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Methadone and HIV meds

Jul 25, 2011

I have been taking HIV meds since 2002 and haven't had any major problems so far. On the other hand, I am also an ex drug user and have been taking methadone for 15 years. I wonder if this can influence my health . My doctor doesn't want me to stop taking it as it would cause my body to suffer by going through a withdrawal crises (I have to say that I am not ready for that). Methadone has enabled me to live and work and to lead a normal life. I have also a hep C . To be honest, sometimes I take some cocaine (twice a month). I would like to ask you if taking the above mentioned could do any damage and if so in what extent.

Thank you in advance.

Response from Dr. Fawcett

Thanks for your question. I would be reluctant to make any changes with your methadone since you appear to be stable and have done well. Methadone, which is metabolized by the liver, can interact with HIV medications that are also metabolized by the liver. Such interactions can cause levels of methadone to rise too high or fall too low, depending on the specific drug it is interacting with. Many NNRTIs (non-nucleoside reverse transcriptase inhibitors) can interact with methadone, as can certain protease inhibitors and other drugs commonly used in the treatment of individuals with HIV, such as fluconazole. These interactions are well-known and it sounds like your physician has made any adjustments in dosage to compensate for this.

Studies have indicated that cocaine use more than doubles the chance of a decline in T-cells because it can interfere with medication adherence and can impact the immune system in ways that aren't really understood. I would seriously reconsider you use.


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