Pharmaceutical Chemistry- Scholarly Publications
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Browsing Pharmaceutical Chemistry- Scholarly Publications by Author "Adeniji, H."
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- ItemRestrictedEffect 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(Science Direct, 2020-08-05) Usman, S.O.; Oreagba, I.A; Akinyede, A.A.; Agbaje, E.O.; Akinleye, M.O.; Onwujuobi, A.G.; Ken-Owotor, C.; Adeuja, O.; Ogunfowokan, T.; Kogbe, S.; Owolabi, E.T.; Adeniji, H.; Busari, A.; Hassan, O.O.; Abideen, G.; Akanmu, A.S.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 ¼ 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 ¼ 0.27) and 328% (p < 0.0001) in the NVP and LPVr arms but decreased in the EFV-arm by 30% (p ¼ 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 ¼ 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.