{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:14:09Z","timestamp":1791976449402,"version":"4.4.0"},"reference-count":52,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,12,9]]},"abstract":"<jats:p>This study aimed to investigate the pharmacokinetic interactions between quinine and lopinavir boosted with ritonavir (LPV\/r) in healthy Thai adults (8 males and 12 females). Period 1 (day 1): subjects received a single oral dose of 600 mg quinine sulfate. Period 2: subjects received LPV\/r (400\/100 mg) twice daily. Period 3: subjects received a single quinine sulfate dose plus LPV\/r twice a day. Intensive blood sampling was performed during each phase. Quinine AUC<jats:sub>0\u201348h<\/jats:sub> (area under the plasma concentration\u2013time curve from time 0 to 48 hours), AUC<jats:sub>0\u2013\u221e<\/jats:sub> (area under the plasma concentration\u2013time curve from time 0 to infinity), and <jats:italic>C<\/jats:italic><jats:sub>max<\/jats:sub> (maximum concentration over the time-span specified), were 56%, 57%, and 47% lower, respectively, in the presence of LPV\/r. 3-Hydroxyquinine AUC<jats:sub>0\u201348h<\/jats:sub>, AUC<jats:sub>0\u2013\u221e<\/jats:sub>, and <jats:italic>C<\/jats:italic><jats:sub>max<\/jats:sub> were significantly lower and the metabolite-to-parent ratio was significantly reduced. Lopinavir and ritonavir exposures were not significantly reduced with quinine coadministration, but <jats:italic>C<\/jats:italic><jats:sub>max<\/jats:sub> of both drugs were significantly lower. The geometric mean ratio (GMR) and 90% CI of AUC<jats:sub>0\u201348h<\/jats:sub>, AUC<jats:sub>0\u2013\u221e<\/jats:sub>, and <jats:italic>C<\/jats:italic><jats:sub>max<\/jats:sub> for quinine, 3-hydroxyquinine, lopinavir, and ritonavir lay outside the bioequivalent range of 0.8\u20131.25. Drug treatments during all periods were generally well tolerated. The reduction in systemic exposure of quinine and 3-hydroxyquinine with concomitant LPV\/r use raises concerns of suboptimal exposure. Studies in HIV\/malaria coinfection patients are needed to determine the clinical impact to decide if any change to the quinine dose is warranted.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0453","type":"journal-article","created":{"date-parts":[[2015,9,29]],"date-time":"2015-09-29T02:38:05Z","timestamp":1443494285000},"page":"1383-1390","source":"Crossref","is-referenced-by-count":9,"title":["Pharmacokinetic Interactions Between Quinine and Lopinavir\/Ritonavir in Healthy Thai Adults"],"prefix":"10.4269","volume":"93","author":[{"given":"Siwalee","family":"Rattanapunya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim R.","family":"Cressey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronnatrai","family":"Rueangweerayut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yardpiroon","family":"Tawon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panida","family":"Kongjam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kesara","family":"Na-Bangchang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"The Top 10 Causes of Death","author":"World Health Organization","year":"2015"},{"key":"ref2","series-title":"Malaria and HIV Interactions and Their Implications for Public Health Policy","author":"World Health Organization","year":"2004"},{"key":"ref3","series-title":"J Infect 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