AEGiS-ATDN: Methadone and Sustiva (efavirenz) - Dosing Recommendations AIDS Treatment Data NetworkImportant note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
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Methadone and Sustiva (efavirenz) - Dosing Recommendations

Information Bulletin #10 April/May 2000

As previously reported in Information Bulletin, the anti-HIV drug Sustiva (other name: efavirenz) can reduce the amount of methadone in the body. This problem is called a drug interaction. At a recent conference in Britain, Dr. Fiona Mulcahy made some specific recommendations for people taking methadone and Sustiva.

Dr. Mulcahy found that it usually takes about a week after starting Sustiva before levels of methadone in the body are reduced. As a result, Dr. Mulcahy does not recommend an immediate increase in methadone dose when a person starts Sustiva. Instead, she recommends building up the methadone dose 10mg at a time as soon as any sign of withdrawal is noticed. The methadone dose should be increased until withdrawal symptoms stop.

Dr. Mulcahy also notes that a person on methadone maintenance that stops Sustiva will then need to reduce their methadone dose again, but recommends that the dose be reduced slowly over a period of 8 - 10 days to avoid withdrawal.

The source for this article is the British Internet site aidsmap. The full text of their report can be read online at http://www.aidsmap.com/news/story.asp?numb=223&archive=true.
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