Levels of the recreational drug commonly known as GHB (gamma hydroxybuytrate) may be increased to life threatening levels if it is taken alongside a protease inhibitor, according to a report from Seattle. A 29 year old man receiving treatment with ritonavir and saquinavir became unconscious after taking half a teaspoonful of GHB. He had taken a half teaspoonful six hours previously, and was trying to reduce unpleasant effects from 2 Ecstasy tablets taken nearly 24 hours previously. The man had not experienced similar reactions to GHB or Ecstasy prior to protease inhibitor treatment, and the University of Washington, Seattle, team suggests that ritonavir and saquinavir slowed down metabolism of both drugs and caused the near-fatal reaction.
Usual symptoms of GHB overdose include vomiting, breathing problems, seizures, stupor and coma, and the dose normally associated with severe distress is greater than 50mg/kg of body weight. In this case the dose has been estimated at less than 10mg/kg body weight.
The full text of the report is freely available from the Archives of Internal Medicine.