Lopinavir (Kaletra)

Raw research findings for this medication. Mostly single studies, not curated or confirmed robust.

About Lopinavir

What it is

Lopinavir is an HIV protease inhibitor that blocks the viral enzyme HIV needs to cut its proteins into working parts. It is always combined with ritonavir (as Kaletra), which slows its breakdown, and taken with other HIV medicines; it remains in use mainly for children and in some second-line treatments.

How genes come into it

Lopinavir is broken down by CYP3A4, held back by ritonavir, and taken into the liver by the transporter SLCO1B1. Studies have linked the SLCO1B1 variant rs11045819 to lower lopinavir levels, and looked at ABCB1, ABCC2 and CYP3A5 for levels and response. The findings come from a few studies, and there is no CPIC or DPWG guideline.

What research found

Every published finding on gene variants and Lopinavir. Upload your DNA file to see which of these rows apply to you.

Rated evidence (8 rated variants)

PharmGKB weighs all studies of a variant and rates how strong the evidence is, from 1A (strongest) to 4.

SLCO1B1 rs4149056: Level 3. Metabolism/PK: HIV infectious disease. 7.

ABCC2 rs8187710: Level 3. Efficacy: HIV infectious disease. 2.

CYP3A4 CYP3A4*1, CYP3A4*22: Level 3. Metabolism/PK: HIV infectious disease. 2.

ABCC2 rs8187710: Level 3. Other. 1.

Metabolism (37 findings)

Studies of how quickly the body processes this medication.

CYP3A4 CYP3A4*1, CYP3A4*22: CYP3A4 *22/*22 is associated with decreased clearance of lopinavir in people with HIV Infections as compared to CYP3A4 *1/*1 + *1/*22.

CYP3A5 rs776746: Allele C is associated with increased trough concentration of lopinavir in people with HIV Infections as compared to allele T.

SLCO1B1 rs4149056: Allele C is associated with increased trough concentration of lopinavir in people with HIV Infections as compared to allele T.

SLCO1B1 rs4149056: Genotype CT is associated with increased exposure to lopinavir in children with HIV Infections as compared to genotype TT.

Response (4 findings)

Studies of how well it worked in people carrying a variant.

ABCC1 rs212091: Genotypes CC + CT are associated with increased resistance to lamivudine, lopinavir, ritonavir and zidovudine in people with HIV Infections as compared to genotype TT.

ABCB1 rs3842: Allele C is not associated with increased resistance to lamivudine, lopinavir, ritonavir and zidovudine in people with HIV Infections as compared to allele T.

ABCC1 rs3743527: Allele T is not associated with increased resistance to lamivudine, lopinavir, ritonavir and zidovudine in people with HIV Infections as compared to allele C.

SLC22A1 rs628031: Allele A is not associated with increased resistance to efavirenz, lamivudine, lopinavir, nevirapine, ritonavir and zidovudine in people with HIV Infections as compared to allele G.

Study findings and evidence levels: PharmGKB (CC BY-SA 4.0). Guidelines: CPIC and DPWG, as bundled in PharmCAT. Most studies were done mainly in people of European ancestry.

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Not a prescribing recommendation. This page is educational information about pharmacogenomic research and clinical guidelines - it is not medical or dosing advice, and not a prediction of how any medication will work for you. Never start, stop, or change a medication or dose based on it; talk to your doctor or pharmacist, who can order clinical-grade testing if appropriate.

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Content updated September 2026.

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