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Confused on Cocktail

Mar 1, 2003

Hi Dr. Boyle, Thank you for your time and service to the HIV community. I am going to make this simple. Is it ok to take Kaletra and Agenerase together? I recently read that"co-administration of Kaletra and Agenerase results in substantial reductions in levels of both drugs and is not recommened." I have been on Kaletra, Agenerase, DDI, and Norvir for almost two years. Can you give me your take on this? Surely I have not been on a wrong combination for so long. Thank you. Todd

Response from Dr. Boyle

It is ok to take these drugs together but since Agenerase (amprenavir) may affect ritonavir levels, this may decrease the levels of both Agenerase and Kaletra (lopinavir/ritonavir). The appropriate dose adjustments for both drugs have not been definitively established; however, acceptable options (supported by recent studies) appear to be adding 100mg of ritonavir twice daily (when you are on 3 Kaletra and 4 Agenerase twice daily) or increasing the kaletra to 4 capsules twice daily and the Agenerase to 750mg (5 capsules) twice daily. Regardless of which method you use, at some point your doctor should probably check drug levels and if the levels are high he/she can consider reducing the doses and if the levels are low he/she can make appropriate dosage increases.

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