Details

Autor(en) / Beteiligte

• McCance-Katz, Elinore F.
• Rainey, Petrie M.
• Friedland, Gerald
• Jatlow, Peter

Titel

The Protease Inhibitor Lopinavir-Ritonavir May Produce Opiate Withdrawal in Methadone-Maintained Patients

Ist Teil von

• Clinical infectious diseases, 2003-08, Vol.37 (4), p.476-482

Ort / Verlag

Chicago, IL: The University of Chicago Press

Erscheinungsjahr

2003

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• This study examines the pharmacokinetic/pharmacodynamic interactions between (1) lopinavir-ritonavir (L/R), a fixed combination of protease inhibitors used for the treatment of HIV disease, and (2) ritonavir alone at the same dosage as that in the L/R formulation, with methadone, an opiate frequently used in substance abuse pharmacotherapy for opioid (heroin)-dependent injection drug users, many of whom are infected with HIV. L/R was associated with significant reductions in the methadone area under the concentration-time curve (P < .001), maximum concentration (P < .001), and minimum concentration (P < .001), as well as increased methadone oral clearance (P < .001) and increased opiate withdrawal symptoms (P = .013), whereas ritonavir use alone modestly and nonsignificantly increased methadone concentrations. Lopinavir is a potent inducer of methadone metabolism, and treatment with L/R requires clinical monitoring and increased methadone doses in some patients, whereas ritonavir has no significant effect on methadone metabolism.