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Kharwade R, More S, Suresh E, Warokar A, Mahajan N, Mahajan U. Improvement in Bioavailability and Pharmacokinetic Characteristics of Efavirenz with Booster Dose of Ritonavir in PEGylated PAMAM G4 Dendrimers. AAPS PharmSciTech 2022; 23:177. [PMID: 35750994 DOI: 10.1208/s12249-022-02315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022] Open
Abstract
Efavirenz (EFV) with a booster dose of ritonavir (RTV) (EFV-RTV) inhibits the metabolism of EFV and improves its bioavailability. However, inadequate organ perfusion with surface permeability glycoprotein (P-gp) efflux sustains the viable HIV. Hence, the present investigations were aimed to evaluate the pharmacokinetics and tissue distribution efficiency of EFV by encapsulating it into PEGyalated PAMAM (polyamidoamine) G4 dendrimers with a booster dose of RTV (PPG4ER). The entrapment efficiency of PEGylated PAMAM G4 dendrimers was found to be 94% and 92.12% for EFV and RTV respectively with a zeta potential of 0.277 mV. The pharmacokinetics and tissue distribution behavior of EFV within PPG4ER was determined by developing and validating a simple, sensitive, and reliable bioanalytical method of RP-HPLC. The developed bioanalytical method was very sensitive with a quantification limit of 18.5 ng/ml and 139.2 ng/ml for EFV and RTV, respectively. The comparative noncompartmental pharmacokinetic parameters of EFV were determined by administrating a single intraperitoneal dose of EFV, EFV-RTV, and PPG4ER to Wistar rats. The PPG4ER produced prolonged release of EFV with a mean residential time (MRT) of 24 h with Cmax 7.68 µg/ml in plasma against EFV-RTV with MRT 11 h and Cmax 3.633 µg/ml. The PPG4ER was also detected in viral reservoir tissues (lymph node and spleen) for 3-4 days, whereas free EFV and EFV-RTV were cleared within 72 h. The pharmacokinetic data including Cmax, t1/2, AUCtot, and MRT were significantly improved in PPG4ER as compared with single EFV and EFV-RTV. This reveals that the PPG4ER has great potential to target the virus harbors tissues and improve bioavailability.
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Affiliation(s)
- Rohini Kharwade
- Dadasaheb Balpande College of Pharmacy, Besa, Nagpur, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, (MS), 440037, India.
| | - Sachin More
- Dadasaheb Balpande College of Pharmacy, Besa, Nagpur, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, (MS), 440037, India
| | - Elizabeth Suresh
- Dadasaheb Balpande College of Pharmacy, Besa, Nagpur, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, (MS), 440037, India
| | - Amol Warokar
- Dadasaheb Balpande College of Pharmacy, Besa, Nagpur, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, (MS), 440037, India
| | - Nilesh Mahajan
- Dadasaheb Balpande College of Pharmacy, Besa, Nagpur, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, (MS), 440037, India
| | - Ujwala Mahajan
- Dadasaheb Balpande College of Pharmacy, Besa, Nagpur, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur, (MS), 440037, India
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Masenga W, Paganotti GM, Seatla K, Gaseitsiwe S, Sichilongo K. A fast-screening dispersive liquid-liquid microextraction-gas chromatography-mass spectrometry method applied to the determination of efavirenz in human plasma samples. Anal Bioanal Chem 2021; 413:6401-6412. [PMID: 34557941 DOI: 10.1007/s00216-021-03604-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/14/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022]
Abstract
We demonstrate the suitability of a fast, green, easy-to-perform, and modified sample extraction procedure, i.e., dispersive liquid-liquid microextraction (DLLME) for the determination of efavirenz (EFV) in human plasma. Data acquisition was done by gas chromatography-mass spectrometry (GC-MS) in the selected ion monitoring (SIM) mode. The simplicity of the method lies in, among others, the avoidance of the use of large organic solvent volumes as mobile phases and non-volatile buffers that tend to block the plumbing in high-performance liquid chromatography (HPLC). Chromatographic and mass spectral parameters were optimized using bovine whole blood for matrix matching due to insufficient human plasma. Method validation was accomplished using the United States Food and Drug Administration (USFDA) 2018 guidelines. The calibration curve was linear with a dynamic range of 0.10-2.0 μg/mL and an R2 value of 0.9998. The within-run accuracy and precision were both less than 20% at the lower limit of quantification (LLOQ) spike level. The LLOQ was 0.027 μg/mL which compared well with some values but was also orders of magnitude better than others reported in the literature. The percent recovery was 91.5% at the LLOQ spike level. The DLLME technique was applied in human plasma samples from patients who were on treatment with EFV. The human plasma samples gave concentrations of EFV ranging between 0.14-1.00 μg/mL with three samples out of seven showing concentrations that fell within or close to the recommended therapeutic range.
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Affiliation(s)
- Wangu Masenga
- Department of Chemistry, Faculty of Science, University of Botswana, PB 00704, Gaborone, Botswana
| | - Giacomo Maria Paganotti
- Botswana - University of Pennsylvania Partnership (BUP), Box AC 157 ACH, Gaborone, Botswana.,Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.,Department of Biomedical Sciences, Faculty of Medicine, University of Botswana, PB 00713, Gaborone, Botswana
| | - Kaelo Seatla
- Botswana Harvard AIDS institute partnership (BHP), P.O. Box BO, 320, Gaborone, Botswana.,Department of Medical Laboratory Sciences, School of Allied Health Professionals, University of Botswana, Gaborone, Botswana
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS institute partnership (BHP), P.O. Box BO, 320, Gaborone, Botswana.,Department of Immunology & Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Kwenga Sichilongo
- Department of Chemistry, Faculty of Science, University of Botswana, PB 00704, Gaborone, Botswana.
