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Description of the drug. Lopinavir and Ritonavir for HIV and COVID-19

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Chemical name

Lopinavir: (2S) -N – [(2S, 4S, 5S) -5- [2- (2,6-dimethylphenoxy) acetamido] -4-hydroxy-1,6-diphenylhexan-2-yl] -3-methyl -2- (2-oxo-1,3-diazinan-1-yl) butanamide.

Ritonavir: 1,3-thiazol-5-ylmethyl N – [(2S, 3S, 5S) -3-hydroxy-5 – [(2S) -3-methyl-2 – {[methyl ({[2- (propan- 2-yl) -1,3-thiazol-4-yl] methyl}) carbamoyl] amino} butanamido] -1,6-diphenylhexan-2-yl] carbamate.

Chemical properties

Combined antiviral drug, protease inhibitor.

Pharmachologic effect

Antiviral. Used to treat HIV and COVID-19 (coronavirus).

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Pharmacodynamics and pharmacokinetics

In a combination of the two, Lopinavir acts as an inhibitor of HIV-2 and HIV-1 protease. It is the main antiviral component in this combination. The synthesis of viral proteins becomes no longer possible, which leads to the formation of an extremely immature virus that cannot infect living cells.

Ritonavir is an inhibitor of the aspartyl proteases of the virus, a fairly active peptidomimetic. Inhibition of specific HIV proteases prevents cleavage of the bond between the group-specific antigen and polymerase polyprotein. This leads to the development of immature and harmless viruses. The substance is very active in relation to HIV protease and practically inactive in relation to this enzyme in humans.

Also, Ritonavir inhibits the metabolic processes of Lopinavir in the liver tissue and this leads to an increase in the plasma concentration of the latter.

The processes of the development of addiction (resistance) of the virus to this drug combination have been thoroughly studied. We took into account data from both patients who had previously received antiretroviral therapy and those who received treatment for the first time, including those from the group of protease inhibitors of the human immunodeficiency virus.

In children and adults who are undergoing antiretroviral therapy for the first time, no mutations, development of resistance or reduced sensitivity to treatment have been identified. In the second phase of research, a certain percentage of mutations were found that increase the viral load and reduce the body’s sensitivity to the drug. The number of such patients was higher among those who had previously been treated for retrovirus.

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Application instruction Lopinavir + Ritonavir (Way and dosage)

Following the instructions for use, the tablets are taken orally, washed down with water, the intake does not depend on food. Tablets should not be chewed or crushed.

Standard therapy:

0.2 g of Lopinavir (400 mg per day) and 50 mg of Ritonavir (dosage of Ritonavir 100 mg per day) twice a day;
0.8 g and 0.2 g, respectively, once a day for patients who have no more than two mutations associated with the development of addiction to Lopinavir.


At the moment, cases of drug overdose have been rare. The drug has no specific antidote.

Treatment usually consists of keeping the body functioning, monitoring vital signs and monitoring the patient’s condition. If the medicine has not yet had time to dissolve in the digestive tract, it is recommended to rinse the stomach and drink Activated Charcoal. This drug combination has a high degree of binding to blood proteins, so dialysis is not used.