Prolavir LR Tablet (Ritonavir (50mg) + Lopinavir (200mg))

Prolavir LR Tablet is a prescription antiretroviral medicine containing lopinavir 200mg and ritonavir 50mg. Lopinavir 200mg tablet is an HIV-1 protease inhibitor; low-dose ritonavir tablet is included primarily to inhibit CYP3A-mediated metabolism and increase lopinavir 200mg exposure.

Therefore, Ritonavir 50mg tablet is used with other antiretroviral medicines for HIV-1 infection. It is not a complete HIV regimen by itself. Modern HIV guidelines often prefer newer integrase-inhibitor-based regimens for many patients, but lopinavir tablet remains clinically relevant in selected settings, resistance patterns, pediatric programs and circumstances where preferred options are unsuitable or unavailable.
However, the 200/50mg tablet contains a fixed ratio of the two medicines. Adult dosing and pediatric dosing differ, and the regimen must be selected using treatment history, resistance data, concomitant medicines, pregnancy considerations and organ function. However, patient must follow strict doctor advice while using this medicine to avoid complications during the treatment.

Prolavir LR tablet should be used only for an appropriate specialist-directed indication. The exact treatment setting, combination regimen and duration depend on the diagnosis and current clinical guidance.
HIV-1 infection: Lopinavir 200mg and ritonavir 50mg tablet is indicated in combination with other antiretroviral agents for treatment of HIV-1 infection in adults and pediatric patients within approved age/weight ranges.
Treatment-experienced patients: Previous antiretroviral exposure and resistance mutations can reduce protease-inhibitor activity. Regimen selection should therefore consider resistance history.
Contemporary role: Current HIV practice frequently uses newer preferred regimens; Prolavir LR tablet should be positioned as one treatment option rather than the universal first-line standard.

The mechanism of action of Lopinavir 200mg involves the inhibition of HIV-1 protease enzyme, which is crucial for the formation of mature viruses. On the other hand, the mechanism of action of Ritonavir 50mg tablet involves the inhibition of HIV protease enzyme as well. However, when combined with Lopinavir 200mg, the mechanism of action of Ritonavir 50mg tablet is mainly focused on the maintenance of Lopinavir 200mg levels in the body. This is achieved by the inhibition of the CYP3A enzyme responsible for the metabolism of Lopinavir 200mg.

• Prolavir LR tablet has extensive clinical experience in treatment-naive and treatment-experienced HIV populations and historically formed part of major antiretroviral regimens.
  
• Long-term HIV control depends on using lopinavir 200mg tablet with other active antiretroviral drugs and maintaining adherence. However, viral resistance can emerge when the regimen is not fully suppressive.
  

Common or clinically relevant adverse effects can include:

• Diarrhea
  
• Nausea
  
• Vomiting
  
• Abdominal discomfort
  
• Hypertriglyceridemia/hypercholesterolemia
  
• Elevated liver enzymes
  
• Hyperglycemia
  
• Fat redistribution/metabolic effects

Serious side effects include:

• Pancreatitis
  
• Hepatotoxicity
  
• PR-interval prolongation
  
• QT prolongation in susceptible patients
  
• Severe drug interactions due to CYP3A inhibition
  
• New-onset/worsening diabetes or hyperglycemia
  
• Immune reconstitution inflammatory syndrome

Patients should receive medicine-specific instructions about symptoms that require urgent medical attention.

There is no safe basis for choosing a dose simply from the Lopinavir 200mg + Ritonavir 50mg pack strength. The prescribed regimen depends on the approved indication and patient factors.

These are molecule-level examples/principles from regulatory labeling and are not instructions for self-dosing. The healthcare specialist determines the actual dose, duration, dose modifications and supportive treatment.

Take a missed dose as soon as remembered unless it is close to the next dose; do not double. However, maintaining adherence is critical because repeated missed doses can allow viral rebound and resistance can allow the HIV viral load to increase and may contribute to the development of drug resistance. Consult the doctor for proper dosing guidance if a dose is missed or there is any uncertainty about the next dose.

Monitoring is individualized according to the disease, regimen and patient risk factors. It may include:

• HIV viral load
  
• CD4 count as clinically appropriate
  
• Liver-function tests
  
• Fasting lipids and glucose
  
• Pancreatitis symptoms/lipase when indicated
  
• ECG in patients with conduction/QT risk
  
• Drug interactions and adherence
  
• Resistance testing when virologically indicated
  

1. DailyMed. KALETRA (lopinavir/ritonavir) prescribing information, effective July 2026 https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8290add3-4449-4e58-6c97-8fe1eec972e3​
2. Current HIV treatment guidelines for contemporary regimen positioning https://www.who.int/news/item/07-01-2026-who-releases-updated-recommendations-on-hiv-clinical-management​
3. Current India-specific Prolavir LR package insert before publication https://5.imimg.com/data5/SELLER/Doc/2025/11/557452750/JA/SQ/PO/79479582/prolavir-lr-tab.pdf​
4. U.S. Food and Drug Administration. KALETRA (lopinavir/ritonavir) Prescribing Information. FDA-approved product information https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021226s036lbl.pdf​
5. National Institutes of Health. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV. Updated September 24, 2026 https://clinicalinfo.hiv.gov/sites/g/files/mnhszr391/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf​