Lopimune general information
What is Lopimune used for?
Human Immunodeficiency Virus (HIV) is a type of virus known as a retrovirus. HIV is transmitted by direct contact with body fluids, such us from unprotected sex, breastfeeding, using contaminated syringes, or transfusion with contaminated blood. Infection with HIV damages the immune system, which is your body’s defence against invasion with harmful organisms. If left untreated, HIV infection can result in a condition called acquired immune deficiency syndrome (AIDS). Lopimune tablets 200/50mg are a fixed-dose combination medication used to treat HIV infection. Lopimune should be used in combination with other HIV-specific medicines that work by a different mechanism. Lopimune tablets help relieve acute symptoms of HIV infection and control the spread of the virus within the body to prevent the development of AIDS.
How does HIV cause AIDS?
HIV damages the immune system by attacking specific immune cells called CD4 cells. These are specialised white cells or T lymphocytes, also known as T helper cells, that interact with other immune cells like B lymphocytes and macrophages in fighting infection. As HIV continues to attack and destroy CD4 cells, the immune system becomes weakened and cannot work effectively.
Acute infection causes symptoms within 2-4 weeks that are like flu and include fever, headache. You may also develop a rash. At this stage, the virus is replicating rapidly, and the number of infectious virus particles in the body, known as the viral load, is very high. If the virus persists untreated in the body, replication continues, but it slows down. It is still highly contagious and is still causing damage to the immune system. This chronic stage of infection can last months, even years.
Eventually, the immune system is so damaged because too many CD4 cells have been destroyed, that it is unable to fight infection. This is the final and life-threatening lead stage of HIV infection known as acquired immune deficiency syndrome (AIDS). If you have been diagnosed with AIDS you will be severely immunocompromised, which means that you are highly susceptible to opportunistic infection. These are infections that would not usually be harmful and include Herpes Simplex Virus, Cytomegalovirus (CMV) that causes pneumonia and gastroenteritis, and Mycobacterium avium complex (MAC) that infects the lungs. Fungal infections of the mouth, lungs and brain can also cause serious problems. Kaposi’s sarcoma is a virus-related cancer that is associated with HIV infection. HIV is still very contagious at this stage, and AIDS has a poor prognosis, usually just a few years.
Antiretroviral therapy (ART)
The genetic material of retroviruses is RNA. The only way a retrovirus can multiply is to convert its RNA to DNA, using an enzyme produced by the virus called reverse transcriptase. Once a DNA copy has been made of the viral RNA, it can then get into (or integrate) the DNA of infected immune cells. This stage of the infection process depends on a viral enzyme known as integrase. Once integrated into the host immune cell DNA, the viral DNA can replicate, using the cellular equipment provided by the host cells.
Antiretroviral drugs are drugs that are only effective against retroviruses. Antiretroviral therapy (ART) is treatment using a combination of different classes of antiretroviral drugs that work by different mechanisms. Using a combination of drugs reduces the risk of the virus developing resistance to treatment. So if one medicine does not work, another one in the combination will.
Treatment for HIV is most effective if started as soon as symptoms appear and before the viral load increases rapidly. Although ART cannot cure the disease, it can reduce the viral load, reduce the risk of viral transmission, and improve quality of life.
How does Lopimune work?
Lopimune tablets 200/50mg contain lopinavir and ritonavir, which are both inhibitors of HIV protease and are used to treat infection with Human Immunodeficiency Virus (HIV). Lopimune tablets are only effective against retroviruses like HIV.
HIV produces a protease protein, which is an enzyme that breaks up large proteins into smaller protein units. HIV uses the host cell to produce a protein called the Gag-Pol polyprotein. This large precursor protein needs to be cut up into smaller units before HIV can develop into a mature, infectious virus particle. One of these protein units is the active viral protease enzyme. The final stage of the HIV replication cycle is the combination of its RNA with these small proteins, once the new virus particle is released from an infected cell. The mature virus, now called a virion (infectious virus particle), can infect more immune cells.
Lopinavir in Lopimune tablets 200/50mg is a protease inhibitor and works by blocking the action of the viral protease. This prevents the breakdown of the Gag-Pol polyprotein into smaller functional protein units, which results in the production of immature, non-infectious viral particles.
