Benzodiazapines?

[angels4kelly]

Hi Everybody

I was just wondering if anyone else has ever heard of there being severe adverse reactions when taking Protease Inhibitors while taking Benzodiazepines together?

Someone told me that this can cause even death!
I must say, I hope this isn't true!!

Peace,
Kelly

[Miss Philicia]

I've taken a bit of them over the years and haven't died yet.  Where did you get this information?

[angels4kelly]

Hello Philly,

Believe it or not it came from my ID Doctor. I really didn't believe it then and I am doubting it more and more as time goes on.

I was taking 5mg. of Xanax at the time, daily and she was constantly on my ass about the benzo's being addictive and then when she had to put me on a PI, she told me this could cause death.
I am seriously beginning to think that this was just her way of getting me to stop taking them.

I hate it! I need them. I had been on them for 5 years straight.
I really think I am gong to get back on them.

Peace,
Kelly

[Strayboy74]

Hello Philly,

Believe it or not it came from my ID Doctor. I really didn't believe it then and I am doubting it more and more as time goes on.

I was taking 5mg. of Xanax at the time, daily and she was constantly on my ass about the benzo's being addictive and then when she had to put me on a PI, she told me this could cause death.
I am seriously beginning to think that this was just her way of getting me to stop taking them.

I hate it! I need them. I had been on them for 5 years straight.
I really think I am gong to get back on them.

Peace,
Kelly

BENZOS are addictive.  and if you stop taking them abruptly, after you've developed a high tolerance, you'll go into withdrawal, and this CAN include death.  as far as taking them with PI's?  hrm.  dunno about that.  However, some drugs can be made more potent by the use of other drugs. (Hell, grapefruit juice makes cholesterol medications exponentially potent.) 

I wouldn't doubt my doctor, rather, I would ask my pharmacist for a second opinion.  My pharmacist tends to be a lot more keen on drug interactions than most doctors are.  It sounds like your doctor might have some sort of NA agenda. LOL

-joseph

[Miss Philicia]

My ID knows I take them, and my psychiatrist knows what PI's I'm on.  Also I've been through three different sets of ID/shrinks over the past 5 years an none have stated anything similar though I think they like to monitor your liver (or is it kidney) when on this combo.

And yes, they are addictive and you also build up a tolerance to benzo's necessitating ever higher dosages.  They're wildly effective for acute anxiety issues though.

[angels4kelly]

Thank you, Philly & Joseph,
Yes I do know they are extremely addictive and that over time you build up tolerance and need more and more, but as you mentioned, Philly, they are so effective for the anxiety disorder. I have that so bad that I can barely function without them, especially in social situations.

I agree with Joseph though about my doctor having the NA issue...lol
I will contact my pharmacist for sure.
I NEED TO BE BACK ON THEM!!
I am becoming a hermit.

Peace,
Kelly

[Boo Radley]

You didn't say what PI you're on but you can check right here at AIDSmeds for interactions:

https://www.aidsmeds.com/cmm/DrugsNewContent.asp

Below are the results for 2 PIs, Ritonavir and Agenerase, FYI.  Caution should be exercised when mixing these 2 PIs with Xanax but I think your doc might have been exaggerating a bit. 

Ritonavir -
MONITOR: The coadministration of ritonavir and benzodiazepines that are substrates of the CYP450 3A4 enzymatic pathway may result in elevated plasma concentrations of the latter. The mechanism is decreased clearance of benzodiazepines due to inhibition of CYP450 3A4 activity by ritonavir. MANAGEMENT: While clinical data are not available for all agents in the class, the possibility of prolonged and/or increased pharmacologic effects of benzodiazepines, including sedation and respiratory depression, should be considered in patients receiving ritonavir therapy. It may be appropriate to use lower benzodiazepine dosages in these patients, or use agents that are not metabolized by the CYP450 3A4 pathway (e.g., lorazepam, oxazepam, temazepam).

Agenerase -
MONITOR: Coadministration with amprenavir or its prodrug, fosamprenavir, may increase the plasma concentrations of drugs that are substrates of the CYP450 3A4 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 3A4 activity by amprenavir. MANAGEMENT: Caution is advised if amprenavir must be used concurrently with medications that undergo metabolism by CYP450 3A4, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever amprenavir is added to or withdrawn from therapy.


I'm not on any PIs but I've taken klonopin for over 10 years and had no side effects with the HAART regimen I'm on.

Good luck!

Boo

[Ann]

Kelly,

Here's a reaction chart from http://www.hiv-druginteractions.org/ detailing PI interactions with quite a few of the "pam" drugs. Hope this helps...

And yes, sounds like a doc with an NA agenda to me.

Ann


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[newt]

Probably the only important benzo interactions with PIs are midazolam (brand names Versed, Hypnovel and Dormicum) and triazolam (Halcion, Novodorm).  Other PI/benzo mixtures may give a stronger effect but it's a person to person thing, some people find no difference - if you feel too sedated just take less.

- matt

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[Eldon]

Hey Kelly!

My little angel of light. Take care of YOU! I pray that it works out well for you.


Happy Holidays!


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