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Andriguetti NB, Barratt DT, Tucci J, Pumuye P, Somogyi AA. Instability of Efavirenz Metabolites Identified During Method Development and Validation. J Pharm Sci 2021; 110:3362-3366. [PMID: 34175301 DOI: 10.1016/j.xphs.2021.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/20/2021] [Accepted: 06/21/2021] [Indexed: 11/27/2022]
Abstract
Accurate quantification of efavirenz metabolites in patient samples is required to investigate their potential contribution to efavirenz adverse events. This study aimed to validate a LC-MS/MS method to quantify and investigate the stability of efavirenz and metabolites in human plasma. Compounds were extracted from plasma by supported liquid extraction and resolved on a C18 column. Validation was performed following FDA bioanalytical method validation guidelines. Stability under common conditions of sample pre-treatment and storage were assessed. Efavirenz and 8-hydroxyefavirenz were stable for all conditions tested. 7-Hydroxyefavirenz and 8,14-dihydroxyefavirenz were not stable in plasma at room temperature for 24 h (46%-69% loss), -20°C for 90 days (17%-50% loss), or 60°C for 1 h (90%-95% loss). Efavirenz and 8-hydroxyefavirenz concentrations in HIV/AIDS patient (n=5) plasma prepared from pre-treated (60°C for 1 h) whole blood varied from 517-8564 ng/mL and 131-813 ng/mL, respectively. 7-Hydroxyefavirenz and 8,14-dihydroxyefavirenz concentrations were below validated lower limits of quantification (0.25 and 0.5 ng/mL, respectively), most likely due to sample pre-treatment. This is the first report of 7-hydroxyefavirenz and 8,14-dihydroxyefavirenz instability under conditions commonly used in preparation of samples from HIV/AIDS patients. Alternative biosafety measures to heat pre-treatment must therefore be used for accurate quantification of plasma 7-hydroxyefavirenz and 8,14-dihydroxyefavirenz.
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Affiliation(s)
| | - Daniel T Barratt
- Discipline of Physiology, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Joseph Tucci
- Department of Pharmacy & Biomedical Sciences, La Trobe University Bendigo Campus, Bendigo, Australia
| | - Paul Pumuye
- School of Medicine and Health Sciences, University of Papua New Guinea, National Capital District, Papua New Guinea
| | - Andrew A Somogyi
- Discipline of Pharmacology, Adelaide Medical School, University of Adelaide, Adelaide, Australia
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Ambhore JP, Chaudhari SR, Cheke RS, Kharkar PS. A Concise Analytical Profile of Efavirenz: Analytical Methodologies. Crit Rev Anal Chem 2021; 52:1583-1592. [PMID: 33722117 DOI: 10.1080/10408347.2021.1895711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Non-nucleoside reverse transcriptase inhibitors are the prime members of antiretroviral therapy that are presently employed for the management of the human immunodeficiency virus. It uses an enzyme i.e., reverse transcriptase to convert its ribonucleic acid into reverse transcription; these agents impede the function of reverse transcriptase and reverse transcription counter human immunodeficiency virus from replicating. Efavirenz is the first-generation non-nucleoside reverse transcriptase inhibitor agent. Similar to the other non-nucleoside reverse transcriptase inhibitor agents; it is prescribed with other inhibitors in combination for regimens antiretroviral therapy. To enhance survival and avoid aggressive infections in patients affected with human immunodeficiency virus infection, adequate antiretroviral therapy is the most significant treatment. Accordingly, the development and validation of such therapeutic agents are challenging work for the analysts. Therefore, the proposed review integrally addresses the analytical reports of efavirenz recorded in the literature databases like Scopus, Web of Science, Google Scholar, Pub-Med, and through many other sources. It has been remarked that for the development of efavirenz many analytical techniques were used for addressing the qualitative and quantitative estimation of efavirenz from various pharmaceutical and biological matrices. This review plan to review the stereochemistry, mechanism of action, resistance, pharmacokinetics, pharmacodynamics, safety and adverse reaction, and various analytical approaches assessed for the same. The hyphenated and chromatographic techniques are frequently used for analysis of cited drug.
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Affiliation(s)
- Jaya P Ambhore
- Department of Pharmaceutical Chemistry, Dr. Rajendra Gode College of Pharmacy, Malkapur, MS, India
| | - Suraj R Chaudhari
- Department of Pharmaceutical Chemistry, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, MS, India
| | - Rameshwar S Cheke
- Department of Pharmaceutical Chemistry, Dr. Rajendra Gode College of Pharmacy, Malkapur, MS, India
| | - Prashant S Kharkar
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Mumbai, MS, India
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Rezaei M, Ramazani A, Hokmabadi F. Simultaneous Estimation and Validation of Tenofovir Disoproxil Fumarate, Emtricitabine and Efavirenz by RP-HPLC Method in Combined tablet Dosage Form. CURR PHARM ANAL 2019. [DOI: 10.2174/1573412914666180208152021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction:
The purpose of this study is the development and validation of assay test for
Tenofovir Disoproxil Fumarate (TDF), Emtricitabine (FTC) and Efavirenz (EFV) in combined tablet
dosage form by Reverse Phase (RP) HPLC.
Materials and Methods:
The assay method by HPLC was found to be linear in the concentration range
of 15-150 µg/mL, 10-100 µg/mL and 30-300 µg/mL for TDF, FTC, and EFV, respectively. Successful
separation of combined drugs was achieved by isocratic elution on a Phenomenex® C8 column (250 mm
× 4.6 mm, 5µm). The mobile phase was composed of buffer pH: 7.0 ± 0.05 potassium dihydrogen
phosphate, acetonitrile and methanol (40:40:20 v/v) at the flow rate of 1 mL/min using UV detection at
262 nm, column oven temperature 25ºC, and injection volume 20 µL.
