Coadministration has not been studied with doravirine or doravirine/lamivudine/tenofovir disoproxil but no effect on buprenorphine is expected. No dose adjustment is required.

Coadministration of buprenorphine (14-16 mg once daily, stable dose with naloxone) and lamivudine (300 mg once daily; n=7) or tenofovir-DF (300 mg once daily; n=10) was studied in HIV-negative opioid-dependent patients and values compared to historical data. Coadministration with lamivudine had few effects on the pharmacokinetics of buprenorphine and its metabolites. Buprenorphine AUC, Cmax and Cmin increased by ~5%, ~1% and ~2%, respectively. Norbuprenorphine AUC, Cmax and Cmin increased by ~6%, ~3% and ~4%, respectively; buprenorphine-3-glucuronide AUC and Cmin increased by ~10% and ~28%, Cmax was unchanged; norbuprenorphine-3-glucuronide AUC, Cmax and Cmin increased by ~7%, ~12% and ~11%, respectively. Only the increases in norbuprenorphine-3-glucuronide AUC and Cmax were statistically significant. No subjects showed evidence of opiate withdrawal symptoms. Lamivudine concentrations during coadministration did not differ significantly from values observed in healthy, nonopioid-dependent, historical controls. Coadministration with tenofovir had no significant effect on buprenorphine (AUC and Cmax increased by ~5% and ~9%, Cmin was unchanged) or its metabolites (norbuprenorphine AUC, Cmax and Cmin increased by ~7%, ~4% and ~1%, respectively; buprenorphine-3-glucuronide AUC and Cmin decreased by ~14% and ~9%, Cmax increased by ~9%; norbuprenorphine-3-glucuronide AUC increased by ~1%, Cmax decreased by ~3% and Cmin was unchanged). There was no effect on tenofovir disposition and concentrations of tenofovir remained in the therapeutic range during coadministration.The authors conclude that standard doses of lamivudine or tenofovir-DF may be safely given with standard buprenorphine/naloxone treatment.