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

Int J Infect Dis. 2013 Oct;17(10):e857-61. doi: 10.1016/j.ijid.2013.02.017. Epub 2013 Apr 12.

Abstract

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 (AUC(0-12h), 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 (C(max)) 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, C(max), or C(trough).

Conclusions: African potato when taken concomitantly with LPV/r is well-tolerated and not associated with clinically significant changes in lopinavir pharmacokinetics.

Keywords: Herbal medicines; Herb–drug interactions; Hypoxis obtusa; Pharmacokinetic interactions.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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
  • HIV Infections / drug therapy*
  • Humans
  • Lopinavir / administration & dosage
  • Lopinavir / pharmacokinetics*
  • Male
  • Middle Aged
  • Plant Extracts / administration & dosage
  • Plant Extracts / pharmacology
  • Ritonavir / administration & dosage
  • Ritonavir / pharmacokinetics*
  • Solanum tuberosum / chemistry
  • Young Adult

Substances

  • Alkynes
  • Anti-HIV Agents
  • Glucosides
  • Plant Extracts
  • Lopinavir
  • hypoxoside
  • Ritonavir