Description of Lopimune
Trade name: Lopimune
Active ingredients: Lopinavir and Ritonavir
Strength of the ingredients: Lopinavir 200mg and Ritonavir 50mg
Container: 60 tablets
Classified: as anti-retroviral drug
Lopimune tablet is a cipla product, which exhibits anti-retroviral property.
Lopimune tablet is a combination of Lopinavir 200mg and Ritonavir 50mg
Both prime active ingredients containing anti-viral activity against human immunodeficiency virus (HIV) which is responsible for causing AIDS
Lopimune is inhibiting the progression of HIV virus from multiplication.
Lopimune tablet is used to reduce problem related to AIDS, it is not cure or prevent the disease.
Lopimune combination helps to postpone the symptoms caused by HIV/AIDS.
Pharmacology of Lopimune
Mechanism of action:
Lopimune is an anti viral medicine that has two prime compounds which are inhibitors of HIV protease and effective against retrovirus.
Retrovirus has capable of converting RNA into DNA with the help of reverse transcriptase enzyme.
Then the viral DNA incorporated into DNA of affected immune cells and then multiplied
Anti viral activity of Lopimune is exhibited by Lopinavir; it is a virulent protease inhibitor which inhibits the separation of Gag-Pol polyprotein.
Gag-Pol polyprotein is most important protein in the augmentation of active virus.
This viral proteases enzyme breaks the Gag-Pol polyprotein at the last stage of multiplication, an active and grown virus released into infected immune cells.
A Lopimune tablet prohibits the proteases enzyme that leads to formation of premature, non-infectious viral particles.
After oral administration, ritonavir present in Lopimune tablet inhibits the metabolism of Lopinavir; therefore the plasma level of Lopinavir is elevated.
The peak plasma concentration of the Lopinavir occurs only at 4 hours after administration
The effect of food, there is no significant difference between fasted and fed condition.
Lopimune should be taken with or without food.
The drug Lopinavir is highly bound to the human plasma protein around 98-99%.
Lopinavir is undergoes oxidative metabolism, it is metabolized by CYP3A isoenzymes.
Ritonavir is a potent CYP3A inhibitor, prohibits metabolism of Lopinavir and increased the plasma level of Lopinavir.
Lopimune is highly excreted through urine and feces.
Lopinavir is a potent protease inhibitor which is responsible for anti viral activity. The terminal half life period is approximately 2.33 hours in case of twice daily, 2.44 hours at once daily.
Indication of Lopimune
Lopimune is primarily indicated for;
HIV infection associated AIDS
Generally, Lopimune is used as combination with other anti-retroviral medicines.
Lopimune is used to suppress the progression of HIV virus in immune cells, and increase T cell counts.
The number of Lopinavir blockade associated substitutions affects the virologic action of Lopimune
Dose & Dosage's of Lopimune
Lopimune tablet should be taken with or without food.
Lopimune is available in fixed dose combination (Lopinavir 200mg + ritonavir 50mg)
Lopimune 400mg/100mg should be given as 200mg/50mg as two tablets two times a day
Lopimune 800mg/200mg should be taken as 200mg/50mg as four tablets once a day.
Lopimune should not administered as a single dose, in case of combination with carbamazepine, Phenobarbital, or phenytoin
Lopimune should be combined with some other anti-viral medicines;
By combining with the above mentioned anti-viral medicines, the prescribed dose of Lopimune is 500mg/125mg, it is taken as 200mg/50mg as two tablets & 100mg/25mg as one tablet at two times a day in concomitant with efavirenz, nevirapine, Nelfinavir
The dose of Lopimune in children is recommended on the basis of;
Body weight or
Body surface area (BSA)
Lopimune is not given as single dose for pediatric patients who are under the age of <18 years
Lopimune not combined with efavirenz, nevirapine, Nelfinavir
15kg to 25kg: The BSA should be ≥0.6 to <0.9, the prescribed dose of Lopimune 100mg/25mg as two tablets two times a day
>25kg to 35kg: BSA- ≥0.9 to <1.4, the recommended dose of Lopimune 100mg/25mg as three tablets two times a day
>35kg: BSA ≥1.4, the dose should be taken as Lopimune 100mg/25mg tablets as four tablets or two Lopimune 200mg/50mg tablets.
