Table 2.

Anti-HCV medication interactions with methadone and buprenorphine

Medication	Effect on methadone	Effect On BUP	Anti-Viral	Comment	Ref
Indirectly Acting Anti-Virals
Pegylated Interferon 2a and 2b	↑ METH AUC by 10 to 15%	No PK study	No PK study	No dose change required for METH, though many patients request dose increases due to the flu-like symptoms caused by interferon.	187–189
Ribavirin (RBV)	No PK study	No PK study	No PK study	Multiple studies have been conducted with patients on methadone and buprenorphine on HCV treatment and patients have reportedly had no difference in adverse events.	N/A
Directly Acting Anti-Virals
Boceprevir	↓ R-METH AUC by 15% ↓ S-METH AUC by 22%	↑ BUP AUC by 19%	No PK study	No opioid withdrawal reported and dose adjustments unlikely.	194
Sofosbuvir	No PK effect	No PK study	No PK effect		195
Telaprevir	↓ R-METH AUC by 29% ↓ S-METH AUC by 36%	No PK effect	No PK study	No opioid withdrawal reported and dose adjustments unlikely.	192, 193
TMC435	No PK effect	No PK study	Non statistical reduction in AUC	No dosage adjustments in TMC435 with methadone predicted	196