Rapaport S, Maroldo-Connelly L, Patterson JB, Stevens RC; International Conference on AIDS.

Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. TuPeB4539.

St. Vincents Hosp and Medical Ctr &West Midtown Medical Group, New York, NY, United States

BACKGROUND: Lopinavir/ritonavir (LPV/r) reduced the AUC of methadone by 47% in healthy volunteers; however, the clinical significance of this interaction has not been characterized. The objective of this observational study was to determine the effect of LPV/r on methadone dose requirements and opiate withdrawal in HIV-infected patients enrolled in a methadone maintenance program. METHODS: HIV-infected patients on a stable methadone dose for at least 1 month prior to starting LPV/r (Kaletra 3 capsules twice daily) were eligible. Patients were excluded if they received medications known to alter methadone clearance within 2 weeks of LPV/r. Methadone dose requirements and opiate withdrawal symptoms were reviewed over 4 weeks after initiating LPV/r. RESULTS: 25 patients were evaluated, of which 8 were considered ineligible mainly due to not being on a stable methadone dose. The median maintenance methadone dose was 90 mg/day (range, 40 to 130) for 34.1 weeks (range, 5.0 to 467.4) before LPV/r. No methadone dose changes or withdrawal symptoms were observed during the 4-week evaluation period. The median HIV RNA change from baseline during the first 12 weeks of LPV/r therapy was -2.49 log10 c/mL (range, -3.80 to 1.04), with 64% achieving <400 c/mL. One patient experienced nausea and vomiting that led to discontinuation of LPV/r after 2 days; however, no adverse events were reported for the remaining patients. CONCLUSION: LPV/r caused no change in methadone dose requirements or precipitation of withdrawal symptoms. Coupled with its acceptable tolerability, LPV/r appears to be a desirable agent for use in HIV-infected patients participating in a methadone maintenance program. As a precaution, it is still recommended to monitor for opiate withdrawal even though none was observed in this study.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• HIV Infections
• HIV Seropositivity
• Humans
• Methadone
• Narcotics
• Pyrimidinones
• Ritonavir
• Substance Withdrawal Syndrome
• lopinavir

Other ID:

• GWAIDS0012476

UI: 102249974

From Meeting Abstracts