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Kaletra - once a day
Apr 15, 2006

Dear Ben,

My friends in the European world were questioning my once daily dosing of Kaletra. They explained to me that in the USA and being newly on meds was approved. However, the Europeans still are abit more cautious and split the six pills in AM/PM in order to avoid any deminishment towards the end of the dosing cycle. Am I ok doing this once a day. I have no problems splitting up my dosing I just wana be sure that I am totally covered. I usually keep within 1.5 hour window on dosing.

Let me know Ben..

ps. The mountains close Monday. You must be heartbroken!

Eric

Response from Dr. Young

Hi Eric-

It is indeed a sad day in the mountains when the ski areas close, no? Fortunately, our local ski hills will stay open for many weeks to come and the backcountry isn't even ripe yet.

Great to hear from you; lopinavir/ritonavir (Kaletra) is US FDA approved for once-daily dosing in first-line protease inhibitor patients. There is a large randomized clinical trial (called Abbott study 418) that compared the once- to twice-daily dosing and found similar virologic efficacy. The gastrointestinal side effects of lopinavir/ritonavir can be increased with once-daily dosing, but as you've experienced, can be quite well tolerated.

I have no reservations about recommending this to you, though if there should be side effects, one could look at stable treatment switches.

I think that the European agencies are simply being conservative about their approval on this topic.

Best, BY



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