Moringa oleifera leaf powder alters the pharmacokinetics of amodiaquine in healthy human volunteers

What is known and objectiveMoringa oleifera (MO) Lam (Moringaceae) is commonly used as food supplement and as medicine in most African countries where malaria is also endemic. Therefore, co-administration of MO with antimalarials is a possibility. This study investigated the effects of MO leaves powder on the pharmacokinetics of amodiaquine (AQ) in human subjects. MethodsTwenty healthy volunteers were recruited for the 3-period study. In the first period, a single dose of AQ tablet (10mg/kg) was administered orally after an overnight fast. After a 7-day washout period, AQ was co-administered with MO. For the third period, each subject took 3g MO once daily for 7days and on the 8th day, MO was co-administered with AQ. The plasma concentrations of amodiaquine and desethylamodiaquine (DEAQ) were simultaneously determined using a validated HPLC method. Results and DiscussionThe results showed a significant decrease (P=.037) in the Cmax of AQ after concurrent administration (CA) with MO, whereas after pretreatment (PT), there was a 32% decrease in the C-max of AQ. For the metabolite, DEAQ, C-max increased significantly (P=.006) by 79.36%, and Cmax in PT was significantly higher than (P=.001) that of the CA arm of the study. AUC of DEAQ increased significantly by 40.4% (P=.006) and by 188% (P=.001) after CA and PT, respectively. What is new and ConclusionThe study established pharmacokinetic interaction between AQ and MO when given together or following a long period of ingestion of MO. This may have clinical implications for malaria therapy.