Results:
The analytical results were validated by recovery studies. All the parameters of validation were
in the acceptance range. This developed method was successfully applied for simultaneous estimation
the amount of TDF, FTC and EFV in the bulk and marketed dosage forms.
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Affiliation(s)
- Mehdi Rezaei
- Department of Chemistry, University of Zanjan, P.O. Box: 45195-313, Zanjan, Iran
| | - Ali Ramazani
- Department of Chemistry, University of Zanjan, P.O. Box: 45195-313, Zanjan, Iran
| | - Fahimeh Hokmabadi
- Chemistry and Chemical Engineering Research Center of Iran, P.O. Box 14335-186, Tehran 1496813151, Iran
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Charbe NB, Zacconi FC, Amnerkar N, Ramesh B, Tambuwala MM, Clementi E. Bio-analytical Assay Methods used in Therapeutic Drug Monitoring of Antiretroviral Drugs-A Review. CURRENT DRUG THERAPY 2019. [DOI: 10.2174/1574885514666181217125550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Several clinical trials, as well as observational statistics, have exhibited that the advantages of antiretroviral [ARV] treatment for humans with Human Immunodeficiency Virus / Acquired Immune Deficiency Syndrome HIV/AIDS exceed their risks. Therapeutic drug monitoring [TDM] plays a key role in optimization of ARV therapy. Determination of ARV’s in plasma, blood cells, and other biological matrices frequently requires separation techniques capable of high effectiveness, specific selectivity and high sensitivity. High-performance liquid chromatography [HPLC] coupled with ultraviolet [UV], Photodiode array detectors [PDA], Mass spectrophotometer [MS] detectors etc. are the important quantitative techniques used for the estimation of pharmaceuticals in biological samples. </P><P> Objective: This review article is aimed to give an extensive outline of different bio-analytical techniques which have been reported for direct quantitation of ARV’s. This article aimed to establish an efficient role played by the TDM in the optimum therapeutic outcome of the ARV treatment. It also focused on establishing the prominent role played by the separation techniques like HPLC and UPLC along with the detectors like UV and Mass in TDM. </P><P> Methods: TDM is based on the principle that for certain drugs, a close relationship exists between the plasma level of the drug and its clinical effect. TDM is of no value if the relationship does not exist. The analytical methodology employed in TDM should: 1) distinguish similar compounds; 2) be sensitive and precise and 3) is easy to use. </P><P> Results: This review highlights the advancement of the chromatographic techniques beginning from the HPLC-UV to the more advanced technique like UPLC-MS/MS. TDM is essential to ensure adherence, observe viral resistance and to personalize ARV dose regimens. It is observed that the analytical methods like immunoassays and liquid chromatography with detectors like UV, PDA, Florescent, MS, MS/MS and Ultra performance liquid chromatography (UPLC)-MS/MS have immensely contributed to the clinical outcome of the ARV therapy. Assay methods are not only helping physicians in limiting the side effects and drug interactions but also assisting in monitoring patient’s compliance. </P><P> Conclusion: The present review revealed that HPLC has been the most widely used system irrespective of the availability of more sensitive chromatographic technique like UPLC.
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Affiliation(s)
- Nitin B. Charbe
- Departamento de Quimica Organica, Facultad de Quimica y de Farmacia, Pontificia Universidad Catolica de Chile, Av. Vicuna McKenna 4860, Macul, Santiago 7820436, Chile
| | - Flavia C. Zacconi
- Departamento de Quimica Organica, Facultad de Quimica y de Farmacia, Pontificia Universidad Catolica de Chile, Av. Vicuna McKenna 4860, Macul, Santiago 7820436, Chile
| | - Nikhil Amnerkar
- Adv V. R. Manohar Institute of Diploma in Pharmacy, Wanadongri, Hingna Road, Nagpur, Maharashtra 441110, India
| | - B. Ramesh
- Sri Adichunchunagiri University, Sri Adichunchunagiri College of Pharmacy, BG Nagar, Karnataka 571418, India
| | - Murtaza M. Tambuwala
- School of Pharmacy and Pharmaceutical Science, University of Ulster, Coleraine, County Londonderry, Northern Ireland BT52 1SA, United Kingdom
| | - Emilio Clementi
- Clinical Pharmacology Unit, CNR Institute of Neuroscience, Department of Biomedical and Clinical Sciences, Luigi Sacco University Hospital, Universita di Milano, Milan, Italy
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Gupta S, Kesarla R, Chotai N, Omri A. Development and validation of reversed-phase HPLC gradient method for the estimation of efavirenz in plasma. PLoS One 2017; 12:e0174777. [PMID: 28505168 PMCID: PMC5432066 DOI: 10.1371/journal.pone.0174777] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 03/15/2017] [Indexed: 11/19/2022] Open
Abstract
Efavirenz is an anti-viral agent of non-nucleoside reverse transcriptase inhibitor category used as a part of highly active retroviral therapy for the treatment of infections of human immune deficiency virus type-1. A simple, sensitive and rapid reversed-phase high performance liquid chromatographic gradient method was developed and validated for the determination of efavirenz in plasma. The method was developed with high performance liquid chromatography using Waters X-Terra Shield, RP18 50 x 4.6 mm, 3.5 μm column and a mobile phase consisting of phosphate buffer pH 3.5 and Acetonitrile. The elute was monitored with the UV-Visible detector at 260 nm with a flow rate of 1.5 mL/min. Tenofovir disoproxil fumarate was used as internal standard. The method was validated for linearity, precision, accuracy, specificity, robustness and data obtained were statistically analyzed. Calibration curve was found to be linear over the concentration range of 1-300 μg/mL. The retention times of efavirenz and tenofovir disoproxil fumarate (internal standard) were 5.941 min and 4.356 min respectively. The regression coefficient value was found to be 0.999. The limit of detection and the limit of quantification obtained were 0.03 and 0.1 μg/mL respectively. The developed HPLC method can be useful for quantitative pharmacokinetic parameters determination of efavirenz in plasma.
