Moringa oleifera leaf powder alters the pharmacokinetics of amodiaquine in healthy human volunteers

Summary What is known and objective Moringa oleifera ( MO ) Lam (Moringaceae) is commonly used as food supplement and as medicine in most African countries where malaria is also endemic. Therefore, co‐administration of MO with antimalarials is a possibility. This study investigated the effects of MO leaves powder on the pharmacokinetics of amodiaquine ( AQ ) in human subjects. Methods Twenty healthy volunteers were recruited for the 3‐period study. In the first period, a single dose of AQ tablet (10 mg/kg) was administered orally after an overnight fast. After a 7‐day washout period, AQ was co‐administered with MO . For the third period, each subject took 3 g MO once daily for 7 days and on the 8th day, MO was co‐administered with AQ . The plasma concentrations of amodiaquine and desethylamodiaquine ( DEAQ ) were simultaneously determined using a validated HPLC method. Results and Discussion The results showed a significant decrease ( P  =   .037) in the Cmax of AQ after concurrent administration ( CA ) with MO , whereas after pretreatment ( PT ), there was a 32% decrease in the C max of AQ . For the metabolite, DEAQ , C max increased significantly ( P  =   .006) by 79.36%, and Cmax in PT was significantly higher than ( P  =   .001) that of the CA arm of the study. AUC of DEAQ increased significantly by 40.4% ( P  =   .006) and by 188% ( P  =   .001) after CA and PT , respectively. What is new and Conclusion The study established pharmacokinetic interaction between AQ and MO when given together or following a long period of ingestion of MO . This may have clinical implications for malaria therapy.