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Confused
Apr 24, 2004

I am confused...I get conflicting advise on the need to take food with Kaletra.

Some say no need to take food, though it helps with nausea if you eat.

Others say food is essential. Without food, Kaletra absorbtion is 50z% less.

What is the right advise. I currently take Sustiva, Kaletra, Epivir and Viread.

Response from Dr. Sherer

The Kaletra package insert recommends that you take Kaletra with food in order to maximize drug levels, on the order of a 20% increase in maximum levels and a 50% in total drug availability (AUC) compared to ingestion without food.

The additional benefit of taking it with food, in my opinion, is the improvement in tolerability. I advise all of my patients on boosted PIs to take their meds immediately after a meal, or , failing that, at least a snack.

For patients who were drug naive when they started Kaletra, and thus more likely to have an inhibitory quotient over 70 times what is needed to inhibit the virus, the extra drug levels due to ingestion with food may not matter, i.e. it may mean the difference between an IQ of 40 and an IQ of 75 times greater than what is needed.

FOr patients who are treatment experienced, and who may harbor some PI mutations, the IQ will be lower due to the higher EC50 or killing level of the drug. In such patients, the extra pharmacologic boost by taking meds with food may be more important.

Since it sounds like this is your case, based on your regimen of 4 drugs including all three classes of drugs, I suggest that you take your Kaletra with food. And, of course, I suggest that you talk to your doctor about this issue and my suggestions.


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