Rilovir Tablet 200 mg+50 mg is a potent antiretroviral combination therapy containing Lopinavir 200 mg and Ritonavir 50 mg. It is primarily indicated for the treatment of Human Immunodeficiency Virus (HIV-1) infection in adults and pediatric patients above 14 days of age. This combination is part of the protease inhibitor class of antiretroviral drugs and is designed to suppress viral replication, reduce viral load, and improve immune function in individuals living with HIV.

Rilovir combines the antiviral efficacy of Lopinavir, a potent inhibitor of HIV-1 protease, with Ritonavir, which acts as a pharmacokinetic enhancer by inhibiting the CYP3A-mediated metabolism of Lopinavir. This boosts Lopinavir levels in the plasma, ensuring sustained antiviral activity and improved therapeutic outcomes. The medication is typically prescribed as part of combination antiretroviral therapy (cART) to prevent the development of drug resistance and to maintain long-term viral suppression.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

• Antiretroviral Agents

• HIV Protease Inhibitors

Indications

• Treatment of HIV-1 infection in adults and pediatric patients aged 14 days and older

• Used in combination with other antiretroviral agents as part of highly active antiretroviral therapy (HAART)

• For patients with prior antiretroviral therapy failure or treatment-naïve patients as recommended

Pharmacology

Lopinavir inhibits HIV-1 protease, an enzyme essential for the cleavage of viral polyproteins into functional proteins. Without active protease, immature viral particles are produced, which are non-infectious. Ritonavir, although an HIV protease inhibitor itself, is primarily used at low doses to inhibit the CYP3A enzyme, slowing the metabolism of Lopinavir and increasing its bioavailability. Together, they provide potent and sustained antiviral effects.

Mode of Action

• Lopinavir: Inhibits HIV-1 protease, preventing viral replication and production of mature, infectious virions

• Ritonavir: Inhibits CYP3A-mediated metabolism of Lopinavir, enhancing plasma concentration and therapeutic efficacy

• Reduces viral load, improves CD4+ T-cell counts, and strengthens immune system response

Dosage & Administration

Adults:

• Standard dose: 2 tablets (200 mg Lopinavir + 50 mg Ritonavir each) twice daily with food

• Take consistently at the same time every day

• Can be administered as part of combination therapy with nucleoside or non-nucleoside reverse transcriptase inhibitors

Pediatric Use:

• Dose is calculated based on body weight or body surface area, usually in combination with other antiretrovirals

• Oral solution is available for infants and children unable to swallow tablets

Important Notes:

• Should be taken with food to improve absorption and reduce gastrointestinal side effects

• Do not miss doses to prevent viral resistance

Drug Interactions

• CYP3A substrates: May increase plasma concentrations of drugs metabolized by CYP3A, e.g., benzodiazepines, statins, antiarrhythmics

• CYP3A inducers: Drugs like rifampicin can reduce Lopinavir/Ritonavir levels, reducing efficacy

• Other antiretrovirals: Dose adjustments may be required when used with efavirenz, nevirapine, or other protease inhibitors

• Avoid co-administration with alfuzosin, cisapride, ergot derivatives, and certain antiarrhythmics due to risk of serious cardiac events

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Contraindications

• Hypersensitivity to Lopinavir, Ritonavir, or any excipients

• Severe hepatic impairment

• Concomitant use with contraindicated drugs that can lead to life-threatening interactions

Side Effects

• Common: Nausea, vomiting, diarrhea, abdominal pain, headache

• Less common: Hyperlipidemia, elevated liver enzymes, fatigue, paresthesia

• Rare but serious: Severe hepatotoxicity, pancreatitis, cardiac conduction abnormalities

Precautions & Warnings

• Monitor liver function in patients with pre-existing hepatic disease

• Use with caution in patients with diabetes, hyperlipidemia, or cardiovascular risk factors

• May cause hyperglycemia and fat redistribution

• Long-term therapy requires regular viral load and CD4+ monitoring

Pregnancy & Lactation

• Use in pregnancy only if benefit outweighs risk

• Lopinavir and Ritonavir are excreted in breast milk; breastfeeding is not recommended

Storage Conditions

• Store in a cool, dry place below 30°C, away from light and moisture

• Keep out of reach of children.