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

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.accessioned2017-04-04T08:41:05Z
dc.date.available2017-04-04T08:41:05Z
dc.date.issued2017-03-14
dc.date.updated2017-03-14T19:02:21Z
dc.description.abstractBackground: 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. Methods: Adult patients at steady-state dosing with nevirapine were admitted for 12-h intensive PK sampling follow ing 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 chromatographytandem 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 com pared by assessing the post/pre geometric mean ratios (GMRs) and associated 90% confidence intervals (CIs). Results: 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. Conclusion: 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>, http://hdl.handle.net/11427/24144en_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> (2017) http://hdl.handle.net/11427/24144en_ZA
dc.identifier.citationMonera-Penduka, T. G., Maponga, C. C., Wolfe, A. R., Wiesner, L., Morse, G. D., & Nhachi, C. F. (2017). 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, 14(1), 12.
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 - Background: 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. Methods: Adult patients at steady-state dosing with nevirapine were admitted for 12-h intensive PK sampling follow ing 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 chromatographytandem 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 com pared by assessing the post/pre geometric mean ratios (GMRs) and associated 90% confidence intervals (CIs). Results: 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. Conclusion: 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 - 2017-03-14 DB - OpenUCT DO - 10.1186/s12981-017-0140-4 DP - University of Cape Town J1 - AIDS Research and Therapy LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 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/11427/24144 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s12981-017-0140-4
dc.identifier.urihttp://hdl.handle.net/11427/24144
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; http://hdl.handle.net/11427/24144.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License
dc.rights.holderThe Author(s)
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceAIDS Research and Therapy
dc.source.urihttps://aidsrestherapy.biomedcentral.com/
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.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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