Title:Drug-Drug Interactions: Antiretroviral Drugs and Recreational Drugs
VOLUME: 9 ISSUE: 3
Author(s):Orietta Staltari, Christian Leporini, Benedetto Caroleo, Emilio Russo, Antonio Siniscalchi, Giovambattista De Sarro and Luca Gallelli
Affiliation:Department of Neurology, Annunziata Hospital, Via F. Migliori, 1 - 87100 Cosenza, Italy.
Keywords:Adverse drug reactions, antiretroviral therapy, clinical failure, drug-drug interactions, recreational drugs.
Abstract:With the advances in antiretroviral (ARV) therapy, patients with Human Immunodeficiency
Virus (HIV) infection are living longer, however, some patients encounter co- morbidities which sometimes
require treatment. Therefore, during the treatment with ARV drugs these patients could take several
recreational drugs (e.g. amphetamines, hallucinogenes, opiates, or alcohol) with a possible development
of drug-drug interactions (DDIs). In particular, Nucleoside/nucleotide reverse transcriptase inhibitors
(NRTIs/NtRTIs) are mainly excreted through the kidney and are not substrates of the cytochrome P450 or P-glycoprotein,
therefore the DDIs during this treatment are minimal. In contrast, the other ARV drugs (i.e. non-nucleoside reversetranscriptase
inhibitors, Protease inhibitors, Integrase inhibitors, chemokine receptor 5 antagonists and HIV-fusion inhibitors)
are an important class of antiretroviral medications that are frequent components of HAART regimens but show several
DDIs related to interaction with the cytochrome P450 or P-glycoprotein. In this paper we will review data concerning
the possibility of DDI in HIV patients treated with ARV and taking recreational drugs.
