivirales en la enfermedad por el nuevo coronavirus sars-cov-2 (COVID-19). Recomendaciones de la Sociedad Española de Farmacia Hospitalaria. None 2020 Consulted on March 15, 2020 Full text (in our servers)
  2. Lim J, Jeon S, Shin HY, Kim MJ, Seong YM, Lee WJ, Choe KW, Kang YM, Lee B, Park SJ. Case of the Index Patient Who Caused Tertiary Transmission of COVID-19 Infection in Korea: the Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Infected Pneumonia Monitored by Quantitative RT-PCR. J Korean Med Sci. 2020 Feb 17;35(6):e79. Consulted on Feb. 20, 2020 Abstract
  3. Li H, Wang YM, Xu JY, Cao B. [Potential antiviral therapeutics for 2019 Novel Coronavirus]. Zhonghua Jie He He Hu Xi Za Zhi. 2020 Feb 5;43(0):E002. Abstract
  4. Oumar AA, Bagayoko-Maiga K, Bahachimi A, Maiga M, Cere MC, Diarra Z, Chatelut E, Sylla M, Murphy RL, Dao S, Gandia P. Efavirenz and Lopinavir Levels in HIV-Infected Women and Their Nursing Infants, in Mali. J Pharmacol Exp Ther. 2018 Sep;366(3):479-484. Abstract
  5. Corbett AH, Kayira D, White NR, Davis NL, Kourtis AP, Chasela C, Martinson F, Phiri G, Musisi B, Kamwendo D, Hudgens MG, Hosseinipour MC, Nelson JA, Ellington SR, Jamieson DJ, van der Horst C, Kashuba A; BAN Study Team.. Antiretroviral pharmacokinetics in mothers and breastfeeding infants from 6 to 24 weeks post-partum: results of the BAN Study. Antivir Ther. 2014;19(6):587-95. Abstract
  6. Shapiro RL, Rossi S, Ogwu A, Moss M, Leidner J, Moffat C, Lockman S, Moyo S, Makhema J, Essex M, Capparelli E. Therapeutic levels of lopinavir in late pregnancy and abacavir passage into breast milk in the Mma Bana Study, Botswana. Antivir Ther. 2013;18(4):585-90. Abstract
  7. Gandhi M, Mwesigwa J, Aweeka F, Plenty A, Charlebois E, Ruel TD, Huang Y, Clark T, Ades V, Natureeba P, Luwedde FA, Achan J, Kamya MR, Havlir DV, Cohan D; Prevention of Malaria and HIV disease in Tororo (PROMOTE) study.. Hair and plasma data show that lopinavir, ritonavir, and efavirenz all transfer from mother to infant in utero, but only efavirenz transfers via breastfeeding. J Acquir Immune Defic Syndr. 2013 Aug 15;63(5):578-84. Abstract
  8. Palombi L, Pirillo MF, Andreotti M, Liotta G, Erba F, Sagno JB, Maulidi M, Ceffa S, Jere H, Marchei E, Pichini S, Galluzzo CM, Marazzi MC, Vella S, Giuliano M. Antiretroviral prophylaxis for breastfeeding transmission in Malawi: drug concentrations, virological efficacy and safety. Antivir Ther. 2012;17(8):1511-9. Abstract

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