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Affiliation(s)
- Shweta Gupta
- Department of Pharmaceutical Technology, Parul University, Vadodara, Gujarat, India
| | - Rajesh Kesarla
- Department of Pharmaceutics, ISF College of Pharmacy, Moga, Punjab, India
| | - Narendra Chotai
- Department of Pharmaceutics, A. R. College of Pharmacy, Anand, Gujarat, India
| | - Abdelwahab Omri
- Department of Chemistry& Biochemistry, Laurentian University, Sudbury, Ontario, Canada
- * E-mail:
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Zelena L, Reznicek J, Ceckova M, Sklenarova H. Universal efavirenz determination in transport study, rat placenta perfusion and placenta lysate by HPLC-UV. J Pharm Biomed Anal 2017; 137:70-77. [PMID: 28092857 DOI: 10.1016/j.jpba.2017.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/04/2017] [Accepted: 01/06/2017] [Indexed: 11/24/2022]
Abstract
Efavirenz is an antiretroviral drug used in the treatment of HIV-positive patients. A simple, fast and sensitive high-performance liquid chromatography (HPLC) method was developed in order to determine efavirenz in three types of samples provided from pharmacokinetic studies. The analysis took 5min and was performed using a C18 analytical column (Discovery HS C18, 150×4.6mm, particle size of 5μm) in isocratic mode with a mobile phase containing acetonitrile and water (65:35, v/v), a flow rate of 1.6mLmin-1, a sample volume of 10μL and UV detection at 245nm. Three different sample matrices (Opti-MEM medium, Krebs perfusion liquid and tissue lysate) and their treatment (dilution, SPE) were considered. The validated method was applied for the analysis of 805 real samples arising from in vitro transcellular transport assays and in vivo organ perfusion experiments in order to evaluate the interaction of efavirenz with ATP-dependent drug efflux transporters. The lack of interaction of efavirenz with ABCB1, ABCG2 and ABCC2 transporters as well as technical aspects of this analysis, including the adhesion of efavirenz to the plastic materials and the stability of the drug during different tissue lysis approaches are discussed.
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Affiliation(s)
- Lucie Zelena
- Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Czechia
| | - Josef Reznicek
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Czechia
| | - Martina Ceckova
- Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Czechia
| | - Hana Sklenarova
- Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Czechia.
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Trace Level Quantification of the (-)2-(2-amino-5-chlorophenyl)-4-cyclopropyl-1,1,1-trifluoro-3-butyn-2-ol Genotoxic Impurity in Efavirenz Drug Substance and Drug Product Using LC-MS/MS. Sci Pharm 2015; 84:456-466. [PMID: 28117312 PMCID: PMC5064237 DOI: 10.3390/scipharm84030456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 10/18/2015] [Indexed: 11/17/2022] Open
Abstract
Efavirenz is a non-nucleoside reverse transcriptase inhibitor used in the treatment of human immunodeficiency virus type-1 (HIV). (2S)-(2-Amino-5-chlorophenyl)-4-cyclopropyl-1,1,1-trifluoro-3-butyn-2-ol (AMCOL), used as an intermediate in the synthesis of efavirenz and a degradation impurity, has an aminoaryl derivative which is a well-known alerting function for genotoxic activity. Upon request from a regulatory agency, a selective and sensitive liquid chromatography–tandem mass spectrometry (LC–MS/MS) method was developed for trace level quantitative determination of AMCOL related compound of efavirenz, for a risk assessment and comparison of impurity levels with the commercially available innovator product (brand name: Sustiva). The method provided excellent sensitivity at a typical target analyte level of <2.5 ppm, an established threshold of toxicological concern (TTC), when the drug substance and drug product samples were prepared at 15.0 mg/mL. The AMCOL sample was analyzed on a Luna C18 (2) (100 mm × 4.6 mm, 3 µm) column interfaced with a triple quadrupole tandem mass spectrometer operated in a multiple reaction monitoring (MRM) mode. Positive electrospray ionization (ESI) was employed as the ionization source and the mobile phase used was 5.0 mM ammonium acetate-methanol (35:65, v/v). The calibration curve showed good linearity over the concentration range of 0.2–5.0 ppm with a correlation coefficient of >0.999. The limit of detection (LOD) and limit of quantification (LOQ) were found to be 0.07 and 0.2 ppm, respectively. The developed method was validated as per international council on harmonization (ICH) guidelines in terms of LOD, LOQ, linearity, precision, accuracy, specificity, and robustness.
