Drug Interactions between Opioids and Antiretroviral Medications: Interaction between Methadone, LAAM, and Nelfinavir

Elinore F. McCance-Katz; Petrie M. Rainey; Patrick Smith; Gene Morse; Gerald Friedland; Marc Gourevitch; Peter Jatlow

doi:10.1080/10550490490436037

Drug Interactions between Opioids and Antiretroviral Medications: Interaction between Methadone, LAAM, and Nelfinavir

Elinore F. McCance-Katz, Petrie M. Rainey, Patrick Smith, Gene Morse, Gerald Friedland, Marc Gourevitch, Peter Jatlow

Urban Initiative

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Abstract

Understanding drug interactions between antiretrovirals and opiate therapies may decrease toxicities and enhance adherence, with improved HIV outcomes in injection drug users. We report results of a clinical pharmacology study designed to examine the interaction of the protease inhibitor, nelfinavir, with methadone and LAAM (N = 48). Nelfinavir decreased methadone exposure, but no withdrawal was observed over the five day study period. LAAM and dinorLAAM concentrations were decreased, while norLAAM concentrations were increased, with minimal overall change in LAAM/metabolite exposure. Methadone and LAAM did not affect nelfinavir concentrations, but methadone decreased M8 metabolite exposure. While no toxicities were observed, clinicians should be aware of the potential for drug interactions when patients require treatment with nelfinavir and these opiate medications.

Original language	English (US)
Pages (from-to)	163-180
Number of pages	18
Journal	American Journal on Addictions
Volume	13
Issue number	2
DOIs	https://doi.org/10.1080/10550490490436037
State	Published - Mar 2004

ASJC Scopus subject areas

Medicine (miscellaneous)
Clinical Psychology
Psychiatry and Mental health

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10.1080/10550490490436037

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title = "Drug Interactions between Opioids and Antiretroviral Medications: Interaction between Methadone, LAAM, and Nelfinavir",

abstract = "Understanding drug interactions between antiretrovirals and opiate therapies may decrease toxicities and enhance adherence, with improved HIV outcomes in injection drug users. We report results of a clinical pharmacology study designed to examine the interaction of the protease inhibitor, nelfinavir, with methadone and LAAM (N = 48). Nelfinavir decreased methadone exposure, but no withdrawal was observed over the five day study period. LAAM and dinorLAAM concentrations were decreased, while norLAAM concentrations were increased, with minimal overall change in LAAM/metabolite exposure. Methadone and LAAM did not affect nelfinavir concentrations, but methadone decreased M8 metabolite exposure. While no toxicities were observed, clinicians should be aware of the potential for drug interactions when patients require treatment with nelfinavir and these opiate medications.",

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AU - McCance-Katz, Elinore F.

AU - Rainey, Petrie M.

AU - Smith, Patrick

AU - Morse, Gene

AU - Friedland, Gerald

AU - Gourevitch, Marc

AU - Jatlow, Peter

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AB - Understanding drug interactions between antiretrovirals and opiate therapies may decrease toxicities and enhance adherence, with improved HIV outcomes in injection drug users. We report results of a clinical pharmacology study designed to examine the interaction of the protease inhibitor, nelfinavir, with methadone and LAAM (N = 48). Nelfinavir decreased methadone exposure, but no withdrawal was observed over the five day study period. LAAM and dinorLAAM concentrations were decreased, while norLAAM concentrations were increased, with minimal overall change in LAAM/metabolite exposure. Methadone and LAAM did not affect nelfinavir concentrations, but methadone decreased M8 metabolite exposure. While no toxicities were observed, clinicians should be aware of the potential for drug interactions when patients require treatment with nelfinavir and these opiate medications.

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Drug Interactions between Opioids and Antiretroviral Medications: Interaction between Methadone, LAAM, and Nelfinavir

Abstract

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