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Garlic and Kaletra Oral Solution

Determining the interaction of Garlic and Kaletra Oral Solution and the possibility of their joint administration.

Check result:
Garlic <> Kaletra Oral Solution
Relevance: 14.12.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Ask your doctor before using garlic together with ritonavir. Using these medications together can make ritonavir less effective. If your doctor prescribes these medications together, you may need a dose adjustment or special tests to safely take both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

GENERALLY AVOID: Coadministration with garlic supplements may decrease the plasma concentrations of saquinavir and possibly other protease inhibitors (PIs). The exact mechanism is unknown but may involve induction of CYP450 3A4 metabolism and/or P-gycloprotein transport in the intestine by certain component(s) of garlic. In nine healthy, HIV-negative volunteers, investigators from the National Institutes of Health found that pretreatment with a garlic supplement (GarliPure Maximum Allicin Formula twice daily for 3 weeks) reduced the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of saquinavir (soft gelatin capsule 1200 mg 3 times daily for 10 doses during the last 4 days of garlic supplementation) by 54% and 51%, respectively, compared to baseline when saquinavir was administered alone. The effects appear to be sustained, since saquinavir Cmax and AUC returned to just 61% and 65% of baseline, respectively, after a 10-day washout period. Whether and how dietary garlic or other formulations of garlic supplement may affect saquinavir pharmacokinetics are currently unknown. It is also uncertain if and to what extent the interaction may occur with other PIs, which are also substrates of CYP450 3A4.

MANAGEMENT: Given the risk of reduced viral susceptibility and resistance development associated with subtherapeutic antiretroviral drug levels, garlic supplements should preferably be avoided in patients treated with PIs, particularly if they are using saquinavir as the sole PI in their antiretroviral regimen. Patients should be advised to consult with their caregivers before using any herbal or alternative medicines.

References
  • Piscitelli SC, Burstein AH, Welden N, Gallicano KD, Falloon J "The Effect of Garlic Supplements on the Pharmacokinetics of Saquinavir." Clin Infect Dis 34 (2002): 234-238
  • NIAID. National Institute of Allergy and Infectious Diseases "Garlic supplements can impede HIV medication. Available from: URL: http://www.niaid.nih.gov/newsroom/releases/garlic.htm." ([2001 Dec 5]):
  • Borek C "Garlic supplements and saquinavir." Clin Infect Dis 35 (2002): 343
  • Durant J, Clevenbergh P, Garraffo R, Halfon P, Icard S, DelGiudice P, Montagne N, Schapiro JM, Dellamonica P "Importance of protease inhibitor plasma levels in HIV-infected patients treated with genotypic-guided therapy: pharmacological data from the Viradapt Study." Aids 14 (2000): 1333-9
Garlic

Generic Name: garlic

Brand name: Garlic Oil

Synonyms: n.a.

Kaletra Oral Solution

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: Kaletra

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

Interaction with food and lifestyle
Disease interaction