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Yin K, Meng X, Dong P, Ding T, Shen L, Zhang L, Zhang R, Cai W, Lu H. A simple, rapid, economical, and practical method for the determination of efavirenz in plasma of Chinese AIDS patients by reverse phase high-performance liquid chromatography with ultraviolet detector. Biosci Trends 2015; 8:227-34. [PMID: 25224629 DOI: 10.5582/bst.2014.01002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study aimed to develop a reverse phase high-performance liquid chromatographic (RP-HPLC) method for the determination of efavirenz in human plasma and to use it for determining the concentrations of efavirenz in Chinese AIDS patient. A simple mobile phase consisting of 0.01 mol/L NaH2PO4 solution and acetonitrile (38:62, V/V) was pumped at a flow rate of 1.0 mL/min through a reverse phase Diamonsil C18 column maintained at 30°C. Diazepam was used as an internal standard and monitored with efavirenz at 247 nm. The protein of 100 μL plasma sample was precipitated before 20 μL of the supernatant was directly injected into the column. The linear response over the concentration ranges 0.10-20.0 μg/mL was obtained and the linear regression equations was Y = 2.2873X ‒ 0.1449 (r = 0.9999). The intra-day and inter-day precisions (1.9-2.6%, 2.2-7.2%, respectively), the relative and absolute recovery (99.3-106.3%, 75.6-80.3%, respectively) met the international standards. Stability of plasma samples were evaluated for short-term (ambient temperature for 16 h) and long-term (-20°C for 30 days) storage conditions and were found to be stable. The mean plasma concentration of efavirenz of the 406 patients was 2.21 ± 1.95 μg/mL, 77.3% of which were within the therapeutic window (1-4 μg/mL), 15.1% were below the window, and 7.6% were over it. In conclusion, the method had advantages of convenience, rapidity, necessary accuracy and precision, high practicality and met the needs for therapeutic drug monitoring and the pharmacokinetic study of efavirenz, especially in underdeveloped countries. For Chinese AIDS patients, it was beneficial to use efavirenz under the guidance of therapeutic drug monitoring.
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Affiliation(s)
- Kang Yin
- Department of Infectious Diseases, Shanghai Public Health Clinical Center
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Pourfarzib M, Shekarchi M, Rastegar H, Akbari-Adergani B, Mehramizi A, Dinarvand R. Molecularly imprinted nanoparticles prepared by miniemulsion polymerization as a sorbent for selective extraction and purification of efavirenz from human serum and urine. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 974:1-8. [DOI: 10.1016/j.jchromb.2014.10.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 10/06/2014] [Accepted: 10/07/2014] [Indexed: 11/29/2022]
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12
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Bienvenu E, Hoffmann KJ, Ashton M, Kayumba PC. A rapid and selective HPLC-UV method for the quantitation of efavirenz in plasma from patients on concurrent HIV/AIDS and tuberculosis treatments. Biomed Chromatogr 2013; 27:1554-9. [DOI: 10.1002/bmc.2959] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 04/29/2013] [Accepted: 05/10/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Emile Bienvenu
- Unit for Pharmacokinetics and Drug Metabolism, Department of Pharmacology; Sahlgrenska Academy at University of Gothenburg; Göteborg; Sweden
| | - Kurt-Jürgen Hoffmann
- Unit for Pharmacokinetics and Drug Metabolism, Department of Pharmacology; Sahlgrenska Academy at University of Gothenburg; Göteborg; Sweden
| | - Michael Ashton
- Unit for Pharmacokinetics and Drug Metabolism, Department of Pharmacology; Sahlgrenska Academy at University of Gothenburg; Göteborg; Sweden
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Srivastava P, Moorthy GS, Gross R, Barrett JS. A sensitive and selective liquid chromatography/tandem mass spectrometry method for quantitative analysis of efavirenz in human plasma. PLoS One 2013; 8:e63305. [PMID: 23755102 PMCID: PMC3673986 DOI: 10.1371/journal.pone.0063305] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 04/01/2013] [Indexed: 11/19/2022] Open
Abstract
A selective and a highly sensitive method for the determination of the non-nucleoside reverse transcriptase inhibitor (NNRTI), efavirenz, in human plasma has been developed and fully validated based on high performance liquid chromatography tandem mass spectrometry (LC-MS/MS). Sample preparation involved protein precipitation followed by one to one dilution with water. The analyte, efavirenz was separated by high performance liquid chromatography and detected with tandem mass spectrometry in negative ionization mode with multiple reaction monitoring. Efavirenz and ¹³C₆-efavirenz (Internal Standard), respectively, were detected via the following MRM transitions: m/z 314.20243.90 and m/z 320.20249.90. A gradient program was used to elute the analytes using 0.1% formic acid in water and 0.1% formic acid in acetonitrile as mobile phase solvents, at a flow-rate of 0.3 mL/min. The total run time was 5 min and the retention times for the internal standard (¹³C₆-efavirenz) and efavirenz was approximately 2.6 min. The calibration curves showed linearity (coefficient of regression, r>0.99) over the concentration range of 1.0-2,500 ng/mL. The intraday precision based on the standard deviation of replicates of lower limit of quantification (LLOQ) was 9.24% and for quality control (QC) samples ranged from 2.41% to 6.42% and with accuracy from 112% and 100-111% for LLOQ and QC samples. The inter day precision was 12.3% and 3.03-9.18% for LLOQ and quality controls samples, and the accuracy was 108% and 95.2-108% for LLOQ and QC samples. Stability studies showed that efavirenz was stable during the expected conditions for sample preparation and storage. The lower limit of quantification for efavirenz was 1 ng/mL. The analytical method showed excellent sensitivity, precision, and accuracy. This method is robust and is being successfully applied for therapeutic drug monitoring and pharmacokinetic studies in HIV-infected patients.
