Assessment of Clinical Pharmacokinetic Drug-Drug Interaction of Antimalarial Drugs α/β-Arteether and Sulfadoxine-Pyrimethamine

• Published in: Antimicrobial agents and chemotherapy 2017-09, Vol.61 (9)
• Main Authors: Chhonker, Y S, Bhosale, V V, Sonkar, S K, Chandasana, H, Kumar, D, Vaish, S, Choudhary, S C, Bhadhuria, S, Sharma, S, Singh, R K, Jain, G K, Vaish, A K, Gaur, S P S, Bhatta, R S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Antimalarials; Antimalarials - blood; Antimalarials - pharmacokinetics; Antimalarials - therapeutic use; Artemisinins; Artemisinins - blood; Artemisinins - pharmacokinetics; Artemisinins - therapeutic use; Chromatography, Liquid; Drug Combinations; Drug Interactions - physiology; Experimental Therapeutics; Healthy Volunteers; Humans; Malaria, Falciparum; Malaria, Falciparum - drug therapy; Malaria, Falciparum - parasitology; Male; Middle Aged; Plasmodium falciparum; Plasmodium falciparum - drug effects; Pyrimethamine; Pyrimethamine - blood; Pyrimethamine - pharmacokinetics; Pyrimethamine - therapeutic use; Sulfadoxine; Sulfadoxine - blood; Sulfadoxine - pharmacokinetics; Sulfadoxine - therapeutic use; Tandem Mass Spectrometry; Young Adult
• ISSN: 0066-4804; 1098-6596
• DOI: 10.1128/AAC.02177-16

Antimalarial drug combination therapy is now being widely used for the treatment of uncomplicated malaria. The objective of the present study was to investigate the effects of coadministration of intramuscular α/β-arteether (α/β-AE) and oral sulfadoxine-pyrimethamine (SP) on the pharmacokinetic properties of each drug as a drug-drug interaction study to support the development of a fixed-dose combination therapy. A single-dose, open-label, crossover clinical trial was conducted in healthy adult Indian male volunteers (18 to 45 years, = 13) who received a single dose of AE or SP or a combination dose of AE and SP. Blood samples were collected up to 21 days postadministration, and concentrations of α-AE, β-AE, sulfadoxine, and pyrimethamine were determined by using a validated liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters were calculated and statistically analyzed to calculate the geometric mean ratio and confidence interval. Following single-dose coadministration of intramuscular AE and oral SP, the pharmacokinetic properties of α/β-AE were not significantly affected, and α/β-AE had no significant effect on the pharmacokinetic properties of SP in these selected groups of healthy volunteers. However, more investigations are needed to explore this further. (This study has been registered in the clinical trial registry of India under approval no. CTRI/2011/11/002155.).