Ritonavir in Lopimune tablets 200/50mg is not included in this combination medication as a protease inhibitor. Ritonavir works by inhibiting the CYP3A-mediated metabolism (breakdown in the liver) of lopinavir. This increases the plasma levels of lopinavir so that it can be used at a lower dose.
The combined action of lopinavir and ritonavir in Lopimune tablets 200/50mg, when used in conjunction with other antiretroviral drugs, inhibits the production of active HIV. This reduces the amount of virus that can infect more cells.
What does Lopimune contain?
Lopimune tablets contains a combination of the active ingredients lopinavir (200mg) and ritonavir (50mg) that are used to treat infection with Human Immunodeficiency Virus (HIV) to control the spread of the virus within the body and prevent the development of AIDS (acquired immune deficiency syndrome).
What are the side effects of Lopimune?
Most medications have some side effects, but they are not experienced by everyone. Some side effects are commonly experienced when taking Lopimune tablets 200/50mg, but others are not so common, and you should discuss any problems or concerns with your primary care physician.
Common side effects when taking Lopimune include diarrhoea, nausea, vomiting, abdominal pain, reflux, bloating, pancreatitis, hepatitis, rash, respiratory infection, headache, dizziness, insomnia, anxiety, muscle and back pain, fatigue, erectile dysfunction, menstrual problems, hypertension, increased blood cholesterol and blood glucose disorders.
Other side effects include redistribution of body fat from the arms, legs and face to the abdominal region; inflammation reaction due to immune reconstitution syndrome, as the immune system recovers and fights infection caused by residual infection.
When should Lopimune not be used?
Have a talk with your primary healthcare physician before taking Lopimune tablets 200/50mg so that you have a full understanding of what this medicine is for and how to use it. There are some reasons for not taking a medication; these are called contraindications, and for Lopimune you should consider the following before taking Lopimune:
- Have you ever had an unusual reaction or an allergy when taking Lopimune?
- Are you pregnant or breastfeeding?
- Do you have a serious liver disease like hepatitis or cirrhosis?
- Do you have a have a heart condition including long QT syndrome, underlying structural heart disease, pre-existing conduction system abnormalities, ischemic heart disease or cardiomyopathies?
- Do you have the blood condition haemophilia, as Lopimune can cause increased bleeding?
- Do you have diabetes, as Lopimune can cause increased blood sugar?
What medications interact with Lopimune?
Some medicines interact with Lopimune tablets 200/50mg and may affect the way it works, or are affected by Lopimune or increase side effects; you should discuss possible interactions with your primary care physician. These may include other retrovirals like zidovudine and saquinavir, antiarrhythmics like amiodarone, anticancer agents like vincristine, the anticoagulant warfarin, anticonvulsants like carbamazepine, analgesics like fentanyl, digoxin for heart failure, the antidepressants trazodone and bupropion, anticonvulsants like phenytoin and carbamazepine, antifungals like ketoconazole, the antibiotics clarithromycin and rifampicin, benzodiazepines sedatives like midazolam, calcium channel blockers like nifedipine, corticosteroids like dexamethasone, the antipsychotic blonanserin, PDE5 inhibitors like sildenafil for erectile dysfunction, statin drugs atorvastatin like for high cholesterol, salmeterol for asthma, contraceptives like ethinyl estradiol, ergot drugs like ergotamine for migraine headaches, the herbal product St John's wort, cisapride for gastric reflux, the antipsychotic pimozide, colchicine for gout.
If other medications may interact with Lopimune, your doctor will discuss these with you.
How should Lopimune be taken and for how long?
You should take your Lopimune tablets 200/50mg swallowed whole with a glass of water with or without food, once or twice daily. The dose you take will depend on your condition, whether you have taken, or are currently taking other antiretroviral drugs and your doctor’s recommendation. Your dose may be increased or decreased depending on how well you respond and whether you have any reactions or side effects. For children, the dose should be calculated based on body weight or body surface area (BSA) and should not exceed the recommended adult dose. You should continue to take your Lopimune tablets 200/50mg regularly for as long as your doctor recommends as it helps control the HIV infection but does not cure it; do not stop taking your tablets even if you feel better without discussion with your doctor.
Missed dose of Lopimune
If you miss a dose of Lopimune tablets 200/50mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose. Do not take a double dose.
How should Lopimune be stored?
You should store your Lopimune tablets 200/50mg below 25°C in a cool dry place.