Can I Continue on Suboxone While Treating with Telaprevir

I am currentl on suboxone: about 1/2 tablet per day sometimes less. Will I be able to do the 3-drug treatment using telaprevir and still take my suboxone? It takes a long time to wean off suboxone and I don't have the time to really wait to do that before beginning treatment. I haven'tt been able to find any info on others who are continuing their suboxone while treating w/ the telaprevir so need information.

[hrsepwrguy]

Interactions between your selected drugs
buprenorphine ↔ telaprevir
Applies to:Suboxone (buprenorphine/naloxone) and Incivek (telaprevir)

MONITOR: Coadministration with inhibitors of CYP450 3A4 may increase the plasma concentrations and pharmacologic effects of buprenorphine, which is partially metabolized (approximately 30%) by the isoenzyme. The interaction appears to be dependent, in part, on the route of administration of buprenorphine. When administered transdermally, buprenorphine peak plasma concentration (Cmax) and systemic exposure (AUC) were not significantly affected by ketoconazole, a potent CYP450 3A4 inhibitor. However, it was reported in another study that ketoconazole increased the Cmax and AUC of buprenorphine (route unspecified) by approximately 70% and 50%, respectively, and to a lesser extent, of the metabolite norbuprenorphine. The interaction has also been reported with atazanavir/ritonavir. A case series describes three patients who experienced excessive opiate effects of buprenorphine during concomitant antiretroviral therapy with atazanavir, ritonavir, and various nucleoside reverse transcriptase inhibitors. Two of the patients had been on their antiretroviral regimen for several months and reported doped-up feeling, dizziness, and feeling high following initiation of buprenorphine 8 mg/day. The dosage was reduced to 8 mg every other day. One was maintained on this dosage while the other had dosage increased up to 12 mg/day, whereupon he developed hypersomnolence but managed to maintain that dosage. The third patient had been inducted with buprenorphine and titrated to a stable dose of 14 mg/day for two days prior to beginning antiretroviral therapy. The next day, the patient complained of daytime somnolence and decreased mental functioning. His buprenorphine dosage was decreased to 8 mg/day, and he developed tolerance to the sedative effects within 7 days.
MANAGEMENT: Caution is advised if buprenorphine is prescribed in combination with a CYP450 3A4 inhibitor. Induction with buprenorphine should begin at a reduced dosage, and dosage escalation should occur more slowly to allow for assessment of opiate effects and development of patient tolerance. In patients who are already stabilized on buprenorphine, pharmacologic response and vital signs should be monitored more closely whenever a CYP450 3A4 inhibitor is added to or withdrawn from therapy, and the buprenorphine dosage adjusted as necessary. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities. Patients should seek medical attention if potential signs and symptoms of toxicity occur such as dizziness, confusion, fainting, extreme sedation, bradycardia, slow or difficult breathing, and shortness of breath.

http://www.drugs.com/drug-interactions/incivek-with-suboxone-439-2040-3328-15346.html

[hrsepwrguy]

As always all meds being taken should be discussed at lenght with your treating doc.

[earthwarrior54]

i was familiar w/ the interaction info posted but thank you. much of this info goes back to the 2-prong treatment. Suboxone is on the list of drugs to "watch" while taking telaprevir but I am curious to find others who continue the suboxone while doing the 3-prong telaprevir treatment. Were they able to sustaing their normal doses (I take a fairly small dose less then 1/2 per day) but i wanted to know if anyone had problems or bad side effects or if the suboxone created problems for their treatment.Even moreso I  was curious if anyone was denied treatment on telaprevir until they stopped taking suboxone.
Thanx for all your help
1.5 days until I start treatment......(but who's counting!)

[Devastatednconfused]

I, too, am on Suboxone. I am afraid of being able to start treatment and still be on Suboxone, as Suboxone is filtered through the liver.  The reality is setting in and I am totally, utterly, and devastatingly scared!!! I never thought I would ever get this kind of news. I also have Crohn's disease and am in the middle of college.  I am now finishing up my sophomore year in college and will be starting at the University in the fall. Im wondering if I will have the strength to continue school, and what is going to happen with the Suboxone treatment?