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Affiliation(s)
- Praveen Srivastava
- Division of Clinical Pharmacology & Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Ganesh S. Moorthy
- Division of Clinical Pharmacology & Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - Robert Gross
- Departments of Pediatrics, Medicine and Biostatistics and Epidemiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Jeffrey S. Barrett
- Division of Clinical Pharmacology & Therapeutics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
- Departments of Pediatrics, Medicine and Biostatistics and Epidemiology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
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Fox D, O’Connor R, Mallon P, McMahon G. Simultaneous determination of efavirenz, rifampicin and its metabolite desacetyl rifampicin levels in human plasma. J Pharm Biomed Anal 2011; 56:785-91. [PMID: 21840662 DOI: 10.1016/j.jpba.2011.07.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 07/20/2011] [Accepted: 07/26/2011] [Indexed: 10/17/2022]
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15
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Determination of salivary efavirenz by liquid chromatography coupled with tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2010; 878:2886-90. [DOI: 10.1016/j.jchromb.2010.08.051] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Revised: 08/17/2010] [Accepted: 08/31/2010] [Indexed: 11/21/2022]
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16
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Rapid method for the quantitative determination of efavirenz in human plasma. J Pharm Biomed Anal 2009; 49:1308-12. [DOI: 10.1016/j.jpba.2009.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Revised: 02/10/2009] [Accepted: 03/09/2009] [Indexed: 11/21/2022]
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17
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Dogan-Topal B, Uslu B, Ozkan SA. Voltammetric studies on the HIV-1 inhibitory drug Efavirenz: the interaction between dsDNA and drug using electrochemical DNA biosensor and adsorptive stripping voltammetric determination on disposable pencil graphite electrode. Biosens Bioelectron 2008; 24:2358-64. [PMID: 19135352 DOI: 10.1016/j.bios.2008.12.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 11/21/2008] [Accepted: 12/03/2008] [Indexed: 11/24/2022]
Abstract
The interaction of Efavirenz (EFV) with fish sperm dsDNA immobilized onto pencil graphite electrode (PGE) has been studied by using differential pulse voltammetric technique using an electrochemical DNA biosensor. The guanine signal was lower with (double stranded-DNA) dsDNA-treated PGE than the untreated electrode after the interaction with EFV occurred. The changes in the experimental parameters such as the accumulation time and the concentration of EFV were also studied. All necessary parameters such as sensitivity, selectivity, accuracy and precision were calculated. In addition, the detection and determination limits, reproducibility and applicability of the analysis to pharmaceutical dosage forms were also investigated. These results showed that this DNA biosensor could be used for the sensitive, rapid simple and cost effective detection and determination of EFV-dsDNA interaction. The linearity was between 2 and 24 ppm of EFV concentration on guanine signal decreasing curve. EFV showed an irreversible oxidation behavior at all investigated pH values. This oxidation step was adsorption controlled on PGE. Hence, differential pulse adsorptive stripping (AdsDPV) voltammetric method was developed for the determination of EFV. Accumulation time and potential were optimized. Under these conditions, the current showed a linear dependence with concentration in the range between 0.018 and 2.56 ppm. Both determination methods were fully validated and applied for the analysis of EFV pharmaceutical dosage form.
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Affiliation(s)
- Burcu Dogan-Topal
- Ankara University, Faculty of Pharmacy, Department of Analytical Chemistry, 06100, Tandogan, Ankara, Turkey
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18
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Dutta T, Agashe HB, Garg M, Balakrishnan P, Balasubramanium P, Kabra M, Jain NK. Poly (propyleneimine) dendrimer based nanocontainers for targeting of efavirenz to human monocytes/macrophagesin vitro. J Drug Target 2008; 15:89-98. [PMID: 17365278 DOI: 10.1080/10611860600965914] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cells of the mononuclear phagocytic system, in particular monocytes/macrophages (Mo/Mac) serve as a reservoir for human immunodeficiency virus (HIV) and are believed to be responsible for its dissemination throughout the body and especially into the brain. Treatment of HIV infection, therefore, must reach these cells in addition to the lymphocytes. The purpose of the present study is to develop poly(propyleneimine) (PPI) dendrimer-based nanocontainers for targeting of efavirenz (EFV) to Mo/Mac. Fifth generation PPI dendrimer, t-Boc-glycine conjugated PPI dendrimer (TPPI) and mannose conjugated dendrimers were synthesized and characterized. While the haemolytic activity and cytotoxicity of PPI dendrimer was found to be very high, the toxicity of t-Boc-glycine conjugated dendrimer and mannose conjugated dendrimers were found to be negligible. The entrapment efficiency of mannose conjugated dendrimer was found to be 47.4%, followed by that of PPI dendrimer (32.15%) and t-Boc-glycine conjugated dendrimer (23.1%). The in vitro drug release profile shows that while PPI dendrimer releases the drug by 24 h, the dendrimer-based nanocontainers prolong the release rate up to 144 h (83 +/- 0.4% in case of t-Boc-glycine conjugated dendrimer and 91 +/- 0.3% in mannose conjugated dendrimer). The cellular uptake of EFV was found to be both concentration and time dependent. Significant increase in cellular uptake of EFV by Mo/Mac cells were observed in case of mannose conjugated dendrimer which is 12 times higher than that of free drug and 5.5 times higher than that of t-Boc-glycine conjugated dendrimer. While mannose conjugated dendrimer was taken up by the lectin receptors of the cells, phagocytosis of t-Boc-glycine conjugated dendrimer might be responsible for its enhanced uptake. Results suggest that the proposed carriers hold potential to increase the efficacy and reduce the toxicity of antiretroviral therapy.
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Affiliation(s)
- Tathagata Dutta
- Department of Pharmaceutical Sciences, Dr H.S. Gour University, Sagar, MP 470 003, India.
