Reviewed by: HU Medical Review Board | Last reviewed: 6/1/22

Kaletra is a combination medication that contains lopinavir and ritonavir. It is used with other antiretroviral agents as a part of antiretroviral therapy (ART) for HIV-1 in adults and children who are at least 14 days old.

Although it is not a cure for HIV, when taken as directed, it allows for the virus to be suppressed. This prevents further transmission of HIV and allows an individual’s immune system to improve through increasing CD4 cell counts and decreasing the amount of active virus in the blood (viral load).

What are the ingredients in Kaletra?

The main ingredients in Kaletra are lopinavir and ritonavir. Both ingredients belong to a class of medications called protease inhibitors.

How does Kaletra work?

During the HIV life cycle, the virus disassembles itself when it gets inside human host CD4 cells. The virus then undergoes reverse transcription and integration to join human host cell DNA, allowing for HIV’s genetic information to continue to get replicated. A form of this replicated genetic information is called messenger RNA (mRNA). mRNA is used to create proteins, including the enzymes HIV virions carry around with them in order to live.

During the process of converting mRNA into these proteins, the virus uses its protease enzyme. The protease enzyme cuts the mRNA into sections that will eventually be turned into the different proteins required for new, mature viruses to form. Protease inhibitors block this protease enzyme and prevent it from cutting the mRNA into its different parts. Without this cutting, or cleavage, of the mRNA, the final protein products aren’t able to be made and a mature virus cannot be formed and released into the blood to infect other cells.

Possible side effects

The most common side effects of Kaletra include, but are not limited to:

  • Nausea
  • Vomiting
  • Diarrhea
  • High levels of fat called triglycerides in the blood
  • High cholesterol

Things to note

As with any medication, there are several very rare but serious risks that need to be considered before taking Kaletra. Your healthcare provider can help determine what issues you may be at risk for and help determine what treatment options are the safest for you. It’s also important to remember that the risk of one or more of these issues occurring is low, and the benefits of treating the virus often greatly outweigh the risks.

Several of these rare but serious side effects of Kaletra include liver issues and an increased risk of developing pancreatitis (inflammation of the pancreas). Signs of liver issues include, but are not limited to:

  • Dark-colored urine
  • Loss of appetite
  • Nausea
  • Yellowing of the whites of the eyes or skin
  • Light-colored bowel movements
  • Pain or tenderness on the right side of your stomach

Signs of pancreatitis include, but are not limited to:

  • Severe stomach-area or abdominal pain
  • Nausea
  • Vomiting

On very rare occasions, changes in the heart’s electrical rhythm may occur while taking Kaletra and could lead to heart problems. This is especially true if you have a history of abnormal heart rhythms or heart issues, or if you take medications that impact your heart’s rhythm. It is important to tell your healthcare provider if you have a history of heart-related issues before starting Kaletra.

Signs of abnormal heart rhythm that require immediate medical assistance include, but are not limited to:

  • Sensation of abnormal heartbeats
  • Fainting
  • Dizziness
  • Lightheadedness

There are many medications that can interact with Kaletra and cause serious issues. It’s important to tell your healthcare provider about any medications you are currently taking, have recently taken, or plan to start taking. The oral form of Kaletra contains propylene glycol and alcohol. If your baby is taking Kaletra and becomes too sleepy or has breathing changes, contact a healthcare provider immediately. Pregnant women should not take oral Kaletra since it contains alcohol.

Rarely, new or worsening diabetes and high blood sugar may occur while taking Kaletra. Let your healthcare provider know if you experience any of the following:

  • Increased hunger or thirst
  • Increase in blood sugar levels
  • Increased urination
  • Unusual weight loss

Before starting Kaletra, tell your doctor if you:

  • Have or previously had hepatitis B virus
  • Have or previously had hepatitis C virus
  • Have a history of liver or pancreas problems
  • Have any heart problems, including a heart condition called Congenital Long QT Syndrome
  • Have ever had an allergic reaction or serious skin rash in response to medicines with lopinavir or ritonavir in them
  • Have low potassium or high cholesterol in your blood
  • Have diabetes
  • Have hemophilia
  • Are pregnant or planning to become pregnant
  • Are breastfeeding or planning to breastfeed
  • Are taking any over-the-counter vitamins, supplements, medicines, or herbal remedies
  • Are on any other medications or are about to start any other medications, including hormonal birth control

Kaletra may cause a condition called IRIS (immune reconstitution inflammatory syndrome). IRIS occurs when an individual’s immune system gets stronger after being weak and responds aggressively to previously hidden infections. This heightened response may make the person fighting the infection feel worse. Alert your healthcare provider immediately if you begin to have new symptoms after taking Kaletra.

Rarely, Kaletra may cause changes in body fat, especially around the breast, trunk, upper back, and neck regions. Skin rashes may also occur on rare occasions while taking Kaletra and should be reported to your healthcare provider. Additionally, individuals with hemophilia who take Kaletra may be at an increased risk of bleeding while on the medication. These are not all the possible side effects of Kaletra. Patients should talk to their doctor about what to expect with treatment with Kaletra.

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