Pharmacokinetic Interactions between ArtemetherlLnmefantrine and Commonly used Antiretroviral Drugs: A Review
), Agbaje EO(2), Oreagba IA(3), Akanmu AS(4),
(1) Department of Pharmacology, Therapeutics & Toxicology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
(2) Department of Pharmacology, Therapeutics & Toxicology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
(3) Department of Pharmacology, Therapeutics & Toxicology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
(4) Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria. APIN Clinic, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
Corresponding Author
Abstract
SId.;:::=n:IUDd: Artemether/lumefantrine (AL) and common-used antiretroviral drugs (ARVs) such as nevirapine (NVP), efavirenz
mne (ETR), ritonavir-boosted lopinavir (LPVlr) and ritonavir-boosted atazanavir(ATV/r) interact with hepatic cytochrome
•'mes as substrates, inducers or inhibitors. Therefore, their co-administration in HIV-infected patients having malaria may
_ ically significant drug-drug interactions (CSDIs).
o::iftm-,e: This study was aimed at evaluating the CSDIs between AL and the ARV s and highlighting the needy areas of research
optimize therapy in patients co-infected with Hl'V and malaria.
Ml5ltI::Ids: A literature review was done on PubMed and ether publications about the pharmacology and interactions ofAL, NVP,
. E:R LPV/r andATV/r and the information obtained was summarized.
lIitzs:::n:_ .:vP, EFV and LPV Ir reduced the exposure of artemether which may results in malaria treatment failure. While EFV
a:::=:sed the exposure of lumefantrine, LPV Ir and NVP increased it. Interaction between AL and ETR or ATVIr has not been
~o::~ Howe er, ETR and ATVIr may potentially decrease and increase, respectively, the exposure of artemether and lumefantrine
CE:S:::~_malaria treatment failure or toxicity. There is paucity of data on the pharmacokinetic interaction between AL and the ARVs
ients co-infected with HIV and malaria.
C.ac:l:mi-on: AL may be ineffective when co-administered with EFV-basedART regimen. Patients on LPV Ir or NVP- based ART
:::.\L hould be monitored for cardiotoxicity. More studies are required to evaluate interaction between AL and the ARVs
1~:e:::3l~.- XIV/r and ETR including studies in adult patients co-infected with malaria and HIV
mne (ETR), ritonavir-boosted lopinavir (LPVlr) and ritonavir-boosted atazanavir(ATV/r) interact with hepatic cytochrome
•'mes as substrates, inducers or inhibitors. Therefore, their co-administration in HIV-infected patients having malaria may
_ ically significant drug-drug interactions (CSDIs).
o::iftm-,e: This study was aimed at evaluating the CSDIs between AL and the ARV s and highlighting the needy areas of research
optimize therapy in patients co-infected with Hl'V and malaria.
Ml5ltI::Ids: A literature review was done on PubMed and ether publications about the pharmacology and interactions ofAL, NVP,
. E:R LPV/r andATV/r and the information obtained was summarized.
lIitzs:::n:_ .:vP, EFV and LPV Ir reduced the exposure of artemether which may results in malaria treatment failure. While EFV
a:::=:sed the exposure of lumefantrine, LPV Ir and NVP increased it. Interaction between AL and ETR or ATVIr has not been
~o::~ Howe er, ETR and ATVIr may potentially decrease and increase, respectively, the exposure of artemether and lumefantrine
CE:S:::~_malaria treatment failure or toxicity. There is paucity of data on the pharmacokinetic interaction between AL and the ARVs
ients co-infected with HIV and malaria.
C.ac:l:mi-on: AL may be ineffective when co-administered with EFV-basedART regimen. Patients on LPV Ir or NVP- based ART
:::.\L hould be monitored for cardiotoxicity. More studies are required to evaluate interaction between AL and the ARVs
1~:e:::3l~.- XIV/r and ETR including studies in adult patients co-infected with malaria and HIV
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