Development of an evidence evaluation and synthesis system for drug-drug interactions, and its application to a systematic review of HIV and malaria co-infection.

A predicted interaction may have been increased arthemeter exposure resulting from lopinavir/ritonavir inhibition of CYP3A4.[ 29 , 30 ] A crossover study in healthy volunteers observed small decreases in artemether exposure which did not reach statistical significance, and moderate decrease in DHA AUC (↓45%).[ 25 ] The observed increased clearance and decreased artemether exposure is likely due to induction of CYP enzymes by lopinavir/ritonavir whereas a decrease in DHA could result from the induction of glucuronidation by ritonavir.

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