Herb-Drug Interaction between Echinacea purpurea and Darunavir-Ritonavir in HIV-Infected Patients
Por:
Molto, J, Valle, M, Miranda, C, Cedeno, S, Negredo, E, Barbanoj, MJ, Clotet, B
Publicada:
1 ene 2011
Resumen:
The aim of this open-label, fixed-sequence study was to investigate the potential of Echinacea purpurea, a commonly used botanical supplement, to interact with the boosted protease inhibitor darunavir-ritonavir. Fifteen HIV-infected patients receiving antiretroviral therapy including darunavir-ritonavir (600/100 mg twice daily) for at least 4 weeks were included. E. purpurea root extract capsules were added to the antiretroviral treatment (500 mg every 6 h) from days 1 to 14. Darunavir concentrations in plasma were determined by high-performance liquid chromatography immediately before and 1, 2, 4, 6, 8, 10, and 12 h after a morning dose of darunavir-ritonavir on days 0 (darunavir-ritonavir) and 14 (darunavir-ritonavir plus echinacea). Individual darunavir pharmacokinetic parameters were calculated by noncompartmental analysis and compared between days 0 and 14 with the geometric mean ratio (GMR) and its 90% confidence interval (CI). The median age was 49 (range, 43 to 67) years, and the body mass index was 24.2 (range, 18.7 to 27.5) kg/m(2). Echinacea was well tolerated, and all participants completed the study. The GMR for darunavir coadministered with echinacea relative to that for darunavir alone was 0.84 (90% CI, 0.63-1.12) for the concentration at the end of the dosing interval, 0.90 (90% CI, 0.74-1.10) for the area under the concentration-time curve from 0 to 12 h, and 0.98 (90% CI, 0.82-1.16) for the maximum concentration. In summary, coadministration of E. purpurea with darunavir-ritonavir was safe and well tolerated. Individual patients did show a decrease in darunavir concentrations, although this did not affect the overall darunavir or ritonavir pharmacokinetics. Although no dose adjustment is required, monitoring darunavir concentrations on an individual basis may give reassurance in this setting.
Filiaciones:
Molto, J:
Hosp Badalona Germans Trias & Pujol, Lluita Sida Fdn, HIV Clin, Badalona, Spain
Univ Autonoma Barcelona, E-08193 Barcelona, Spain
Valle, M:
Univ Autonoma Barcelona, E-08193 Barcelona, Spain
Inst Recerca HSCSP, CIM St Pau, Barcelona, Spain
Miranda, C:
Hosp Badalona Germans Trias & Pujol, Lluita Sida Fdn, HIV Clin, Badalona, Spain
Cedeno, S:
Hosp Badalona Germans Trias & Pujol, IrsiCaixa Fdn, HIV Clin, Barcelona 08916, Spain
Negredo, E:
Hosp Badalona Germans Trias & Pujol, Lluita Sida Fdn, HIV Clin, Badalona, Spain
Barbanoj, MJ:
Univ Autonoma Barcelona, E-08193 Barcelona, Spain
Inst Recerca HSCSP, CIM St Pau, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Dept Clin Pharmacol, Barcelona, Spain
Clotet, B:
Hosp Badalona Germans Trias & Pujol, Lluita Sida Fdn, HIV Clin, Badalona, Spain
Univ Autonoma Barcelona, E-08193 Barcelona, Spain
Hosp Badalona Germans Trias & Pujol, IrsiCaixa Fdn, HIV Clin, Barcelona 08916, Spain
Green Published, Bronze
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