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Pharmacokinetic Study of Interaction Between Nevirapine and Methadone in HIV-1 Infected, Opioid-Dependent Adults
This study has been completed.
First Received: January 9, 2006   Last Updated: November 26, 2008   History of Changes
Sponsored by: Boehringer Ingelheim Pharmaceuticals
Information provided by: Boehringer Ingelheim Pharmaceuticals
ClinicalTrials.gov Identifier: NCT00273988
  Purpose

The purpose of this study was to determine the effects of nevirapine treatment on the pharmacokinetics of methadone in HIV-1 infected, opioid-dependent adults who had been on a stable methadone maintenance therapy for at least five days prior to study entry.


Condition Intervention Phase
Acquired Immunodeficiency Syndrome
Drug: nevirapine
Phase IV

Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Crossover Assignment, Pharmacokinetics Study
Official Title: Pharmacokinetics Study to Evaluate Interaction Between Nevirapine and Methadone in HIV-1 Infected Opioid-Dependent Adults

Resource links provided by NLM:


Further study details as provided by Boehringer Ingelheim Pharmaceuticals:

Primary Outcome Measures:
  • Clearance of methadone at steady state in the presence and absence of nevirapine.

Secondary Outcome Measures:
  • Pharmacokinetics of methadone at steady state in the presence and absence of nevirapine

Estimated Enrollment: 10
Study Start Date: April 2002
Estimated Study Completion Date: October 2003
Detailed Description:

Ten HIV-1 infected, opioid-dependent adults on stable methadone treatment were to be enrolled in this study. This was an open-label, sequential treatment study, with methadone pharmacokinetics sampling before and after twenty-one (21) days of nevirapine administration. All patients received the same regimen. Methadone was administered in the first treatment period, and combination treatment of methadone and nevirapine was given in the second treatment period. In the first period, patients received methadone at their current steady state dose. In the second period (study days 1-21), they also received nevirapine 200mg qd (study days 1 to 14) and 200mg bid (study days 15 to 21). Blood samples were taken at the start of the first treatment period and at the end of the second treatment period for analysis of methadone and nevirapine pharmacokinetics parameters.

Study Hypothesis:

It was expected that nevirapine would decrease methadone levels in this patient population.

Comparison(s):

The study compared methadone steady state exposure in the absence and presence of steady state nevirapine. A range of pharmacokinetics parameters were assessed including clearance of methadone (the primary endpoint variable), area under the concentration-time curve, maximum concentration, time to maximum concentration and minimum concentration (measured for both methadone and nevirapine).

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria:

  • Treatment-naïve, fulfilling standard criteria to commence antiretroviral therapy. Previous exposure to less than two weeks of nucleoside reverse transcriptase therapy was permitted. (Later amended to allow previous exposure to non-nucleoside reverse transcriptase inhibitor therapy (NNRTI) if the patient was off NNRTI therapy for at least two weeks prior to entry.)
  • Plasma HIV-1 ribonucleic acid (RNA) assay performed at screening documenting HIV-1 infection or previous laboratory documentation of HIV-1 positive status. CD4+ cell count at least 100 cells/mm3 (later amended to at least 50 cells/mm3), within 28 days prior to study day 0.
  • Patients who met the following laboratory parameters:

    • Lymphocyte count at least 1 x 109/L
    • Haemoglobin at least 5.7 mmol/L [9.0 g/dL] (men and women)
    • Platelet count at least 75 x 109/L
    • Alkaline phosphatase less than or equal to 3 times the upper limit of normal
    • Serum glutamate oxaloacetate transferase (SGOT) and serum pyruvate oxaloacetate transferase (SGPT) less than or equal to 3 times the upper limit of normal
    • Total bilirubin less than or equal to 1.5 times the upper limit of normal
    • Serum creatinine less than or equal to 2.0 mg/dL.
  • On stable methadone maintenance therapy for at least five days prior to entry.
  • Patients of reproductive potential must have been willing to use a reliable method of double-barrier contraception (such as a diaphragm with spermicidal cream or jelly, or condoms with spermicidal foam).
  • Informed of, and willing and able to comply with the investigational nature of the study, and have signed a written consent in accordance with ethics committee and regulatory guidelines.

Exclusion criteria:

  • Female patients who were pregnant or breast-feeding.
  • Systemic treatment with corticosteroids or drugs known to be hepatic enzyme inducers or inhibitors within 14 days of study entry. Substances in these categories include macrolide antibiotics (e.g. erythromycin, clarithromycin), azole antifungals (e.g. ketoconazole, fluconazole, itraconazole), rifampin, rifabutin, and phenytoin.
  • Treatment with any investigational drug within 30 days of the first dose of study medication, and any neoplastic agent or radiotherapy other than local skin radiotherapy treatment within 12 weeks before starting study medication.
  • Malabsorption, severe chronic diarrhoea or unable to maintain adequate oral intake.
  • Treatment for an active infection (secondary to HIV-1).
  • Hepatic insufficiency due to cirrhosis.
  • Renal insufficiency.
  • Excessive alcohol intake.
  • Treatment with ritonavir.
  • Treatment with protease inhibitors.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00273988

Locations
Ireland
Department of Genito Urinary Medicine, St James' Hospital
Dublin, Ireland, 8
Sponsors and Collaborators
Boehringer Ingelheim Pharmaceuticals
Investigators
Study Chair: Boehringer Ingelheim Study Coordinator BIL UK / Ireland
  More Information

Additional Information:
No publications provided

Study ID Numbers: 1100.1390
Study First Received: January 9, 2006
Last Updated: November 26, 2008
ClinicalTrials.gov Identifier: NCT00273988     History of Changes
Health Authority: Ireland: Irish Medicines Board

Study placed in the following topic categories:
Anti-Infective Agents
Sexually Transmitted Diseases, Viral
Anti-HIV Agents
Acquired Immunodeficiency Syndrome
Antiviral Agents
Immunologic Deficiency Syndromes
Reverse Transcriptase Inhibitors
Virus Diseases
Methadone
Nevirapine
Anti-Retroviral Agents
HIV Infections
Sexually Transmitted Diseases
Retroviridae Infections

Additional relevant MeSH terms:
Anti-Infective Agents
Sexually Transmitted Diseases, Viral
Slow Virus Diseases
Molecular Mechanisms of Pharmacological Action
Reverse Transcriptase Inhibitors
Pathologic Processes
Anti-Retroviral Agents
Syndrome
Therapeutic Uses
Retroviridae Infections
Nucleic Acid Synthesis Inhibitors
RNA Virus Infections
Disease
Anti-HIV Agents
Immune System Diseases
Acquired Immunodeficiency Syndrome
Enzyme Inhibitors
Antiviral Agents
Immunologic Deficiency Syndromes
Pharmacologic Actions
Virus Diseases
Nevirapine
HIV Infections
Sexually Transmitted Diseases
Lentivirus Infections

ClinicalTrials.gov processed this record on September 01, 2009