A snapshot into lumefantrine pharmacokinetics in healthy adults recruited for drug-drug interactions between ciprofloxacin and lumefantrine

Considering the geographical overlap of bacterial and malaria infection, artemether/lumefantrine and ciprofloxacin may be administered together for the treatment of malaria-typhoid co-infection. Ciprofloxacin is known to upset the degree of activities of some drug-metabolizing enzymes in an inhibitory manner, thus capable of perpetrating drug-drug interaction. This study aims to assess the disposition of lumefantrine and the extent of pharmacokinetic interactions between lumefantrine and Ciprofloxacin. Participants in a two-phase parallel pharmacokinetic study were given 80/480 mg tablets of artemether-lumefantrine, and blood samples were taken for preliminary pharmacokinetics analysis. After a washout period of 28 days, the participants were grouped into AL and AL-CIP groups. The AL group received six standard doses of AL twelve hourly for three days, while the AL-CIP group proceeded with 500 mg ciprofloxacin for three days before commencing standard doses of AL. The blood samples were collected at predetermined sampling points. The plasma concentration of lumefantrine was measured by a validated bioanalytical assay, and pharmacokinetic analysis was conducted using WinNonlin® pharmacokinetic software. The mean maximum plasma concentration (Cmax) of lumefantrine was 3032 μg/ml (142 to 6776 μg/ml range). Time for lumefantrine to reach Cmax (tmax) was on average 6 hrs followed by a slow clearance of 5 L/h. Total Area Under Concentration AUC0–∞ was 111945.9 μgh/L. The results are preliminary; they demonstrate that the pharmacokinetics of lumefantrine are consistent with those described in previously reported studies.