Date of report 16 May 2019
Reported case interaction between
Darunavir and Tejocote root (Crataegus mexicana or Crataegus pubescens)
Darunavir and Tejocote root (Crataegus mexicana or Crataegus pubescens)
Drugs suspected to be involved in the DDI
Complete list of drugs taken by the patient
Tejocote root (Crataegus mexicana or Crataegus pubescens), Diclofenac
Clinical case description
Patient taking Tejocote root (Crataegus mexicana or Crataegus pubescens) to loose weight. Cratageus mexicana can inhibit UGT, increasing concentrations of drugs metabolized through this pathway. It may also induce CYP3A4, potentially decreasing concentrations of drugs metabolized trough this pathway. Furthermore, it has alcaloids with similar structure to digoxin, so it could interfere in its pharmacodynamic action (Source: Memorial Sloan Kettering Cancer Center database) The patient had detectable viral load, but without selecting resistance mutations. This could be due to irregular adherence and/or to the high genetic barrier of both drugs in the regimen.
Clinical Outcome
Drug Interaction Probability Scale (DIPS)
Editorial Comment
Cratageus mexicana can inhibit UGT, increasing concentrations of drugs metabolized through this pathway. It may also induce CYP3A4, potentially decreasing concentrations of drugs metabolized trough this pathway. Furthermore, it has alcaloids with similar structure to digoxin, so it could interfere in its pharmacodynamic action (Source: Memorial Sloan Kettering Cancer Center database)