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19
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Dutta T, Garg M, Jain NK. Targeting of efavirenz loaded tuftsin conjugated poly(propyleneimine) dendrimers to HIV infected macrophages in vitro. Eur J Pharm Sci 2008; 34:181-9. [DOI: 10.1016/j.ejps.2008.04.002] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Revised: 03/10/2008] [Accepted: 04/10/2008] [Indexed: 11/30/2022]
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20
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Liu P, Foster G, LaBadie RR, Gutierrez MJ, Sharma A. Pharmacokinetic interaction between voriconazole and efavirenz at steady state in healthy male subjects. J Clin Pharmacol 2007; 48:73-84. [PMID: 18025525 DOI: 10.1177/0091270007309703] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A randomized, placebo-controlled (with respect to voriconazole), 2-period, multiple-dose intragroup fixed-dose sequence study was conducted in 34 healthy male subjects to evaluate the interactions between voriconazole (triazole antifungal agent) and efavirenz (reverse transcriptase inhibitor). In period 1, subjects received 200 mg twice-daily (bid) voriconazole (n = 17) or placebo (n = 17) for 3 days (400-mg bid loading doses on day 1). In period 2, following a 7-day washout, subjects received 400 mg once-daily (qd) efavirenz alone for 10 days (days 11-20). Then efavirenz was coadministered with 200 mg bid voriconazole or placebo for the next 9 days (days 21-29). Serial plasma voriconazole and efavirenz concentrations were measured on days 3, 19, and 29, and the safety data were collected throughout the study. The 400-mg qd efavirenz dose substantially reduced the steady-state mean voriconazole area under the curve over the dosing interval (AUC0-12) by 80% (90% confidence interval [CI], 75%-84%) and peak concentration (Cmax) by 66% (90% CI, 57%-73%). The decrease in voriconazole exposure during coadministration is probably mainly due to the induction of CYP2C19 and CYP2C9 by efavirenz. The 200 mg bid voriconazole increased the steady-state mean AUC0-24 and Cmax of efavirenz by 43% (90% CI, 36%-51%) and 37% (90% CI, 29%-46%), respectively. The increase in efavirenz exposure during coadministration is probably due to the inhibition of CYP3A4 by voriconazole. Coadministration of 200 mg bid voriconazole with 400 mg (or higher) qd efavirenz is contraindicated due to the clinically significant effect of efavirenz on voriconazole pharmacokinetics.
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Affiliation(s)
- Ping Liu
- Department of Clinical Pharmacology, Pfizer Global Research and Development, 50 Pequot Avenue, MS6025-A3232, New London, CT 06320, USA.
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21
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Dogan-Topal B, Ozkan SA, Uslu B. Simultaneous Determination of Abacavir, Efavirenz and Valganciclovir in Human Serum Samples by Isocratic HPLC-DAD Detection. Chromatographia 2007. [DOI: 10.1365/s10337-007-0302-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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22
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Moltó J, Blanco A, Miranda C, Miranda J, Puig J, Valle M, DelaVarga M, Fumaz CR, Barbanoj MJ, Clotet B. Variability in non-nucleoside reverse transcriptase and protease inhibitor concentrations among HIV-infected adults in routine clinical practice. Br J Clin Pharmacol 2007; 62:560-6. [PMID: 17061963 PMCID: PMC1885171 DOI: 10.1111/j.1365-2125.2006.02694.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIMS The objective of this study was to assess interindividual variability in trough concentrations of plasma of non-nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors (PI) among HIV-infected adults in a routine outpatient setting. METHODS One hundred and seventeen patients who attended our clinic for routine blood tests, and who were receiving antiretroviral therapy which included NNRTI or PI were studied. Patients were not informed that drug concentrations were going to be measured until blood sampling. The times of the last antiretroviral dose and of blood sampling were recorded. Drug concentrations were considered optimal if they were above the proposed minimum effective value. In addition, efavirenz, nevirapine and atazanavir concentrations were considered potentially toxic if they were > 4.0 mg l(-1), > 6.0 mg l(-1) and > 0.85 mg l(-1), respectively. RESULTS Overall, interindividual variability of NNRTI and PI concentrations in plasma was approximately 50%, and only 68.4% of the patients had drug concentrations within the proposed therapeutic range. Poor adherence explained only 35% of subtherapeutic drug concentrations. CONCLUSION Interindividual variability in trough concentrations of NNRTI and PI among HIV-infected adults is large in routine clinical practice, with drug concentrations being outside the therapeutic window in a significant proportion of patients. These findings provide further evidence that therapeutic drug monitoring may be useful to guide antiretroviral therapy in clinical practice.
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Affiliation(s)
- José Moltó
- Lluita Contra la SIDA Foundation, Badalona, Barcelona, Spain.
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23
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Moltó J, Blanco A, Miranda C, Miranda J, Puig J, Valle M, Delavarga M, Fumaz CR, Barbanoj MJ, Clotet B. Variability in non-nucleoside reverse transcriptase and protease inhibitors concentrations among HIV-infected adults in routine clinical practice. Br J Clin Pharmacol 2007; 63:715-21. [PMID: 17223856 PMCID: PMC2000601 DOI: 10.1111/j.1365-2125.2006.02834.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIMS The objective of this study was to assess interindividual variability in plasma trough concentrations of non-nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors (PI) among HIV-infected adults in an outpatient routine clinical practice setting. METHODS The study included 117 patients who attended our clinic for routine outpatient blood tests and who were receiving antiretroviral therapy which included NNRTI or PI. Patients were not informed that drug concentrations were going to be assessed until blood sampling. The time of the last antiretroviral treatment intake and blood sampling were recorded. Drug concentrations were considered optimal if they were above the proposed minimum effective concentration. In addition, efavirenz, nevirapine and atazanavir concentrations were considered potentially toxic if they were higher than 4.0 mg l(-1), 6.0 mg l(-1), and 0.85 mg l(-1), respectively. RESULTS Overall, interindividual variability in NNRTI and PI plasma concentrations was approximately 50%, and only 68.4% of the patients had drug concentrations within the proposed therapeutic range. Inappropriate adherence only explained 35% of subtherapeutic drug concentrations. CONCLUSION Interindividual variability in trough concentrations of NNRTI and PI among HIV-infected adults is large in routine clinical practice, with drug concentrations being outside the therapeutic window in a significant proportion of patients. Therapeutic drug monitoring may be useful to guide antiretroviral therapy in clinical practice.
