Interactions between Buprenorphine and Antiretrovirals. I. The Nonnucleoside Reverse-Transcriptase Inhibitors Efavirenz and Delavirdine

• Published in: Clinical infectious diseases Vol. 43; no. Supplement-4; pp. S224 - S234
• Main Authors: McCance-Katz, Elinore F., Moody, David E., Morse, Gene D., Friedland, Gerald, Pade, Patricia, Baker, Jennifer, Alvanzo, Anika, Smith, Patrick, Ogundele, Abayomi, Jatlow, Peter, Rainey, Petrie M.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL The University of Chicago Press 15-12-2006; University of Chicago Press; Oxford University Press
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral drugs; Antiretrovirals; Antiviral agents; Area Under Curve; Benzoxazines; Biological and medical sciences; Buprenorphine - pharmacokinetics; Buprenorphine - therapeutic use; Case-Control Studies; Cohort Studies; Delavirdine - pharmacokinetics; Delavirdine - therapeutic use; Dosage; Dose-Response Relationship, Drug; Drug addiction; Drug addictions; Drug Administration Schedule; Drug Interactions; Female; HIV; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Inhibitor drugs; Male; Medical sciences; Medications; Mental concentration; Methadone; Narcotic Antagonists - pharmacokinetics; Narcotic Antagonists - therapeutic use; Opiates; Opioid analgesics; Opioid-Related Disorders - diagnosis; Opioid-Related Disorders - drug therapy; Opioid-Related Disorders - epidemiology; Oxazines - pharmacokinetics; Oxazines - therapeutic use; Pharmacokinetics; Pharmacology; Pharmacology. Drug treatments; Probability; Prognosis; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reference Values; Reverse Transcriptase Inhibitors - pharmacokinetics; Reverse Transcriptase Inhibitors - therapeutic use; Risk Assessment; Statistics, Nonparametric; Substance abuse treatment; Toxicology; Treatment Outcome; Human; Immunopathology; Drug addiction; Antiretroviral agent; Benzoxazine derivatives; RNA-directed DNA polymerase; Acetylenic compound; Enzyme; Non nucleoside compound; Transferases; Enzyme inhibitor; Opiates; AIDS; Narcotic analgesic; Immune deficiency; Efavirenz; Delavirdine; Infection; Allosteric inhibitor; Nucleotidyltransferases; Buprenorphine; Viral disease; Reverse transcriptase inhibitor; Antiviral
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/508187

This study examined drug interactions between buprenorphine, an opioid partial agonist medication used in the treatment of opioid dependence, and the nonnucleoside reverse-transcriptase inhibitors (NNRTIs) efavirenz (EFV) and delavirdine (DLV). Opioid-dependent, buprenorphine/naloxone-maintained, human immunodeficiency virus (HIV)-negative volunteers (n = 10 per NNRTI) participated in 24-h sessions to determine pharmacokinetics of buprenorphine and of buprenorphine with either EFV or DLV after administration of standard doses of either antiretroviral for 15 or 7 days, respectively. Opiate withdrawal symptoms, cognitive effects, and adverse events were determined before and after antiretroviral administration in opioid-dependent participants. The pharmacokinetics of NNRTIs in healthy control participants were used to determine the effect of buprenorphine on NNRTIs. EFV decreased the buprenorphine area under the concentration-time curve (P < .001). DLV increased buprenorphine concentrations (P < .001). Clinically significant consequences of these interactions were not observed. Buprenorphine did not alter antiretroviral pharmacokinetics. Adjustments of doses of either buprenorphine or EFV or DLV are not likely to be necessary when these drugs are administered for the treatment of opiate dependence and HIV disease.