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Effects of HCV seropositive status on buprenorphine pharmacokinetics in opioid-dependent individuals
Carmen L Masson1, Petrie M Rainey, David E Moody
1Department of Psychiatry, University of California, San Francisco, California.
Background And Objectives:
The purpose of this study was to examine the effect of hepatitis C virus (HCV) infection on buprenorphine pharmacokinetics in opioid-dependent, buprenorphine/naloxone-maintained adults.
Methods:
A retrospective analysis of buprenorphine pharmacokinetics in HCV seropositive and seronegative buprenorphine/naloxone-maintained individuals (N = 49) was undertaken.
Results:
Relative to HCV seronegative subjects, HCV seropositive subjects had higher buprenorphine exposure, as demonstrated by elevated buprenorphine AUC and Cmax values (p = .03 and .02, respectively) and corresponding elevations in the metabolites, buprenorphine-3-glucuronide AUC values (p = .03) and norbuprenorphine-3-glucuronide AUC and C24 values (p = .05 and .03, respectively).
Discussion And Conclusions:
HCV infection was associated with higher plasma concentrations of buprenorphine and buprenorphine metabolites.
Scientific Significance And Future Directions:
Findings suggest the potential for opioid toxicity among HCV-infected patients treated with buprenorphine/naloxone, and possible hepatotoxic effects related to increased buprenorphine exposure. HCV-infected patients receiving buprenorphine may need lower doses to maintain therapeutic plasma concentrations.
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