期刊
AIDS RESEARCH AND THERAPY
卷 14, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s12981-017-0140-4
关键词
Moringa oleifera; Nevirapine; Pharmacokinetics; HIV
资金
- Office of Global AIDS Coordinator (U. S. Department of State) [2U2RTW007367, D43TW007991-01A2, D43TW010313-01]
- Fogarty International Centre (National Institutes of Health, U.S. Department of Health and Human Services)
- National Institute of Allergy and Infectious Diseases of the National Institutes of Health [UM1 AI068634, UM1 AI068636, UM1AI106701, U01 AI068632]
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institute of Mental Health [AI068632]
Background: Moringa oleifera Lam., an herb commonly consumed by HIV-infected people on antiretroviral therapy, inhibits cytochrome P450 3A4, 1A2 and 2D6 activity in vitro; and may alter the pharmacokinetics (PK) of antiretroviral drugs metabolized via the same pathways. However, in vitro drug interaction activity may not translate to a clinically significant effect. Therefore, the effect of moringa leaf powder on the PK of nevirapine in HIV-infected people was investigated. Methods: Adult patients at steady-state dosing with nevirapine were admitted for 12-h intensive PK sampling following a 21-day herbal medicine washout. Blood sampling was repeated after 14 days of nevirapine and moringa (1.85 g leaf powder/day) co-administration. Nevirapine plasma concentrations were determined by liquid chromatographytandem mass spectrometry. To assess the effect of moringa on nevirapine PK, the change in nevirapine area under the plasma concentration-time curve (AUC) was determined. The mean difference in pre-and post-moringa nevirapine, maximum concentration (C-max) and concentration at 12 h (C-12h) were also calculated. The PK parameters were compared by assessing the post/pre geometric mean ratios (GMRs) and associated 90% confidence intervals (CIs). Results: Pharmacokinetics analyses were performed on the results from 11 participants for whom complete data were obtained. The post/pre GMRs and associated 90% CIs for nevirapine were 1.07 (1.00-1.14) for the AUC; 1.06 (0.98-1.16) for Cmax and 1.03 (0.92-1.16) for C-12h. Conclusion: Co-administration of Moringa oleifera Lam. leaf powder at the traditional dose did not significantly alter the steady-state PK of nevirapine.
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