Effect of nevirapine, efavirenz and lopinavir/ritonavir on the therapeutic concentration and toxicity of lumefantrine in people living with HIV at Lagos University Teaching Hospital, Nigeria
Patients living with HIV in malarial endemic regions may experience clinically significant drug interaction between antiretroviral and antimalarial drugs. Effects of nevirapine (NVP), efavirenz (EFV) and lopinavir/ritonavir (LPVr) on lumefantrine (LM) therapeutic concentrations and toxicity were eva...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-11-01
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| Series: | Journal of Pharmacological Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1347861320300785 |
| _version_ | 1811294741216624640 |
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| author | Sikiru Olatunji Usman Ibrahim Adekunle Oreagba Akinwumi Akinyinka Akinyede Esther Oluwatoyin Agbaje Moshood Olusola Akinleye Adaobi Goodness Onwujuobi Chioma Ken-Owotor Olatunbosun Adeuja Tosin Ogunfowokan Segun Kogbe Emmanuel Tope Owolabi Hannah Adeniji Abdul Wasiu Busari Olayinka Olayiwola Hassan Ganiu Abideen Alani Sulaimon Akanmu |
| author_facet | Sikiru Olatunji Usman Ibrahim Adekunle Oreagba Akinwumi Akinyinka Akinyede Esther Oluwatoyin Agbaje Moshood Olusola Akinleye Adaobi Goodness Onwujuobi Chioma Ken-Owotor Olatunbosun Adeuja Tosin Ogunfowokan Segun Kogbe Emmanuel Tope Owolabi Hannah Adeniji Abdul Wasiu Busari Olayinka Olayiwola Hassan Ganiu Abideen Alani Sulaimon Akanmu |
| author_sort | Sikiru Olatunji Usman |
| collection | DOAJ |
| description | Patients living with HIV in malarial endemic regions may experience clinically significant drug interaction between antiretroviral and antimalarial drugs. Effects of nevirapine (NVP), efavirenz (EFV) and lopinavir/ritonavir (LPVr) on lumefantrine (LM) therapeutic concentrations and toxicity were evaluated. In a four-arm parallel study design, the blood samples of 40 participants, treated with artemether/lumefantrine (AL), were analysed. Lumefantrine Cmax was increased by 32% (p = 0.012) and 325% (p < 0.0001) in the NVP and LPVr arms respectively but decreased by 62% (p < 0.0001) in the EFV-arm. AUC of LM was, respectively, increased by 50% (p = 0.27) and 328% (p < 0.0001) in the NVP and LPVr arms but decreased in the EFV-arm by 30% (p = 0.019). Median day 7 LM concentration was less than 280 ng/mL in EFV-arm (239 ng/mL) but higher in control (290 ng/mL), NVP (369 ng/mL, p = 0.004) and LPVr (1331 ng/mL, p < 0.0001) arms. There were no clinically relevant toxicities nor adverse events in both control and test arms. Artemether/lumefantrine is safe and effective for treatment of malaria in PLWHA taking NVP and LPVr based ART regimen but not EFV-based regimen. |
| first_indexed | 2024-04-13T05:21:56Z |
| format | Article |
| id | doaj.art-58ea2b93925148bdba38399cff5c1205 |
| institution | Directory Open Access Journal |
| issn | 1347-8613 |
| language | English |
| last_indexed | 2024-04-13T05:21:56Z |
| publishDate | 2020-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pharmacological Sciences |
| spelling | doaj.art-58ea2b93925148bdba38399cff5c12052022-12-22T03:00:43ZengElsevierJournal of Pharmacological Sciences1347-86132020-11-01144395101Effect of nevirapine, efavirenz and lopinavir/ritonavir on the therapeutic concentration and toxicity of lumefantrine in people living with HIV at Lagos University Teaching Hospital, NigeriaSikiru Olatunji Usman0Ibrahim Adekunle Oreagba1Akinwumi Akinyinka Akinyede2Esther Oluwatoyin Agbaje3Moshood Olusola Akinleye4Adaobi Goodness Onwujuobi5Chioma Ken-Owotor6Olatunbosun Adeuja7Tosin Ogunfowokan8Segun Kogbe9Emmanuel Tope Owolabi10Hannah Adeniji11Abdul Wasiu Busari12Olayinka Olayiwola Hassan13Ganiu Abideen14Alani Sulaimon Akanmu15Department of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, Nigeria; Corresponding author.Department of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, Nigeria; West African Postgraduate College of Pharmacists, Yaba, Lagos State, Nigeria; National Agency for Food and Drug Administration and