Pharmacokinetic Characterization of Piperaquine in Nigerian Healthy Volunteers after Co-administration with a Commercial Brand of Moringa Tea

This 2-phase cross-over drug–herb interaction study investigated the effect of co-administration of tea prepared from the commercial product of Moringa oleifera on the pharmacokinetic parameters of piperaquine. Fourteen healthy subjects were recruited for this study, but ten subjects (age range, 22–30 years) completed the study. Blood samples were collected from the subjects at the Obafemi Awolowo University (Ile Ife, Nigeria) and the bio-analysis took place in the Therapeutic Drug Monitoring Laboratory (TDM) of Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Nigeria, between January 2016 and October 2016. In the first phase of the study, each of the subjects received three tablets of Dihydroartemisin- Piperaquine (DHA/PQ) combination (artelad® containing DHA/PQP, 40/320 mg). After a washout period of three months, each of the subjects received 25g freshly prepared Moringa tea twice daily for 5 days and on the sixth day, received Moringa tea concurrently with three tablets of DHA/PQ combination. The plasma concentrations of PQ were determined using a validated HPLC method. The results showed a 23.8% significant decrease (P=0. 01) in the Cmax of PQ and a 5.8% decrease in the AUC after co-administration with Moringa Tea. The Tmax also increased by 61%, while the half-life increased by 12.2%. There was no difference in the clearance and C28. The geometric mean ratio showed that there is no significant difference in the disposition of PQ with Moringa Tea. The study showed wide variability in PQ pharmacokinetics following a single oral dose. The effects of concurrent administration of Moringa oleifera tea did not significantly influence the PQ plasma exposure but delayed its absorption.