Page 130 - HIV/AIDS Guidelines

Table 11. Drug Interactions between Antiretroviral Agents and Drugs Used to Treat
Opioid Addiction (page 1 of 2)

Concomitant Antiretroviral Pharmacokinetic Interactions
Drug Drug Clinical Comments/Recommendations
a
Buprenorphine EFV buprenorphine AUC ↓ 50%; norbuprenorphine AUC ↓ 71%
No withdrawal symptoms reported. No dosage adjustment recommended; however,
monitor for withdrawal symptoms.
ETR buprenorphine AUC ↓ 25%
No dosage adjustment necessary.

ATV buprenorphine AUC ↑ 93%; norbuprenorphine AUC ↑ 76%;
↓ ATV levels possible
Do not coadminister buprenorphine with unboosted ATV.
ATV/r buprenorphine AUC ↑ 66%; norbuprenorphine AUC ↑ 105%

Monitor for sedation. Buprenorphine dose reduction may be necessary.
DRV/r buprenorphine: no significant effect;
norbuprenorphine AUC ↑ 46% and C min ↑ 71%

No dose adjustment necessary.
FPV/r buprenorphine: no significant effect;
norbuprenorphine AUC ↓ 15%

No dosage adjustment necessary.
TPV/r buprenorphine: no significant effect;
norbuprenorphine AUC, C max , and C min ↓ 80%;
TPV C min ↓ 19%–40%

Consider monitoring TPV level.
3TC, ddI, TDF, ZDV, No significant effect
NVP, LPV/r, NFV
No dosage adjustment necessary.
ABC, d4T, FTC, ETR, No data
IDV +/- RTV, SQV/r,
RAL, MVC, T20

Methadone ABC methadone clearance ↑ 22%
No dosage adjustment necessary.
d4T d4T AUC ↓ 23% and C max ↓ 44%
No dosage adjustment necessary.

ZDV ZDV AUC ↑ 29%–43%
Monitor for ZDV-related adverse effects.

EFV methadone AUC ↓ 52%
Opioid withdrawal common; increased methadone dose often necessary.

Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents I-14

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