Yale University

An investigation of the interactions between methadone and elvitegravir/cobicistat in subjects receiving chronic methadone maintenance.

TitleAn investigation of the interactions between methadone and elvitegravir/cobicistat in subjects receiving chronic methadone maintenance.
Publication TypeJournal Article
Year of Publication2013
AuthorsBruce, Douglas R., P. Winkle, Jm Custodio, X. Wei, M. S. Rhee, Bp Kearney, S. Ramanathan, and Gerald H. Friedland
JournalAntimicrobial agents and chemotherapy
Date Published2013 Sep 30
ISSN1098-6596
AbstractAim: Interactions between HIV and opioid-dependence therapies are known to occur. We sought to determine if such interactions occurred between methadone and elvitegravir boosted with cobicistat.Methods: We performed a within-subject open labeled pharmacokinetic and pharmacodynamic study in eleven HIV-seronegative subjects stabilized on at least 2 weeks of methadone. Subjects underwent baseline and steady-state evaluation of the effect of elvitegravir 150 mg qD boosted with 150 mg qD of cobicistat (EVG/COBI) on methadone pharmacokinetic parameters. Safety and pharmacodynamics were monitored throughout the study.Results: Compared to baseline values, R-methadone mean AUCtau (5550 vs. 6210 hr*ng/mL) and mean Cmax (316 vs. 337 ng/mL) did not significantly increase in the presence of EVG/COBI. Compared to baseline values, S-methadone mean AUCtau (7040 vs. 7540 hr*ng/mL) and mean Cmax (446 vs. 452 ng/mL) did not significantly increase in the presence of EVG/COBI. The AUCtau, Cmax and Ctau of elvitegravir and cobicistat did not significantly differ from historical controls. Opioid withdrawal or overdose was not observed among subjects in this study.Conclusion: The addition of EVG/COBI to stabilized patients receiving methadone did not affect methadone pharmacodynamics. The two can be safely co-administered.
DOI10.1128/AAC.01229-13
Alternate JournalAntimicrob. Agents Chemother.

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