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Las concentraciones de indinavir y la hierba de San Juan.

S C Piscitelli, A H Burstein, D Chaitt

    Lancet (London, England)
    |February 22, 2000
    PubMed
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    La hierba de San Juan reduce significativamente la exposición al medicamento para el VIH indinavir en individuos sanos. Esta interacción puede aumentar el riesgo de resistencia a los medicamentos y el fracaso del tratamiento en pacientes con VIH.

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    Área de la Ciencia:

    • Farmacología Farmacología.
    • Interacciones farmacológicas Interacciones farmacológicas
    • Medicina a base de hierbas Interacciones Medicina a base de hierbas

    Sus antecedentes:

    • La hierba de San Juan es un suplemento popular a base de hierbas con interacciones conocidas.
    • Indinavir es un inhibidor crítico de la proteasa para el manejo de la infección por VIH-1.
    • Comprender las interacciones entre hierbas y medicamentos es crucial para la seguridad del paciente y la eficacia del tratamiento.

    Objetivo del estudio:

    • Cuantificar el efecto de la hierba de San Juan en el perfil farmacocinético del indinavir en voluntarios sanos.
    • Evaluar la importancia clínica de esta interacción para el tratamiento del VIH.

    Principales métodos:

    • Se administró indinavir a voluntarios sanos.
    • Se midió el impacto de la administración concomitante de hierba de San Juan en la exposición al indinavir.
    • Se analizaron los parámetros farmacocinéticos clave, incluido el área debajo de la curva y las concentraciones mínimas.

    Principales resultados:

    • La hierba de San Juan redujo el área bajo la curva (AUC) de indinavir en una media del 57%.
    • Las concentraciones mínimas de indinavir extrapoladas a las 8 horas disminuyeron en un 81%.
    • Estas reducciones indican una disminución sustancial en la exposición total a las drogas.

    Conclusiones:

    • El uso concomitante de hierba de San Juan con indinavir conduce a una reducción significativa en la exposición al indinavir.
    • Esta interacción plantea un riesgo de fracaso terapéutico y el desarrollo de resistencia a los medicamentos en pacientes con VIH.
    • Los médicos deben tener precaución al prescribir hierba de San Juan a los pacientes en tratamiento con indinavir.