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Kaletra and Mepron

Determining the interaction of Kaletra and Mepron and the possibility of their joint administration.

Check result:
Kaletra <> Mepron
Relevance: 06.08.2022 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:

Ritonavir may reduce the blood levels of atovaquone, which may make the medication less effective in treating your condition. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use 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 ritonavir may decrease the plasma concentrations of atovaquone and proguanil. The mechanism of interaction has not been established, but may involve ritonavir induction of the glucuronidation of atovaquone and the CYP450 2C19-mediated metabolism of proguanil. According to an open-label study from the Netherlands, HIV patients stabilized on antiretroviral regimens containing efavirenz (600 mg once daily; n=20), atazanavir/ritonavir (300 mg/100 mg once daily; n=19), or lopinavir/ritonavir (400 mg/100 mg twice daily or 800 mg/200 mg once daily; n=19) had significantly lower plasma concentrations of atovaquone and proguanil compared to healthy volunteers (n=18) following a single 250 mg/100 mg dose of atovaquone/proguanil. Specifically, atovaquone systemic exposure (AUC) was 46% lower in the atazanavir/ritonavir group and 74% lower in the lopinavir/ritonavir group than in the control group. Likewise, proguanil AUC was 41% and 38% lower in the atazanavir/ritonavir and lopinavir/ritonavir groups, respectively. The clinical significance is unknown. There are no published reports in the medical literature regarding atovaquone/proguanil treatment failure in HIV patients receiving ritonavir-boosted protease inhibitor regimens.

MANAGEMENT: The potential for treatment failure should be considered when atovaquone or atovaquone/proguanil is used with ritonavir. Some experts recommend avoiding concomitant use. If coadministration is required, an increased dosage of atovaquone and proguanil may be required.

References
  • "Product Information. Norvir (ritonavir)." Abbott Pharmaceutical, Abbott Park, IL.
  • Van Luin M, Van der Ende ME, Richter C, et al. "Lower atovaquone/proguanil concentrations in patients taking efavirenz, lopinavir/ritonavir or atazanavir/ritonavir." AIDS 24 (2010): 1223-6
Kaletra

Generic Name: lopinavir / ritonavir

Brand name: Kaletra

Synonyms: n.a.

Mepron

Generic Name: atovaquone

Brand name: Mepron

Synonyms: n.a.

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.

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Disease interaction