Long-acting Injectable Containing Lopinavir Eliminates Reliance on Ritonavir Pharmacokinetic Enhancement.

Perazzolo, Simone; Flexner, Charles W; Stephen, Zachary R; Acosta, Edward P; Bender Ignacio, Rachel A; Ho, Rodney J Y · J Infect Dis · 2025

basic_science · Level V

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Abstract

High-extraction protease inhibitors (eg, for human immunodeficiency virus and severe acute respiratory syndrome coronavirus 2) typically require ritonavir to enhance bioavailability by overcoming first-pass metabolism. However, in the long-acting subcutaneous injectable dosage form TLC-ART 101, lopinavir persisted in plasma for 57 days, while ritonavir was detectable for only 3-7 days. The remarkable duration of lopinavir suggests that ritonavir may be unnecessary in long-acting injectable products, potentially reducing side effects and drug-drug interactions.

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