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Darunavir Tablets and Methadone Tablets

Determining the interaction of Darunavir Tablets and Methadone Tablets and the possibility of their joint administration.

Check result:
Darunavir Tablets <> Methadone Tablets
Relevance: 17.05.2023 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Darunavir may increase the blood levels and effects of methadone. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if you experience increased side effects such as excessive drowsiness, tiredness, confusion, disorientation, nausea, vomiting, and shallow or difficult breathing. High blood levels of methadone can also occasionally cause an irregular heart rhythm that may be serious. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations of methadone, which is metabolized primarily by CYP450 3A4, 2B6, 2C19, and to a lesser extent by CYP450 2C9 and 2D6. The possibility of prolonged and/or increased pharmacologic effects of methadone, such as central nervous system and respiratory depression, should be considered. In addition, high dosages (particularly above 200 mg/day) and serum levels of methadone have been associated with QT interval prolongation and torsade de pointes arrhythmia.

MANAGEMENT: Caution is advised if methadone is prescribed in combination with CYP450 3A4 inhibitors. Pharmacologic response to methadone should be closely monitored and the dosage adjusted accordingly, particularly following initiation or discontinuation of the CYP450 3A4 inhibitor in patients who are stabilized on their methadone regimen. Patients should be advised to report excessive drowsiness, nausea, or asthenia to their physician, and to seek immediate medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope. ECG monitoring should be considered for patients on methadone with heart or liver disease; conduction abnormalities; electrolyte disturbances (i.e., hypokalemia, hypomagnesemia); concomitant use of drugs that may cause QT prolongation or electrolyte loss; concomitant use of CYP450 3A4 inhibitors; or use of methadone at dosages greater than 200 mg daily.

References
  • Bell J, Seres V, Bowron P, Lewis J, Batey R "The use of serum methadone levels in patients receiving methadone maintenance." Clin Pharmacol Ther 43 (1988): 623-9
  • "Product Information. Stribild (cobicistat/elvitegravir/emtricitabine/tenofov)." Gilead Sciences, Foster City, CA.
  • Krantz MJ, Lewkowiez L, Hays H, et al "Torsade de pointes associated with very-high-dose methadone." Ann Intern Med 137 (2002): 501-4
  • Ehret GB, Desmeules JA, Broers B "Methadone-associated long QT syndrome: improving pharmacotherapy for dependence on illegal opioids and lessons learned for pharmacology." Expert Opin Drug Saf 6 (2007): 289-303
  • Iribarne C, Berthou F, Baird S, Dreano Y, Picart D, Bail JP, Beaune P, Menez JF "Involvement of cytochrome P450 3A4 enzyme in the N-demethylation of methadone in human liver microsomes." Chem Res Toxicol 9 (1996): 365-73
  • Oda Y, Kharasch ED "Metabolism of methadone and levo-alpha-acetylmethadol (LAAM) by human intestinal cytochrome P450 3A4 (CYP3A4): potential contribution of intestinal metabolism to presystemic clearance and bioactivation." J Pharmacol Exp Ther 298 (2001): 1021-32
  • Foster DJ, Somogyi AA, Bochner F "Methadone N-demethylation in human liver microsomes: lack of stereoselectivity and involvement of CYP3A4." Br J Clin Pharmacol 47 (1999): 403-12
  • Moody DE, Alburges ME, Parker RJ, Collings JM, Strong JM "The involvement of cytochrome P450 3A4 in the N-demethylation of L-alpha-acetylmethadol (LAAM), norLAAM, and methadone." Drug Metab Dispos 25 (1997): 1347-53
Darunavir Tablets

Generic Name: darunavir

Brand name: Prezista

Synonyms: Darunavir

Methadone Tablets

Generic Name: methadone

Brand name: Dolophine, Methadose, Methadose Sugar-Free, Diskets

Synonyms: Methadone

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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