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Interaction Checker
Potential Interaction
Nevirapine (NVP)
Amodiaquine
Quality of Evidence: Low
Summary:
Amodiaquine is metabolised mainly by CYP2C8 to N-desethylamodiaquine, an active metabolite but less potent than the parent compound. Coadministration of nevirapine (200 mg twice daily with zidovudine/lamivudine) and amodiaquine (600 once daily with artesunate) decreased the AUCs of amodiaquine and desethylamodiaquine by 29% and 33%, respectively. This may negatively impact the effectiveness of artesunate/amodiaquine in patients receiving nevirapine. The mechanism for this interaction is unclear as nevirapine is not thought to inhibit CYP2C8 in the range of clinical concentrations. In addition, coadministration of these drugs may increase the risk of hepatotoxicity through additive toxicity. Careful clinical monitoring for efficacy and toxicity is recommended.
Description:
The effect of nevirapine (200 mg twice daily with zidovudine/lamivudine) on the pharmacokinetics of amodiaquine (600 mg once daily, administered with artesunate 200 mg once daily) were determined in two groups of HIV+ subjects (NVP n=10; control n=11). Exposures to both amodiaquine and its active metabolite desethylamodiaquine were significantly lower in the nevirapine group with AUCs of amodiaquine and its active metabolite decreasing by 29% and 33%. The mechanism for this interaction is unclear. Lower exposures may negatively impact the effectiveness of amodiaquine/artesunate in patients receiving nevirapine.
Disposition of amodiaquine and desethylamodiaquine in HIV-infected Nigerian subjects on nevirapine-containing antiretroviral therapy. Scarsi KK, Fehintola FA, Ma Q, et al. J Antimicrob Chemother. 2014, 69(5): 1370-6.
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