HIV medication drug interactions

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michaelrack

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I am studying for my consult psych recert boards. Various sources indicate that ritonavir and other HIV antivirals tend to lower methadone levels. According to the UCSF site, ritonavir may induce 3A4, thus lowering methadone levels: Interactions with Methadone.

However, other sources, including wikipedia, states the ritonavir inhibits 3A4 - thus increasing the levels of drugs such as statins.

the package insert (https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209512lbl.pdf) indicates that ritonavir is a 3A4 inhibitor

Does anyone have an explanation??
 
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