TY - JOUR
T1 - Pharmacokinetic and metabolic effects of American ginseng (Panax quinquefolius) in healthy volunteers receiving the HIV protease inhibitor indinavir
AU - Andrade, Adriana S.A.
AU - Hendrix, Craig
AU - Parsons, Teresa L.
AU - Caballero, Benjamin
AU - Yuan, Chun Su
AU - Flexner, Charles W.
AU - Dobs, Adrian S.
AU - Brown, Todd T.
N1 - Funding Information:
We would like to thank Chryssanthi Stylianopoulos, PhD and Margia Arguello for their technical expertise in measuring glucose during the insulin clamp procedure and Alice Ryan, PhD for her guidance with the insulin clamp procedure. We are thankful to Andrea Weiss for dispensing study drugs and preparation of solutions used in the insulin clamp procedure. Finally, we also would like to acknowledge Dr Angela Kashuba for the analysis of the indinavir assays. Her work is supported by #9P30 AI 50410-04, University of North Carolina at Chapel Hill Center for AIDS Research (CFAR). This work was supported by a National Center for Complementary and Alternative Medicine supplement to the National Cancer Institute Grant # P30CA06973, the National Center for Complementary and Alternative Medicine K23 AT002862-01 (TTB), and the Johns Hopkins University School of Medicine General Clinical Research Grant M01-RR00052 from the National Center for Research Resources/National Institutes of Health.
PY - 2008/8/19
Y1 - 2008/8/19
N2 - Background: Complementary and alternative medicine (CAM) use is prevalent among HIV-infected patients to reduce the toxicity of antiretroviral therapy. Ginseng has been used for treatment of hyperglycemia and insulin resistance, a common side effect of some HIV-1 protease inhibitors (PI). However, it is unknown whether American ginseng (AG) can reverse insulin resistance induced by the PI indinavir (IDV), and whether these two agents interact pharmacologically. We evaluated potential pharmacokinetic interactions between IDV and AG, and assessed whether AG improves IDV-induced insulin resistance. Methods: After baseline assessment of insulin sensitivity using the insulin clamp technique, healthy volunteers received IDV 800 mg q8 h for 3 days and then IDV and AG 1g q8h for 14 days. IDV pharmacokinetics and insulin sensitivity were assessed before and after AG co-administration. Results: There was no difference in the area-under the plasma-concentration-time curve after the co-administration of AG, compared to IDV alone (n = 13). Although insulin-stimulated glucose disposal per unit of insulin (M/I) decreased by an average of 14.8 ± 5.9% after 3 days of IDV (from 0.113 ± 0.012 to 0.096 ± 0.014 mg/kgFFM/min per μU/ml of insulin, p = 0.03, n = 11), M/I remained unchanged after co-administration of IDV and AG. Conclusion: IDV decreases insulin sensitivity, which is unaltered by AG co-administration. AG does not significantly affect IDV pharmacokinetics.
AB - Background: Complementary and alternative medicine (CAM) use is prevalent among HIV-infected patients to reduce the toxicity of antiretroviral therapy. Ginseng has been used for treatment of hyperglycemia and insulin resistance, a common side effect of some HIV-1 protease inhibitors (PI). However, it is unknown whether American ginseng (AG) can reverse insulin resistance induced by the PI indinavir (IDV), and whether these two agents interact pharmacologically. We evaluated potential pharmacokinetic interactions between IDV and AG, and assessed whether AG improves IDV-induced insulin resistance. Methods: After baseline assessment of insulin sensitivity using the insulin clamp technique, healthy volunteers received IDV 800 mg q8 h for 3 days and then IDV and AG 1g q8h for 14 days. IDV pharmacokinetics and insulin sensitivity were assessed before and after AG co-administration. Results: There was no difference in the area-under the plasma-concentration-time curve after the co-administration of AG, compared to IDV alone (n = 13). Although insulin-stimulated glucose disposal per unit of insulin (M/I) decreased by an average of 14.8 ± 5.9% after 3 days of IDV (from 0.113 ± 0.012 to 0.096 ± 0.014 mg/kgFFM/min per μU/ml of insulin, p = 0.03, n = 11), M/I remained unchanged after co-administration of IDV and AG. Conclusion: IDV decreases insulin sensitivity, which is unaltered by AG co-administration. AG does not significantly affect IDV pharmacokinetics.
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U2 - 10.1186/1472-6882-8-50
DO - 10.1186/1472-6882-8-50
M3 - Article
C2 - 18713456
AN - SCOPUS:52449087498
SN - 1472-6882
VL - 8
JO - BMC Complementary and Alternative Medicine
JF - BMC Complementary and Alternative Medicine
M1 - 50
ER -