Lopimune combined with efavirenz, nevirapine, Nelfinavir
15kg to 20kg: The BSA should be ≥0.6 to <0.8, the prescribed dose of Lopimune 100mg/25mg as two tablets two times a day
>20kg to 30kg: BSA- ≥0.8 to <1.2, the recommended dose of Lopimune 100mg/25mg as three tablets two times a day
>30kg to 45kg: BSA ≥1.2 to <1.7, the dose should be taken as Lopimune 100mg/25mg tablets as four tablets or two Lopimune 200mg/50mg tablets.
>45kg: BSA ≥1.7, Lopimune 100mg/25mg taken as 5 tablets at twice daily
Side Effects of Lopimune
Blood and lymphatic system:
Anemia, leucopenia, neutropenia, lymphadenopathy
Atherosclerosis such as myocardial infarction, atrioventricular block
Ear and labyrinth problems:
Diarrhea, nausea, vomiting, abdominal pain, gastroenteritis, colitis, dyspepsia, pancreatitis, ulcers, dry mouth
AST, ALT and GGT elevation, hepatomegaly, cholangitis, hepatic steatosis
Hypersensitivity reaction like; urticaria and angioedema
Infections and infestation:
Upper and lower respiratory tract infection, cellulitis, folliculitis and furuncle
Hypercholesterolemia, hyper triglycerides, weight decreased, loss of appetite
Arthralgia, back pain, Myalgia, rhabdomyolysis
Headache, insomnia, neuropathy, ageusia, convulsions
Renal failure, Hematuria, nephritis
Erectile dysfunction, amenorrhea, menorrhagia
Rashes, seborrheic dermatitis, night sweats, Pruritus, alopecia, capillaritis, vasculitis
Contraindication of Lopimune
Lopimune is contraindicated to any active ingredients that present in Lopimune tablet;
Produce anaphylactic reactions like toxic epidermal necrolysis, Stevens-Johnson syndrome, Erythema multiforme, urticaria, angioedema etc
Lopimune is concomitant with potent CYP3A inducers; it leads to contraindicated causes depletion of plasma concentration of Lopinavir that leads to loss of virologic response
Some of medicines contraindicated to Lopimune;
Alfuzosin with Lopimune: increase concentration of Alfuzosin causes hypotension
Rifampin with Lopimune: loss of virologic response and resistance to Lopimune happens
Cisapride or pimozide with Lopimune: causes cardiac arrhythmia
St. Johns wort causes resistance of Lopimune
Lovastatins, simvastatin causes myopathy along with rhabdomyolysis
Midazolam with Lopimune: increased sedation, respiratory depression
Drug Interaction of Lopimune
Some of the medicines involved in drug interaction while taking with Lopimune;
HIV-1 proteases inhibitors like Fosamprenavir/ritonavir, Indinavir, Nelfinavir (should not administered as a single dose with Lopimune), ritonavir, saquinavir, tipranavir
Non-nucleoside reverse transcriptase inhibitors: efavirenz, nevirapine, delaveridine
Nucleoside reverse transcriptase inhibitor: tenofovir, abacavir, zidovudine
Amiodarone, lidocaine, quinidine, vincristine, vinblastine, dasatinib, nilotinib, rivaroxaban, etc
Precaution of Lopimune
Caution should be taken;
Usage & Safety profile of Lopimune Pregnancy & Lactation
Pregnancy category: C
Lopimune is not recommended for pregnancy women or who become pregnant.
Lopimune cause harm to unborn babies
To avoid risk of infection, Lopimune is not given to breastfeeding mothers.
Storage of Lopimune
The Storage condition of Lopimune should between 20oC – 25oC (68oF-77oF).
Lopimune should be keep away from moisture, heat, and light