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This pharmacokinetic study investigated the interaction between lopinavir/ritonavir (800/200 mg given once daily) and buprenorphine/naloxone in 12 HIV-seronegative subjects who were on stable buprenorphine therapy.

After administration of lopinavir/ritonavir for at least 10 days, the buprenorphine AUC and C_max were not significantly different from baseline values. For norbuprenorphine, the primary metabolite of buprenorphine, the C_max was lower during coadministration with lopinavir/ritonavir (73.7 vs 52.7 ng•hr/mL, p < .05) whereas the AUC was not significantly lower (5.29 vs 3.11 ng/mL). Concentrations of naloxone were unchanged, and the lopinavir AUC and C_min were not significantly different from those of two historical comparators.

Clinical Bottom Line

Based on these data, no dosage modification of either buprenorphine/naloxone or lopinavir/ritonavir is needed when these drugs are coadministered.

References

Bruce D, Altice F, Moody D, et al. Pharmacokinetic Interactions Between Buprenorphine/Naloxone and Once-Daily Lopinavir/Ritonavir. In: Program and abstracts of the 17th Conference on Retroviruses and Opportunistic Infections; February 16-19, 2010; San Francisco. Abstract 620.