Co-administration of a commonly used Zimbabwean herbal treatment (African potato) does not alter the pharmacokinetics of lopinavir/ritonavir

• Published in: International journal of infectious diseases 2013-10, Vol.17 (10), p.e857-e861
• Main Authors: Gwaza, Luther, Aweeka, Francesca, Greenblatt, Ruth, Lizak, Patricia, Huang, Liusheng, Guglielmo, B. Joseph
• Format: Article
• Language: English
• Subjects: Adult; Alkynes - administration & dosage; Alkynes - pharmacology; Anti-HIV Agents - administration & dosage; Anti-HIV Agents - pharmacokinetics; Area Under Curve; Cross-Over Studies; Drug Therapy, Combination; Female; Glucosides - administration & dosage; Glucosides - pharmacology; Herbal medicines; Herb–drug interactions; HIV Infections - drug therapy; Humans; Hypoxis obtusa; Infectious Disease; Lopinavir - administration & dosage; Lopinavir - pharmacokinetics; Male; Middle Aged; Pharmacokinetic interactions; Plant Extracts - administration & dosage; Plant Extracts - pharmacology; Pulmonary/Respiratory; Ritonavir - administration & dosage; Ritonavir - pharmacokinetics; Solanum tuberosum - chemistry; Young Adult
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2013.02.017

Summary Objective African potato ( Hypoxis obtusa) is commonly used in Sub-Saharan Africa as a complementary herbal remedy for HIV-infected patients. It is unknown whether or not co-administration of African potato alters the pharmacokinetics of protease inhibitor antiretrovirals. The objective of this study was to investigate the impact of the African potato on the steady-state pharmacokinetics of ritonavir-boosted lopinavir (LPV/r). Methods Sixteen adult volunteers were administered LPV/r 400/100 mg twice a day for 14 days, followed by concomitant administration with African potato given once daily for 7 days. Lopinavir plasma exposure as estimated by the area under the concentration–time curve over the 12-h dosing interval (AUC0–12h , AUCτ) was determined on day 14 and again on day 21. Lopinavir in plasma was analyzed using a validated liquid chromatography with tandem mass spectrometry (LC-MS/MS) method. Steady-state AUCτ and the maximum concentration following dose administration (Cmax ) were determined using non-compartmental methods using WinNonlin Professional version 5.2.1. Statistical analyses were performed using Stata version 12.1. Results Co-administration of African potato was not associated with any change in lopinavir AUCτ, Cmax , or Ctrough. Conclusions African potato when taken concomitantly with LPV/r is well-tolerated and not associated with clinically significant changes in lopinavir pharmacokinetics.