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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Bruce, Robert Douglas Altice, Frederick L. Moody, David E. Morse, Gene D. Andrews, Laurie Lin, Shen-Nan Fang, Wenfang B. Ma, Qing Friedland, Gerald H. |
| Description | Country affiliation: United States Author Affiliation: Bruce RD ( Department of Medicine, Yale University AIDS Program, New Haven, CT, USA. robert.bruce@yale.edu) |
| Abstract | BACKGROUND: This study was conducted to examine the pharmacokinetic interactions between buprenorphine/naloxone (BUP/NLX) and lopinavir/ritonavir (LPV/r) in HIV-seronegative subjects chronically maintained on BUP/NLX. METHODS: This study was an open labeled pharmacokinetic study in twelve HIV-seronegative subjects stabilized on at least 3 weeks of BUP/NLX therapy. Subjects sequentially underwent baseline and steady-state pharmacokinetic evaluation of once-daily LPV/r (800/200 mg). RESULTS: Compared to baseline values, BUP AUC0-24h (46.8 vs. 46.2 ng*hr/mL) and Cmax (6.54 vs. 5.88 ng/mL) did not differ significantly after achieving steady-state LPV/r. Similar analyses of norBUP, the primary metabolite of BUP, demonstrated no significant difference in norBUP AUC0-24 hours (73.7 vs. 52.7 ng x h/mL); however, Cmax (5.29 vs. 3.11 ng/mL) levels were statistically different (P < 0.05) after LPV/r administration. Naloxone concentrations were similarly unchanged for AUC0-24 hours (0.421 vs. 0.374 ng x hr/mL) and Cmax (0.186 vs. 0.186 ng/mL). Using standardized measures, no objective opioid withdrawal was observed. The AUC0-24 hours and Cmin of LPV in this study did not significantly differ from historical controls (159.6 vs. 171.3 microg x hr/mL) and (2.3 vs. 1.3 microg/mL). CONCLUSIONS: The addition of LPV/r to stabilized patients receiving BUP/NLX did not affect buprenorphine pharmacokinetics but did increase the clearance of norbuprenorphine. Pharmacodynamic responses indicate that the altered norbuprenorphine clearance did not lead to opioid withdrawal. Buprenorphine/naloxone and LPV/r can be safely coadministered without need for dosage modification. |
| File Format | HTM / HTML |
| ISSN | 15254135 |
| e-ISSN | 10779450 |
| Journal | JAIDS Journal of Acquired Immune Deficiency Syndromes |
| Issue Number | 5 |
| Volume Number | 54 |
| Language | English |
| Publisher | Lippincott Williams & Wilkins |
| Publisher Date | 2010-08-01 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Discipline AIDS Analgesics, Opioid Pharmacokinetics Anti-hiv Agents Buprenorphine Hiv Infections Drug Therapy Naloxone Pyrimidinones Ritonavir Therapeutic Use Drug Interactions Lopinavir Metabolic Clearance Rate Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Infectious Diseases Pharmacology (medical) |
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