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Affiliation(s)
- José Moltó
- 'Lluita contra la SIDA' Foundation, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain.
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24
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Ramachandran G, Kumar AKH, Swaminathan S, Venkatesan P, Kumaraswami V, Greenblatt DJ. Simple and rapid liquid chromatography method for determination of efavirenz in plasma. J Chromatogr B Analyt Technol Biomed Life Sci 2006; 835:131-5. [PMID: 16574512 DOI: 10.1016/j.jchromb.2006.03.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2005] [Revised: 01/23/2006] [Accepted: 03/05/2006] [Indexed: 11/30/2022]
Abstract
A simple and rapid high performance liquid chromatographic method for determination of efavirenz in human plasma was developed. The method involved extraction of sample with ethyl acetate and analysis using a reversed-phase C(18) column (150 mm) with UV detection. The assay was linear from 0.0625 to 10.0 microg/ml. The method was specific for efavirenz estimation and the drug was stable in plasma up to one month at -20 degrees C. The average recovery of efavirenz from plasma was 101%. Due to its simplicity, the assay can be used for pharmacokinetic studies and therapeutic drug monitoring of efavirenz.
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Affiliation(s)
- Geetha Ramachandran
- Tuberculosis Research Centre, Indian Council of Medical Research, Chetput, Chennai, India
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25
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López-Cortés LF, Ruiz-Valderas R, Viciana P, Alarcón-González A, Gómez-Mateos J, León-Jimenez E, Sarasanacenta M, López-Pua Y, Pachón J. Pharmacokinetic interactions between efavirenz and rifampicin in HIV-infected patients with tuberculosis. Clin Pharmacokinet 2002; 41:681-90. [PMID: 12126459 DOI: 10.2165/00003088-200241090-00004] [Citation(s) in RCA: 157] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To evaluate the pharmacokinetic interactions between efavirenz and rifampicin (rifampin) in patients with HIV infection and tuberculosis. DESIGN Nonblind, randomised, pharmacokinetic study. PATIENTS 24 patients (21 male, 3 female; mean age 37 years) with HIV infection and tuberculosis. INTERVENTIONS Patients were randomised to one of the following treatments: group A (n = 16) received antituberculosis drugs without rifampicin, plus highly active antiretroviral therapy (HAART) including efavirenz 600 mg once daily, on days 1 to 7. Patients were then switched to rifampicin in bodyweight-adjusted fixed-dose combination plus HAART including efavirenz 600 mg once daily (group A-1; n = 8) or efavirenz 800 mg once daily (group A-2; n = 8). Group B (n = 8) received rifampicin in bodyweight-adjusted fixed-dose combination on days 1 to 7; on day 8, HAART including efavirenz 800 mg once daily was added. Blood samples were obtained on days 7 and 14. METHODS Plasma concentrations of efavirenz and rifampicin were quantified by using validated high performance liquid chromatography assays, and pharmacokinetic parameter values were determined by noncompartmental methods. The differences between pharmacokinetic parameters on days 7 and 14 were used to assess interactions. RESULTS There was a correlation between the pharmacokinetic parameters of efavirenz and the dose/kg administered. For efavirenz, mean (median) peak concentration, trough concentration and area under the concentration-time curve over the administration interval decreased 24% (24%), 25% (18%) and 22% (10%), respectively, in the presence of rifampicin. Large interpatient variability was observed, suggesting that plasma concentration monitoring of efavirenz may be advisable. Overall, the pharmacokinetics of efavirenz 800 mg plus rifampicin were similar to those of efavirenz 600 mg without rifampicin. The pharmacokinetics of rifampicin did not change substantially in the presence of efavirenz. Differences in patients' bodyweight appeared to cause further differences in exposure to efavirenz. Plasma concentrations of efavirenz in patients weighing <50 kg were similar to those previously described in HIV-infected patients without concomitant tuberculosis. However, plasma concentrations in patients weighing >or=50 kg were almost halved compared with those in patients weighing <50 kg. CONCLUSIONS Although the minimal effective efavirenz plasma concentration that assures virological success is not currently known, it may be advisable to increase the dosage of efavirenz to 800 mg once daily when it is coadministered with rifampicin. Rifampicin can be used with efavirenz without dosage modification.
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Affiliation(s)
- Luis F López-Cortés
- Infectious Diseases Service, University Hospital Virgen del Rocío, Seville, Spain.
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Rezk NL, Tidwell RR, Kashuba ADM. Simple and rapid quantification of the non-nucleoside reverse transcriptase inhibitors nevirapine, delavirdine, and efavirenz in human blood plasma using high-performance liquid chromatography with ultraviolet absorbance detection. J Chromatogr B Analyt Technol Biomed Life Sci 2002; 774:79-88. [PMID: 12052725 DOI: 10.1016/s1570-0232(02)00210-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A simple reversed-phase high-performance liquid chromatography assay for the simultaneous quantitative determination of three HIV non-nucleoside reverse transcriptase inhibitors (nevirapine, delavirdine, and efavirenz) in human blood plasma is described. The method was validated over the range of 10 ng/ml to 50 microg/ml for nevirapine, 25 ng/ml to 25 microg/ml for delavirdine, and 10 ng/ml to 10 microg/ml for efavirenz. The method is accurate (average accuracies over eight concentrations ranging from 87.3 to 113%), and precise (within-day and between-day precision measures ranging from 0.12 to 7.9% and 0.26 to 5.9%, respectively). All three non-nucleoside reverse transcriptase inhibitors proved to be stable under various conditions. Due to its simplicity, this assay can readily be used for investigational or clinical monitoring of plasma concentrations.
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Affiliation(s)
- Naser L Rezk
- Pharmacology Core, Center for AIDS Research, 808 Brinkhouse-Bullitt, CB #7525, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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