Significant pharmacokinetic interactions between artemether/lumefantrine and efavirenz or nevirapine in HIV-infected Ugandan adults

Co-administration of artemether/lumefantrine with antiretroviral therapy has potential for pharmacokinetic drug interactions. We investigated drug-drug interactions between artemether/lumefantrine and efavirenz or nevirapine. We performed a cross-over study in which HIV-infected adults received stan...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2012-09, Vol.67 (9), p.2213-2221
Main Authors: Byakika-Kibwika, Pauline, Lamorde, Mohammed, Mayito, Jonathan, Nabukeera, Lillian, Namakula, Rhoda, Mayanja-Kizza, Harriet, Katabira, Elly, Ntale, Muhammad, Pakker, Nadine, Ryan, Mairin, Hanpithakpong, Warunee, Tarning, Joel, Lindegardh, Niklas, de Vries, Peter J, Khoo, Saye, Back, David, Merry, Concepta
Format: Article
Language:English
Subjects:
Adult
Alkynes
Anti-HIV Agents - administration & dosage
Anti-HIV Agents - pharmacokinetics
Antimalarials - administration & dosage
Antimalarials - pharmacokinetics
Antiretroviral drugs
Artemether, Lumefantrine Drug Combination
Artemisinins - administration & dosage
Artemisinins - pharmacokinetics
Benzoxazines - administration & dosage
Benzoxazines - pharmacokinetics
Chemotherapy
Cross-Over Studies
Cyclopropanes
Drug Combinations
Drug Interactions
Drug therapy
Ethanolamines - administration & dosage
Ethanolamines - pharmacokinetics
Female
Fluorenes - administration & dosage
Fluorenes - pharmacokinetics
HIV
HIV Infections - complications
HIV Infections - drug therapy
Human immunodeficiency virus
Humans
Malaria - complications
Malaria - drug therapy
Male
Nevirapine - administration & dosage
Nevirapine - pharmacokinetics
Original Research
Pharmacology
Plasma - chemistry
Uganda
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Summary:Co-administration of artemether/lumefantrine with antiretroviral therapy has potential for pharmacokinetic drug interactions. We investigated drug-drug interactions between artemether/lumefantrine and efavirenz or nevirapine. We performed a cross-over study in which HIV-infected adults received standard six-dose artemether/lumefantrine 80/480 mg before and at efavirenz or nevirapine steady state. Artemether, dihydroartemisinin, lumefantrine, efavirenz and nevirapine plasma concentrations were measured and compared. Efavirenz significantly reduced artemether maximum concentration (C(max)) and plasma AUC (median 29 versus 12 ng/mL, P 
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dks207