Study Objective. To characterize the pharmacokinetics of indinavir in the presence and absence of milk thistle and to determine the offset of any effect of milk thistle on indinavir disposition. Design. Prospective open-label drug interaction study. Setting. Outpatient clinic. Subjects. Ten healthy volunteers. Intervention. Blood samples were collected over 8 hours after the volunteers took four doses of indinavir 800 mg every 8 hours on an empty stomach for baseline pharmacokinetics. This dosing and sampling were repeated after the subjects took milk thistle 175 mg (confirmed to contain silymarin 153 mg, the active ingredient) 3 times/day for 3 weeks. After an 11-day washout, indinavir dosing and blood sampling were repeated to evaluate the offset of any potential interaction. Measurements and Main Results. Indinavir concentrations were measured by using a validated high-performance liquid chromatography method. The following pharmacokinetic parameters were determined: highest concentration (Cmax), hour-0 concentration, hour-8 concentration (C8), time to reach Cmax, and area under the plasma concentration-time curve over the 8-hour dosing interval (AUC8). Milk thistle did not alter significantly the overall exposure of indinavir, as evidenced by a 9% reduction in the indinavir AUC8 after 3 weeks of dosing with milk thistle, although the least squares mean trough level (C8) was significantly decreased by 25%. Conclusion. Milk thistle in commonly administered dosages should not interfere with indinavir therapy in patients infected with the human immunodeficiency virus.
研究目的描述
茚地那韦在奶蓟草存在和不存在的情况下的药代动力学特征,并确定奶蓟草对
茚地那韦处置的任何影响的抵消作用。 设计。前瞻性开放标签药物相互作用研究。 环境。门诊。 受试者。十名健康志愿者。 干预。志愿者每8小时空腹服用四次
茚地那韦800毫克后,在8小时内采集血液样本,以测定基线药代动力学。受试者连续3周每天3次服用奶蓟草175毫克(经证实含有
水飞蓟素153毫克,活性成分)后,重复上述剂量和采样。经过11天的冲洗后,再次进行
茚地那韦剂量和血液采样,以评估任何潜在相互作用的抵消情况。 测量和主要结果。
茚地那韦浓度的测定采用经过验证的高效
液相色谱法。测定了以下药代动力学参数:最高浓度(Cmax)、0小时浓度、8小时浓度(C8)、达到Cmax的时间以及8小时给药间隔的血浆浓度-时间曲线下面积(AUC8)。服用奶蓟草3周后,
茚地那韦的AUC8降低了9%,但最小二乘法平均谷浓度(C8)显著降低了25%,这表明奶蓟草并未显著改变
茚地那韦的总体暴露量。 结论在人类免疫缺陷病毒感染者中,常用剂量的奶蓟草不会干扰
茚地那韦治疗。