Lack of a pharmacologic interaction between rifabutin and methadone in HIV-infected former injecting drug users.

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Lack of a pharmacologic interaction between rifabutin and methadone in HIV-infected former injecting drug users.

Drug Alcohol Depend. 1996 Dec 2;43(1-2):71-7. Unique Identifier : AIDSLINE MED/97116057
Brown LS; Sawyer RC; Li R; Cobb MN; Colborn DC; Narang PK; Addiction Research and Treatment Corporation, Brooklyn, NY 11201, USA.

Abstract: Rifampin, an agent known to decrease the half-life of methadone, and rifabutin are two rifamycins that are structurally similar and share mechanisms of action. Hence the possibility of a drug-drug interaction between rifabutin and methadone was evaluated in 24 methadone-maintained, former injecting drug users infected with the human immunodeficiency virus. The study was an open-label, drug-drug interaction and safety trial in which patients were followed for 15 days. Each patient received rifabutin 300 mg as a single dose concomitantly with their individualized methadone dosage. No significant differences in methadone peak plasma concentration, time to peak plasma concentration, area under the plasma concentration-time curve, systemic clearance or renal clearance was observed in the presence of rifabutin. Seventy-five percent of the patients reported at least one symptom of narcotic withdrawal during the study, however, these symptoms were mild. A relationship between the development of narcotic withdrawal and methadone systemic exposure could not be established. Concurrent administration of rifabutin and methadone appeared to be safe in human immunodeficiency virus-infected injecting drug users maintained on stable doses of methadone and is not expected to produce any significant changes in the pharmacokinetics of methadone in these patients.

Keywords: *AIDS-Related Opportunistic Infections/BLOOD *HIV Infections/BLOOD *Narcotic Dependence/BLOOD *Substance Abuse, Intravenous/BLOOD *Tuberculosis, Pulmonary/BLOOD
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M9761162

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