Alterations in Pharmacokinetics of Orally Administered Carbamazepine in Rats Treated with Sodium alginate: Possible Interaction between Therapeutic Drugs and Semi-solid Enteral Nutrients

Nagai, Katsutoshi; Omotani, Sachiko; Ito, Akihiko; Nishimura, Ikumi; Hatsuda, Yasutoshi; Mukai, Junji; Teramachi, Hitomi; Myotoku, Michiaki

doi:10.1055/a-0662-5701

Cited by 5 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We previously reported that CBZ was adsorbed by guar gum and xanthan gum in solution, which reflected gastric juice and fluid in the intestinal tract, and this may be responsible for the alterations observed in the pharmacokinetic profile of CBZ 7. Our previous findings also demonstrated the adsorption of CBZ onto sodium alginate in solution, which reflected fluid in the intestinal tract, resulting in reductions in the serum levels of CBZ following its oral administration 8. Furthermore, SA was found to gel in the stomach when ingested 10.…”

Section: Discussionmentioning

confidence: 71%

“…However, dietary fibers used for the semi-solidification of enteral nutrients have been shown to interact with clinical drugs 6. We also previously demonstrated that the pharmacokinetic behavior of carbamazepine (CBZ), a tricyclic anticonvulsant, after its oral administration was affected by concurrent treatments with these fibers in rats 7,8. Therefore, we hypothesized that a pharmacokinetic interaction may occur between CBZ and semi-solid enteral nutrients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of semi-solidification of enteral nutrients on the pharmacokinetic behavior of orally administered carbamazepine in rats

et al. 2019

Self Cite

View full text Add to dashboard Cite

The use of semi-solid enteral nutrients plays an extremely important role in accurate nutrition management. In the present study, we compared the pharmacokinetic profile of orally administered carbamazepine (CBZ) in rats treated with liquid RACOL®, semi-solid RACOL®, and HINE E-gel®, which are enteral nutrients marketed in Japan. Since liquid and semi-solid formulations are both marketed in Japan for RACOL®, liquid RACOL® was orally administered to control rats. The serum concentration of CBZ at each sampling point was lower in the semi-solid RACOL®-treated group than in the liquid RACOL®-treated group. No significant differences were observed in the pharmacokinetic behavior of CBZ between the semi-solid RACOL®-treated and HINE E-gel®-treated groups. Regarding pharmacokinetic parameters, the impact of the area under the curve (AUC0→5h) was the liquid RACOL® group > the semi-solid RACOL® group ≈ the HINE E-gel® group. Therefore, we concluded that serum concentrations of CBZ were lower when concurrently treating with semi-solid enteral nutrients than when simultaneously processing liquid enteral nutrients.

show abstract

Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Effects of semi-solidification of enteral nutrients on the pharmacokinetic behavior of orally administered carbamazepine in rats

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our findings indicate that creating a Med Pass-like program that provides EN_M or EN_T to take with NSAIDs could help prevent NSAIDs-induced gastric ulcers and prevent malnutrition from the use of multiple drugs. This Med Pass suggestion could help alleviate malnutrition, but should be implemented with caution because the nutrients could cause drug interactions [26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Study of the Inhibitory Effects of Enteral Nutrition Formula on Indomethacin-Induced Gastric Lesions in Mice

et al. 2019

View full text Add to dashboard Cite

We investigated the effects of enteral nutrition formula on non-steroidal anti-inflammatory drug (NSAID)-induced gastric lesions in mice. Male ICR mice aged 7–9 weeks old were fasted, then orally given either purified water, Mermed® One, or 2-fold diluted Terumeal® 2.0α as enteral nutrition (25 or 50 mL/kg each). Indomethacin (IND) was orally administered at 20 mg/kg after 30 min, and the stomach was removed 6 h later and fixed in formalin. The number and area of lesions in the stomachs of the mice given enteral nutrition showed a significant, dose-dependent decrease compared to the purified water-treated group, and no significant difference was seen between the two enteral nutrition-treated groups. Comparable time courses of plasma IND concentrations suggest that enteral nutrition does not inhibit gastrointestinal absorption of IND. Our findings indicate that administering enteral nutrition could inhibit the onset of NSAID-induced gastric ulcers.

show abstract

“…Clark-Schmidt et al reported that carbamazepine in suspension adsorbs on the NG tube, depending on the dilution method [13]. Furthermore, previous studies have reported that semi-solidified ENs and the fiber used for semi-solidification cause a decrease in the gastrointestinal absorption of CBZ after a single oral administration [14][15][16]. However, liquid ENs are currently the most used formulation; thus, it is essential to clarify the interaction between liquid ENs and CBZ.…”

Section: Introductionmentioning

confidence: 99%

Liquid Enteral Nutrients Alter the Pharmacokinetics of Orally Administered Carbamazepine in Rats

et al. 2022

Self Cite

View full text Add to dashboard Cite

The interaction between enteral nutrients (ENs) and drugs co-administered through a nasogastric (NG) tube reportedly affects the absorption and resultant plasma concentrations of the respective drugs. However, the gastrointestinal absorption of carbamazepine (CBZ), an antiepileptic drug, co-administered with liquid ENs through an NG tube has not been clarified. In this study, we measured the recovery rate (%) of CBZ (Tegretol ® powder) passed through an NG tube when co-administered with distilled water or ENs (F2α ® , Racol ® NF, Ensure Liquid ® , and Renalen ® LP) of different compositions, frequently used in Japan. We also measured the plasma CBZ level in 26 rats after oral co-administration of CBZ with liquid ENs. The CBZ recovery rate was close to 100% in rats of all EN groups after passage through the NG tube. Furthermore, CBZ area under the plasma concentration-time curve from time zero to 9 h (AUC0  9h) of the Ensure liquid ® group decreased compared with that of control group (P < 0.05) and Renalen ® LP group (P < 0.01). However, the AUC0  9h of CBZ remained unchanged when co-administered with Ensure liquid ® 2 h after initial CBZ administration. In conclusion, the co-administration of CBZ with Ensure Liquid ® caused a reduction in the absorption of CBZ from the gastrointestinal tract, without adsorption on the NG tube. The administration of Ensure Liquid ® 2 h after CBZ is a way to prevent a decrease in plasma CBZ concentration. Our findings suggest that carefully monitoring the plasma levels of CBZ is necessary in co-administation with Ensure liquid ® to prevent the unintended effects of the interaction between CBZ and liquid EN.

show abstract

Alterations in Pharmacokinetics of Orally Administered Carbamazepine in Rats Treated with Sodium alginate: Possible Interaction between Therapeutic Drugs and Semi-solid Enteral Nutrients

Abstract: The pharmacological efficacies of CBZ might be reduced by SA through the pharmacokinetic interactions, and that the careful attention should be paid to the timing of administration of CBZ and semi-solid enteral nutrients.

Cited by 5 publications

References 18 publications

Effects of semi-solidification of enteral nutrients on the pharmacokinetic behavior of orally administered carbamazepine in rats

Effects of semi-solidification of enteral nutrients on the pharmacokinetic behavior of orally administered carbamazepine in rats

Study of the Inhibitory Effects of Enteral Nutrition Formula on Indomethacin-Induced Gastric Lesions in Mice

Liquid Enteral Nutrients Alter the Pharmacokinetics of Orally Administered Carbamazepine in Rats

Contact Info

Product

Resources

About