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We have no conflicts of interest that are directly relevant to the context of this study. This study was funded by a grant from the Spanish Health Department (Ministerio de Sanidad, Politica Social e Igualdad; EC10-093) and by the Lluita contra la SIDA Foundation, Gala contra la SIDA, Barcelona, 2011. M. V. is supported by FIS through grant CP04/00121 from the Spanish Health Department in collaboration with Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, and she is a member of CIBERSAM (a research network funded by the Spanish Health Ministry, Instituto de Salud Carlos III).

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Article

Herb-Drug Interaction between Echinacea purpurea and Etravirine in HIV-Infected Patients

Publicated to:Antimicrobial Agents And Chemotherapy. 56 (10): 5328-5331 - 2012-10-01 56(10), DOI: 10.1128/AAC.01205-12

Authors: Molto, Jose; Valle, Marta; Miranda, Cristina; Cedeno, Samandhy; Negredo, Eugenia; Clotet, Bonaventura

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Abstract

The aim of this open-label, fixed-sequence study was to investigate the potential of the botanical supplement Echinacea purpurea to interact with etravirine, a nonnucleoside reverse transcriptase inhibitor of HIV. Fifteen HIV-infected patients receiving antiretroviral therapy with etravirine (400 mg once daily) for at least 4 weeks were included. E. purpurea root/extract-containing capsules were added to the antiretroviral treatment (500 mg every 8 h) for 14 days. Etravirine concentrations in plasma were determined by high-performance liquid chromatography immediately before and 1, 2, 4, 6, 8, 10, 12, and 24 h after a morning dose of etravirine on day 0 and etravirine plus E. purpurea on day 14. Individual etravirine pharmacokinetic parameters were calculated by noncompartmental analysis and compared between days 0 and 14 by means of the geometric mean ratio (GMR) and its 90% confidence interval (CI). The median age was 46 years (interquartile range, 41 to 50), and the median body weight was 76 kg (interquartile range, 68 to 92). Echinacea was well tolerated, and all participants completed the study. The GMR for etravirine coadministered with E. purpurea relative to etravirine alone was 1.07 (90% CI, 0.81 to 1.42) for the maximum concentration, 1.04 (90% CI, 0.79 to 1.38) for the area under the concentration-time curve from 0 to 24 h, and 1.04 (90% CI, 0.74 to 1.44) for the concentration at the end of the dosing interval. In conclusion, the coadministration of E. purpurea with etravirine was safe and well tolerated in HIV-infected patients; our data suggest that no dose adjustment for etravirine is necessary.

Keywords

ComplementaryEfavirenMedicines

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Antimicrobial Agents And Chemotherapy due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2012, it was in position 31/261, thus managing to position itself as a Q1 (Primer Cuartil), in the category Pharmacology & Pharmacy.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 2.44, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-02, the following number of citations:

  • WoS: 16
  • Scopus: 24
  • OpenCitations: 23

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-02:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 50.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 50 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 3.
  • The number of mentions on the social network X (formerly Twitter): 6 (Altmetric).