- Natural product: Cannabis (Cannabis sativa)
- Associated study: The effects of cannabinoids on the pharmacokinetics of indinavir and nelfinavir
In Vivo Interaction Study
IDV+THC PK at Baseline and Day 14
No Effect (based on bioequivalence limits) was detected.
IDV = indiavir
THC = delta-9-THC
Baseline = control
Day 14 = test
Results
Table 2. Cmax % Change reported as -14.1 (-58 to 7), p = 0.039; AUC0-8 % change reported as -14 (-66 to 44)
Despite a statistically significant decrease in Cmax of IDV in the marijuana arm, the magnitude of changes in IDV and NFV pharmacokinetic parameters in the marijuana arm are likely to have no short-term clinical consequence. The use of marijuana or dronabinol is unlikely to impact antiretroviral efficacy.
| Sample | Compound measured | Value | Measurement | Study sequence | Additional information | N replicates |
|---|
Experimental Conditions
Inclusion criteria: at least 18 years old, have documented HIV infection, and be on a stable antire- troviral treatment regimen that included either IDV or NFV as the sole PI in addition to nucleoside and/or non-nucleoside reverse transcriptase inhibitors, for at least 8 weeks prior to enrollment. Subjects were also required to have a stable viral load, de®ned as less than a threefold change in HIV RNA level for the 16 weeks prior to enrollment. All subjects were required to have prior experience smoking marijuana (defined as six or more times) to ensure that they knew how to inhale and what neuropsychiatric effects to expect.
Exclusion criteria included the following: any active opportunistic infection or malignancy requiring acute treatment; unintentional loss of ≥10 percent of body weight during the past 6 months; current substance dependence; methadone maintenance; use of tobacco or cannabinoids (smoked or oral) within 30 days of enrollment; history of serious pulmonary disease; pregnancy; and Stage II or higher AIDS dementia complex. Laboratory exclusion criteria were hematocrit < 25% and hepatic transaminase elevations to greater than five times the upper limit of normal.
Parallel
Placebo-controlled
Females
Males
No marijuana use
Black or African American
More than one race
White
28
Patient demographics reported include subjects not taking IDV.
Nine subjects' ethnicity is reported as "mixed/other" and is not further specified.
Age (years):
- < 40: 18 (29%)
- 40 - 49: 33 (53%)
- ≥ 50: 11 (18%)
Baseline and day 14: 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8 hr post-dose
Empty stomach
Day 14: just prior the second marijuana cigarette; 2, 60 min, 6 hr after smoking
Drug or Natural Product Administration
Oral
Capsule (not specified)
2400 mg
800 mg TID
25 days
Inhalation
Cigarette
Up to 3 cigarettes containing 3.95% delta-9-THC
Up to three times, as tolerated, 1 hr prior to meals
21 days
The National Institute on Drug Abuse
Not specified