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- W2331036215 abstract "To the Editors: We appreciate the opportunity to clarify our finding of similar buprenorphine/naloxone (bup/nx) doses in patients receiving atazanavir-based and other antiretroviral regimens.1 Some of the clinicians who performed the bup/nx inductions were aware of the described pharmacodynamic and pharmacokinetic interactions between atazanavir and bup/nx; but this did not alter induction protocols at any site nor practice in the majority of patients. Physician participants in the initiative known as the Buprenorphine-HIV Evaluation and Support (BHIVES) Collaborative were trained according to federal guidelines that recommend a maximum dose of 16 mg of bup/nx within 48 hours in opioid tolerant patients. The BHIVES Evaluation and Support Center (Center) did not explicitly encourage physicians to use a slower rate of dose escalation in patients on atazanavir-based regimens. Each BHIVES site provided a treatment protocol to the Center before study initiation and up to 1 year after protocol implementation. All protocols conformed to guidelines regarding standard dose escalation, and no site reported a unique protocol for patients receiving atazanavir-based regimens. In addition, the Center conducted monthly clinical telephone calls to collect data on drug interactions and received no reports of bup/nx–atazanavir interactions. In only 5 (13%) of the 38 patients prescribed atazanavir does it seem that there may have been a deviation from standard protocols. We believe that our study, reflecting the largest clinical cohort of HIV-infected patients to date, provides reassurance and lends empiric evidence to the safe use of standard bup/nx induction and maintenance doses in patients receiving atazanavir-based regimens. We do concur with the Department of Health and Human Services guidelines,3 however, that buprenorphine products should not be coadministered to patients receiving unboosted atazanavir regimens because of the potential for subtherapeutic atazanavir levels.4" @default.
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- W2331036215 date "2011-12-01" @default.
- W2331036215 modified "2023-10-18" @default.
- W2331036215 title "Reply to Letter “Additional Explanation for Lack of Pharmacodynamic Interaction Between Atazanavir and Buprenorphine Reported by Vergara-Rodriquez et al”" @default.
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- W2331036215 doi "https://doi.org/10.1097/qai.0b013e318232e955" @default.
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