Street Drugs and HIV Drugs

Amphetamines (speed)

Potential twofold to threefold increase levels of "speed" in your system in conjunction with ritonavir (Norvir).

Barbituates (downers)
Downers are very slowly metabolized in the liver and generally increased the concentrations of other drugs to some degree.

Cocaine
It is unlikely that cocaine will interact with protease inhibitors. However, in one reported test-tube study, cocaine made HIV reproduce 20 times faster than normal.

Ecstasy (MDMA)
HIV drugs may cause a potential threefold to tenfold increase of MDMA in the blood stream and you could overdose and die.

Heroin
Reports suggest HIV drugs may cause heroin to be metabolized more quickly. There is a potential 50 percent or less decrease in heroin levels with ritonavir (Norvir).

Marijuana
There are no known drug/drug interactions.

Methadone
Most antiviral drugs used to treat HIV infection do not lower the levels of methadone in your blood stream. The only anti-HIV drug so far shown to decrease levels of methadone is nevirapine (Viramune). You can safely adhere to a treatment regimen with most antivirals, including protease inhibitors. In fact, there are reports of a twofold methadone level increase (the level of methadone doubles) with people who take ritonavir (Norvir). There is a likely increase with both nelfinavir and delavirdine. Methadone is not likely to interact with saquinavir. Methadone has been found to increase AZT levels twofold, so halving the dose of AZT may get the same or similar results of full dose AZT. (Remember Combavir is a compound that contains AZT). If you get too much AZT in your system, the side effects can mimic the beginning symptoms of opiate withdrawal. Again, most antiviral drugs used to treat HIV infection do not lower the levels of methadone in your system. Drugs that are used to treat TB and/or MAC infection such as Rifampin and Rifabutin can and do reduce the levels of methadone. If you are prescribed these drugs to treat TB or MAC and are on methadone maintenance, you will need to increase your dose of methadone.

Reference

HIV Plus, Research + Treatment Magazine -- September, 1998

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