title: A review of pharmacological interactions between HIV or hepatitis C virus medications and opioid agonist therapy: implications and management for clinical practice.
abstract: Global access to opioid agonist therapy and HIV/hepatitis C virus (HCV) treatment is expanding but when used concurrently, problematic pharmacokinetic and pharmacodynamic interactions may occur. Articles published from 1966 to 2012 in Medline were reviewed using the following keywords: HIV, AIDS, HIV therapy, HCV, HCV therapy, antiretroviral therapy, highly active antiretroviral therapy, drug interactions, methadone and buprenorphine. In addition, a review of abstracts from national and international meetings and conference proceedings was conducted; selected reports were reviewed as well. The metabolism of both opioid and antiretroviral therapies, description of their known interactions and clinical implications and management of these interactions were reviewed. Important pharmacokinetic and pharmacodynamic drug interactions affecting either methadone or HIV medications have been demonstrated within each class of antiretroviral agents. Drug interactions between methadone, buprenorphine and HIV medications are known and may have important clinical consequences. Clinicians must be alert to these interactions and have a basic knowledge regarding their management.
authors: Yale University AIDS Program, New Haven, CT, USA. rdouglasbruce@mac.com
authors: R Douglas
authors: RD
authors: Bruce
authors: David E
authors: DE
authors: Moody
authors: Frederick L
authors: FL
authors: Altice
authors: Marc N
authors: MN
authors: Gourevitch
authors: Gerald H
authors: GH
authors: Friedland
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000701:Analgesics, Opioid / Q000493:pharmacokinetics / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002047:Buprenorphine / Q000493:pharmacokinetics / Q000627:therapeutic use; D004347:Drug Interactions; D015658:HIV Infections / Q000188:drug therapy*; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D008691:Methadone / Q000493:pharmacokinetics / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000379:methods; D011957:Receptors, Opioid / Q000819:agonists
chemical_list: D000701:Analgesics, Opioid; D044966:Anti-Retroviral Agents; D011957:Receptors, Opioid; D002047:Buprenorphine; D008691:Methadone
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