Control, Wuse, Abuja, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Pharmaceutical Chemistry, Faculty of Pharmacy of the University of Lagos, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaApin Clinic, Lagos University Teaching Hospital, Idi-Araba, Lagos State, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Pharmacology, Therapeutics and Toxicology, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, NigeriaDepartment of Haematology and Blood Transfusion, Faculty of Clinical Science, College of Medicine of the University of Lagos, Idi-Araba, Lagos State, Nigeria; Apin Clinic, Lagos University Teaching Hospital, Idi-Araba, Lagos State, NigeriaPatients living with HIV in malarial endemic regions may experience clinically significant drug interaction between antiretroviral and antimalarial drugs. Effects of nevirapine (NVP), efavirenz (EFV) and lopinavir/ritonavir (LPVr) on lumefantrine (LM) therapeutic concentrations and toxicity were evaluated. In a four-arm parallel study design, the blood samples of 40 participants, treated with artemether/lumefantrine (AL), were analysed. Lumefantrine Cmax was increased by 32% (p = 0.012) and 325% (p < 0.0001) in the NVP and LPVr arms respectively but decreased by 62% (p < 0.0001) in the EFV-arm. AUC of LM was, respectively, increased by 50% (p = 0.27) and 328% (p < 0.0001) in the NVP and LPVr arms but decreased in the EFV-arm by 30% (p = 0.019). Median day 7 LM concentration was less than 280 ng/mL in EFV-arm (239 ng/mL) but higher in control (290 ng/mL), NVP (369 ng/mL, p = 0.004) and LPVr (1331 ng/mL, p < 0.0001) arms. There were no clinically relevant toxicities nor adverse events in both control and test arms. Artemether/lumefantrine is safe and effective for treatment of malaria in PLWHA taking NVP and LPVr based ART regimen but not EFV-based regimen.http://www.sciencedirect.com/science/article/pii/S1347861320300785LumefantrineAntiretroviral drugsTherapeutic concentrationsMalariaHIV |
| spellingShingle | Sikiru Olatunji Usman Ibrahim Adekunle Oreagba Akinwumi Akinyinka Akinyede Esther Oluwatoyin Agbaje Moshood Olusola Akinleye Adaobi Goodness Onwujuobi Chioma Ken-Owotor Olatunbosun Adeuja Tosin Ogunfowokan Segun Kogbe Emmanuel Tope Owolabi Hannah Adeniji Abdul Wasiu Busari Olayinka Olayiwola Hassan Ganiu Abideen Alani Sulaimon Akanmu Effect of nevirapine, efavirenz and lopinavir/ritonavir on the therapeutic concentration and toxicity of lumefantrine in people living with HIV at Lagos University Teaching Hospital, Nigeria Journal of Pharmacological Sciences Lumefantrine Antiretroviral drugs Therapeutic concentrations Malaria HIV |
| title | Effect of nevirapine, efavirenz and lopinavir/ritonavir on the therapeutic concentration and toxicity of lumefantrine in people living with HIV at Lagos University Teaching Hospital, Nigeria |
| title_full | Effect of nevirapine, efavirenz and lopinavir/ritonavir on the therapeutic concentration and toxicity of lumefantrine in people living with HIV at Lagos University Teaching Hospital, Nigeria |
| title_fullStr | Effect of nevirapine, efavirenz and lopinavir/ritonavir on the therapeutic concentration and toxicity of lumefantrine in people living with HIV at Lagos University Teaching Hospital, Nigeria |
| title_full_unstemmed | Effect of nevirapine, efavirenz and lopinavir/ritonavir on the therapeutic concentration and toxicity of lumefantrine in people living with HIV at Lagos University Teaching Hospital, Nigeria |
| title_short | Effect of nevirapine, efavirenz and lopinavir/ritonavir on the therapeutic concentration and toxicity of lumefantrine in people living with HIV at Lagos University Teaching Hospital, Nigeria |
| title_sort | effect of nevirapine efavirenz and lopinavir ritonavir on the therapeutic concentration and toxicity of lumefantrine in people living with hiv at lagos university teaching hospital nigeria |
| topic | Lumefantrine Antiretroviral drugs Therapeutic concentrations Malaria HIV |
| url | http://www.sciencedirect.com/science/article/pii/S1347861320300785 |
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