{"id":16067,"date":"2012-02-01T13:18:35","date_gmt":"2012-02-01T13:18:35","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=16067"},"modified":"2012-07-19T13:54:44","modified_gmt":"2012-07-19T13:54:44","slug":"interactions-between-nevirapine-and-antimalarials-artemether-and-lumefantrine","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/16067","title":{"rendered":"Interactions between nevirapine and antimalarials (artemether and lumefantrine)"},"content":{"rendered":"<p><strong>www.hiv-druginteractions.org<\/strong><\/p>\n<p><strong>Artemether-lumefantrine and nevirapine-based antiretroviral therapy (ART) are the most commonly recommended first-line treatments for malaria and HIV respectively in Africa.<\/strong><\/p>\n<p>However, there is the potential for drug interactions with this combination as artemether and lumefantrine are substrates of CYP3A4 and nevirapine is both a substrate and inducer of CYP3A4.<\/p>\n<p>This parallel-design pharmacokinetic study, obtained concentration-time profiles for lumefantrine, artemether, dihydroartemisinin and nevirapine in two groups of HIV-infected patients: ART-na\u00efve and those stable on nevirapine-based therapy. Both groups (n=18 per group) received the recommended artemether-lumefantrine dose (80\/480 mg). The primary outcome was day-7 lumefantrine concentrations, as these are associated with therapeutic response in malaria.<\/p>\n<p>Nevirapine decreased artemether (p&lt;0.0001) and dihydroartemisinin (p=0.01) AUC, but unexpectedly increased lumefantrine exposure.  Median (range) day  7 lumefantrine concentrations were 622 ng\/mL (185-2040) and 336 ng\/mL (29-934) in the nevirapine and ART-na\u00efve groups, respectively (p=0.0002).  In the ART-na\u00efve group, 6\/18 subjects had day 7 lumefantrine concentrations below target (280 ng\/ml) compared with 1\/18 in the nevirapine group (Odds Ratio=8.5, 95%CI 0.9 to 80.02, p=0.061).  Adverse events were similar between groups, with no difference in electrocardiographic QTcF and PR intervals.<\/p>\n<p>The mechanism of inhibition of lumefantrine remains to be elucidated. Studies investigating the interaction of nevirapine and artemether-lumefantrine in HIV-infected patients with malaria are urgently needed.<\/p>\n<p>Source: hiv-druginteractions.org (16 November 2011).<\/p>\n<p><a href=\"http:\/\/www.hiv-druginteractions.org\/LatestArticlesContent.aspx?ID=564\">http:\/\/www.hiv-druginteractions.org\/LatestArticlesContent.aspx?ID=564<\/a><\/p>\n<p>Reference:<\/p>\n<p>Kredo T et al. The interaction between artemether-lumefantrine and nevirapine-based antiretroviral therapy in HIV-1 infected patients. Antimicrob Agents Chemother, 2011, 55(12): 5616-5323.<\/p>\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21947399\">http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21947399<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>www.hiv-druginteractions.org Artemether-lumefantrine and nevirapine-based antiretroviral therapy (ART) are the most commonly recommended first-line treatments for malaria and HIV respectively in Africa. However, there is the potential for drug interactions with this combination as artemether and lumefantrine are substrates of CYP3A4 &hellip;<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[],"class_list":["post-16067","post","type-post","status-publish","format-standard","hentry","category-pk-and-drug-interactions"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/16067","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=16067"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/16067\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=16067"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=16067"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=16067"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}