Pharmacokinetic interactions between buprenorphine and antiretroviral medications.
Buprenorphine is used for the treatment of opioid dependence. As the number of persons receiving buprenorphine treatment and antiretroviral therapy continues to grow, so too does the existence and clinical impact of drug interactions between buprenorphine and medications for treating human immunodeficiency virus (HIV) infection. Awareness that such interactions exist may deter some patients and physicians from initiating potentially lifesaving therapy or lead to complications among patients whose treatment is already under way. Complications include nonadherence to antiretroviral therapy and the development of viral resistance. Illicit drug use is a frequent consequence of adverse drug effects experienced by injection drug users. The occurrence of unrecognized drug interactions can lead to unsuccessful therapy for HIV infection and the treatment of substance dependence. The present review is organized to provide a working background of buprenorphine pharmacology. Review of the current state of knowledge regarding specific interactions between buprenorphine and antiretrovirals is followed by a review of the clinical applicability of these interactions.
Bruce
R Douglas
RD
Yale University AIDS Program, New Haven, CT 06511, USA. robert.bruce@yale.edu
McCance-Katz
Elinore
E
Kharasch
Evan D
ED
Moody
David E
DE
Morse
Gene D
GD
D000818:Animals; D044966:Anti-Retroviral Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002047:Buprenorphine / Q000493:pharmacokinetics* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004347:Drug Interactions; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D009292:Narcotic Antagonists / Q000493:pharmacokinetics* / Q000627:therapeutic use; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016312:Treatment Refusal
D044966:Anti-Retroviral Agents; D009292:Narcotic Antagonists; D002047:Buprenorphine