Life-threatening interactions between HIV-1 protease inhibitors and the illicit drugs MDMA and γ-hydroxybutyrate

Robert D. Harrington, Jane A. Woodward, Thomas M. Hooton, John R. Horn

Research output: Contribution to journalArticle

91 Scopus citations

Abstract

Human immunodeficiency virus 1 (HIV-1) protease inhibitors have dramatically reduced the morbidity and mortality due to HIV-1 infection. However, most of these antiretrovirals are also potent inhibitors (and occasionally inducers) of hepatic and intestinal cytochrome P450 systems and, therefore, have the potential to alter the elimination of any substance that utilizes these metabolic pathways. We describe a patient infected with HIV-1 who was treated with ritonavir and saquinavir and then experienced a prolonged effect from a small dose of methylenedioxymetamphetamine (MDMA or ecstacy) and a nearly fatal reaction from a small dose of γ-hydroxybutyrate (GHB). We also discuss the potential for HIV-1 protease inhibitors to alter the metabolism of other abusable prescribed and illicit substances.

Original languageEnglish (US)
Pages (from-to)2221-2224
Number of pages4
JournalArchives of internal medicine
Volume159
Issue number18
DOIs
StatePublished - Oct 11 1999
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine

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