Page 131 - HIV/AIDS Guidelines

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

Methadone, cont’d NVP methadone AUC ↓ 41%
NVP: no significant effect

Opioid withdrawal common; increased methadone dose often necessary.
b
ATV/r, DRV/r, FPV/r, With ATV/r, DRV/r, FPV/r: R-methadone AUC ↓ 16%−18%;
IDV/r, LPV/r, SQV/r, With LPV/r: methadone AUC ↓ 26%–53%;
TPV/r With SQV/r 1000/100 mg BID: R-methadone AUC ↓ 19%;
With TPV/r: R-methadone AUC ↓ 48%
Opioid withdrawal unlikely but may occur. Adjustment of methadone dose usually
not required; however, monitor for opioid withdrawal and increase methadone dose
as clinically indicated.
FPV No data with FPV (unboosted)
With APV: R-methadone C min ↓ 21%, no significant change in AUC
Monitor and titrate methadone as clinically indicated.
The interaction with FPV is presumed to be similar.
NFV methadone AUC ↓ 40%
Opioid withdrawal rarely occurs. Monitor and titrate dose as clinically indicated. May
require increased methadone dose.
ddI (EC capsule), No significant effect
3TC, TDF, ETR, RTV,
ATV, IDV, RAL No dosage adjustment necessary.
FTC, MVC, T20 No data

a Norbuprenorphine is an active metabolite of buprenorphine.
b R-methadone is the active form of methadone.
Key to Abbreviations: 3TC = lamivudine, ABC = abacavir, APV = amprenavir, ATV = atazanavir, ATV/r = atazanavir/ ritonavair, AUC = area under
the curve, BID = twice daily, C max = maximum plasma concentration, C min = minimum plasma concentration, d4T = stavudine,
ddI = didanosine, DRV/r = darunavir/ritonavir, EC = enteric coated, EFV = efavirenz, ETR = etravirine, FPV = fosamprenavir,
FPV/r = fosamprenavir/ritonavir, FTC = emtricitabine, IDV = indinavir, IDV/r = indinavir/ritonavir, LPV/r = lopinavir/ritonavir, MVC = maraviroc,
NFV = nelfinavir, NVP = nevirapine, RAL = raltegravir, RTV = ritonavir, SQV/r = sacquinavir/ritonavir, T20 = enfuvirtide, TDF = tenofovir,
TPV = tipranavir, TPV/r = tipranavir/ritonavir, ZDV = zidovudine

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Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents I-15

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