Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study

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dc.contributor.authorMonera-Penduka, Tsitsi G
dc.contributor.authorMaponga, Charles C
dc.contributor.authorWolfe, Alan R
dc.contributor.authorWiesner, Lubbe
dc.contributor.authorMorse, Gene D
dc.contributor.authorNhachi, Charles F B
dc.date.accessioned2021-10-08T11:00:54Z
dc.date.available2021-10-08T11:00:54Z
dc.date.issued2017
dc.description.abstractMoringa oleifera Lam., an herb commonly consumed by HIV-infected people on antiretroviral therapy, inhibits cytochrome P450 3A4, 1A2 and 2D6 activity in vitro; and may alter the pharmacokinetics (PK) of antiretroviral drugs metabolized via the same pathways. However, in vitro drug interaction activity may not translate to a clinically significant effect. Therefore, the effect of moringa leaf powder on the PK of nevirapine in HIV-infected people was investigated. Adult patients at steady-state dosing with nevirapine were admitted for 12-h intensive PK sampling following a 21-day herbal medicine washout. Blood sampling was repeated after 14 days of nevirapine and moringa (1.85 g leaf powder/day) co-administration. Nevirapine plasma concentrations were determined by liquid chromatography-tandem mass spectrometry. To assess the effect of moringa on nevirapine PK, the change in nevirapine area under the plasma concentration–time curve (AUC) was determined. The mean difference in pre- and post-moringa nevirapine, maximum concentration (Cmax) and concentration at 12 h (C12h) were also calculated. The PK parameters were compared by assessing the post/pre geometric mean ratios (GMRs) and associated 90% confidence intervals (CIs). Pharmacokinetics analyses were performed on the results from 11 participants for whom complete data were obtained. The post/pre GMRs and associated 90% CIs for nevirapine were 1.07 (1.00–1.14) for the AUC; 1.06 (0.98–1.16) for Cmax and 1.03 (0.92–1.16) for C12h. Co-administration of Moringa oleifera Lam. leaf powder at the traditional dose did not significantly alter the steady-state PK of nevirapine. Trial registration number NCT01410058 (ClinicalTrials.gov)
dc.identifier.apacitationMonera-Penduka, T. G., Maponga, C. C., Wolfe, A. R., Wiesner, L., Morse, G. D., & Nhachi, C. F. B. (2017). Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study. <i>AIDS Research and Therapy</i>, 14(1), 174 - 177. http://hdl.handle.net/11427/35043en_ZA
dc.identifier.chicagocitationMonera-Penduka, Tsitsi G, Charles C Maponga, Alan R Wolfe, Lubbe Wiesner, Gene D Morse, and Charles F B Nhachi "Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study." <i>AIDS Research and Therapy</i> 14, 1. (2017): 174 - 177. http://hdl.handle.net/11427/35043en_ZA
dc.identifier.citationMonera-Penduka, T.G., Maponga, C.C., Wolfe, A.R., Wiesner, L., Morse, G.D. & Nhachi, C.F.B. 2017. Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study. <i>AIDS Research and Therapy.</i> 14(1):174 - 177. http://hdl.handle.net/11427/35043en_ZA
dc.identifier.issn1742-6405
dc.identifier.ris TY - Journal Article AU - Monera-Penduka, Tsitsi G AU - Maponga, Charles C AU - Wolfe, Alan R AU - Wiesner, Lubbe AU - Morse, Gene D AU - Nhachi, Charles F B AB - Moringa oleifera Lam., an herb commonly consumed by HIV-infected people on antiretroviral therapy, inhibits cytochrome P450 3A4, 1A2 and 2D6 activity in vitro; and may alter the pharmacokinetics (PK) of antiretroviral drugs metabolized via the same pathways. However, in vitro drug interaction activity may not translate to a clinically significant effect. Therefore, the effect of moringa leaf powder on the PK of nevirapine in HIV-infected people was investigated. Adult patients at steady-state dosing with nevirapine were admitted for 12-h intensive PK sampling following a 21-day herbal medicine washout. Blood sampling was repeated after 14 days of nevirapine and moringa (1.85 g leaf powder/day) co-administration. Nevirapine plasma concentrations were determined by liquid chromatography-tandem mass spectrometry. To assess the effect of moringa on nevirapine PK, the change in nevirapine area under the plasma concentration–time curve (AUC) was determined. The mean difference in pre- and post-moringa nevirapine, maximum concentration (Cmax) and concentration at 12 h (C12h) were also calculated. The PK parameters were compared by assessing the post/pre geometric mean ratios (GMRs) and associated 90% confidence intervals (CIs). Pharmacokinetics analyses were performed on the results from 11 participants for whom complete data were obtained. The post/pre GMRs and associated 90% CIs for nevirapine were 1.07 (1.00–1.14) for the AUC; 1.06 (0.98–1.16) for Cmax and 1.03 (0.92–1.16) for C12h. Co-administration of Moringa oleifera Lam. leaf powder at the traditional dose did not significantly alter the steady-state PK of nevirapine. Trial registration number NCT01410058 (ClinicalTrials.gov) DA - 2017 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - AIDS Research and Therapy LK - https://open.uct.ac.za PY - 2017 SM - 1742-6405 T1 - Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study TI - Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study UR - http://hdl.handle.net/11427/35043 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/35043
dc.identifier.vancouvercitationMonera-Penduka TG, Maponga CC, Wolfe AR, Wiesner L, Morse GD, Nhachi CFB. Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study. AIDS Research and Therapy. 2017;14(1):174 - 177. http://hdl.handle.net/11427/35043.en_ZA
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceAIDS Research and Therapy
dc.source.journalissue1
dc.source.journalvolume14
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12981-017-0140-4
dc.subject.otherMoringa oleifera
dc.subject.otherNevirapine
dc.subject.otherPharmacokinetics
dc.subject.otherHIV
dc.titleEffect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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