LOPIMUNE 40/10 ORAL PELLETS – scripted patients only

LOPIMUNE 40/10 ORAL PELLETS is an anti-viral medicine used in the treatment of HIV infection.^1a,b LOPIMUNE 40/10 ORAL PELLETS is a ‘2-in-1’ formulation containing two antiretrovirals medicines, namely lopinavir (strength 40 mg) and ritonavir (strength 10 mg).^1c,d
These two active ingredients are combined in an oral pellet form inside a capsule.^1d
This combination HIV medicine is often referred to by its active ingredients as lopinavir/ritonavir or Lpv/r

Lopinavir and ritonavir are antivirals that inhibit HIV multiplication in the body.¹ LOPIMUNE 40/10 ORAL PELLETS is designed to be taken together with other HIV medicines as part of an HIV regimen every-day.¹

It is important to continually improve HIV medicines for children to encourage good adherence to HIV therapy.³
Antiretroviral regimens for infants and young children often require taking multiple daily doses of pills and liquids, some of which are unpalatable or difficult to store. HIV medicines are taken every-day – for life. It is therefore best to try and prescribe the least number of pills or volume of liquid required to effectively treat HIV. This is also why many HIV medicines are available in combination to reduce the number of medicines to be taken each day.³
Lopinavir/ritonavir is also available in an oral liquid, but this known to be poorly tolerated.^2,3 Children often spit out the dose or it is regurgitated by infants due to its poor taste. If infants or children are ingesting sub-standard amounts of an HIV medicine, they may acquire resistance and consequently such patients may need to change over to a more expensive second- or third-line regimen. Lopinavir/ritonavir is also available in tablet form which must be swallowed.²
Trying to persuade a child to take any medicine can be difficult³ and so the easier the medicine is to take, the better!

The oral pellets are designed to make administration easier than the liquid or tablet formulations.²
The oral pellets overcome several challenges of previous formulations^2,4 – the corresponding liquid formulation is high in alcohol with an unpleasant taste. It is also not heat stable and requires cold chain transport until in use. The liquid bottles can also be difficult to collect from clinics and store at home. Tablet formulations are made so that they MUST be swallowed whole and cannot be broken – for younger children and infants this makes administration difficult especially if they cannot yet swallow whole tablets.²
LOPIMUNE 40/10 ORAL PELLETS is suitable for infants and children over the age of 6 months¹ and can be sprinkled over soft food such as porridge, potato or butternut mash or mashed fruits such as bananas.¹
The instructions on how to take LOPIMUNE 40/10 ORAL PELLETS are detailed below:

• Place sweetened porridge or cereal, at room temperature, in a small bowl.¹
• Take out the required number of capsules needed for one dose.
• It is important to make sure the child has taken the entire dose of pellets by limiting the food used to an amount the child is able to easily consume in one swallow (e.g. 1 teaspoon).^1,2
• The mixture of the pellets and food is NOT to be stored for later use.^1,2
• Do not chew or crush the pellets.¹ The infant or child may drink some water after eating to ensure the pellets do not remain in the mouth.¹