Beneficial Pharmacokinetic Drug Interactions

Edwards, David J.

doi:10.4172/2167-1052.s1-002

Cited by 9 publications

(14 citation statements)

References 52 publications

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“…“take two”) to increase the effectiveness of the method. Although this strategy is one commonly used in pharmacotherapeutics [18], there is currently no evidence to support this approach for obese EC users.…”

Section: Introductionmentioning

confidence: 99%

Impact of obesity on the pharmacokinetics of levonorgestrel-based emergency contraception: single and double dosing

et al. 2016

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Objective To determine if differences exist in the pharmacokinetics (PK) of levonorgestrel-based emergency contraception (LNG-EC) in obese and normal body mass index (BMI) users and test whether doubling the dose of LNG-EC in obese women increases total and free (active) LNG serum concentrations. Study design Healthy, reproductive-age women with obese and normal BMIs received 1.5 mg LNG orally (ECx1) and then in a subsequent menstrual cycle, the obese group also received 3mg LNG (ECx2). Dosing occurred during the follicular phase. Total and free LNG PK parameters were obtained via serum samples through an indwelling catheter at 0, 0.5, 1, 1.5, 2, and 2.5 hours. The primary outcome was the difference in total and free LNG concentration maximum (Cmax) between ECx1 and ECx2 in the obese group. Results A total of 10 women enrolled and completed the study (normal BMI = 5, median 22.8 kg/m2, range 20.8–23.7; obese BMI = 5, 39.5 kg/m2, range 35.9–46.7). The total LNG Cmax for obese subjects following ECx1 (5.57±2.48 ng/mL) was significantly lower than the level observed in normal BMI women (10.30±2.47, p=0.027). Notably, ECx2 increased the Cmax significantly (10.52±2.76, p=0.002); approximating the level in normal BMI subjects receiving ECx1. Free LNG Cmax followed a similar pattern. Conclusion Obesity adversely impacts both the total and free Cmax levels of LNG EC and this likely explains its lack of efficacy in obese women. Doubling the dose appears to correct the obesity-related PK changes but additional research is needed to determine if this also improves EC effectiveness in obese women. Implications This study demonstrates that obesity interferes with the pharmacokinetics of LNG EC, and that doubling the dose may be an effective strategy to improve its efficacy in obese women.

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Section: Introductionmentioning

confidence: 99%

Impact of obesity on the pharmacokinetics of levonorgestrel-based emergency contraception: single and double dosing

et al. 2016

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“…In both groups the blood samples had been collected at the last day of drugs dosing (5 th day). Blood samples (1ml each) were taken from wing vein just after 5,10,15,30 minutes, 1,2,4,6,8,12,24,48,72 and 96 hrs post-drug administrations. Also all blood samples were left to clot for 30 minutes, centrifuged at 3000 r.p.m.…”

Section: Multiple Doses Studiesmentioning

confidence: 99%

Influence of Vitamin E on the Disposition Kinetics of Florfenicol after single and multiple oral administrations in Broiler Chickens

El-Ela¹

2017

Insights Vet Sci

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Investigation the infl uences of vitamin (vit) E over a period of 5 days on the pharmacokinetics of fl orfenicol after single and multiple oral administrations in broiler chickens. Total of 12 broiler chickens had been taken single and multiple oral administrations of fl orfenicol (30 mg/kg) alone or pre-treated with vit E (2 mg/kg). The serum concentrations of fl orfenicol were determined using microbiological assay with Bacillus subtilis (ATCC 25922) as a tested microorganism. The mean serum concentrations of fl orfenicol alone were markedly lower when compared with fl orfenicol pre-treated with vit E after single and multiple dosing. The peak serum concentrations (C max ) were 5.9±0.46, 7.48±0.3 ug/ml, absorption half-life (t 0.5ab ) of 0.51±0.06, 0.71±0.1 h and elimination halflife (t 0.5el ) of 2.72±0.34, 3.34±0.5 after single fl orfenicol alone and fl orfenicol pre-treated with vit E respectively. While, after multiple dosing, (C max ) were 7.4±0.3, 8.04±0.3 ug/ml, (t 0.5ab ) 0.82±0.04, 0.81±0.04 h and (t 0.5 el ) 3.77±0.2, 4.52±0.7 h after multiple dosing of fl orfenicol alone and fl orfenicol pre-treated with vit E respectively. In conclusion Vit E alter the disposition kinetics of fl orfenicol after single and multiple oral administrations as, vit E allows prolongation of the duration of action for more 24 and 48 h of the drug concentration in the serum indicated by prolonged elimination half-lives and MRT refl ecting the importance of this combination for the drug duration in serum but the increase in the serum concentration of fl orfenicol increasing its effi cacy not toxicity as fl orfenicol of wide safety margin so, it's advisable for poultry farms owners to use this combinations.

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“…Many patients are taking food, herbs, supplements and/or over-the-counter health products together with their prescribed medications [ 1 , 2 ]. Concomitant use of these products may lead to food-drug, herb-drug, supplement-drug and/or drug-drug interactions [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Concomitant use of these products may lead to food-drug, herb-drug, supplement-drug and/or drug-drug interactions [ 3 , 4 ]. Although these interactions are usually complicated and unpredictable, it is known that they can indeed influence the pharmacodynamics and/or pharmacokinetics of some co-administered drugs [ 1 , 2 , 3 , 4 , 5 ]. Pharmacodynamic interactions mainly involve diverse reactions at receptor sites resulting in antagonistic or synergistic effects as well as causing changes in physiological environments, while pharmacokinetic interactions affect the absorption, distribution, metabolism and excretion of the co-administered agent (e.g., food component, herb, supplement, health product ingredient) and/or co-administered drug [ 1 , 2 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Beneficial Pharmacokinetic Drug Interactions: A Tool to Improve the Bioavailability of Poorly Permeable Drugs

et al. 2018

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Simultaneous oral intake of herbs, supplements, foods and drugs with other drug(s) may result in pharmacokinetic or pharmacodynamic interactions with the latter. Although these interactions are often associated with unwanted effects such as adverse events or inefficacy, they can also produce effects that are potentially beneficial to the patient. Beneficial pharmacokinetic interactions include the improvement of the bioavailability of a drug (i.e., by enhancing absorption and/or inhibiting metabolism) or prolongation of a drug’s plasma level within its therapeutic window (i.e., by decreasing excretion), whereas beneficial pharmacodynamic interactions include additive or synergistic effects. Mechanisms by which pharmacokinetic interactions can cause beneficial effects include enhancement of membrane permeation (e.g., structural changes in the epithelial cell membranes or opening of tight junctions), modulation of carrier proteins (e.g., inhibition of efflux transporters and stimulation of uptake transporters) and inhibition of metabolic enzymes. In the current review, selected pharmacokinetic interactions between drugs and various compounds from different sources including food, herb, dietary supplements and selected drugs are discussed. These interactions may be exploited in the future to the benefit of the patient, for example, by delivering drugs that are poorly bioavailable in therapeutic levels via alternative routes of administration than parenteral injection.

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Beneficial Pharmacokinetic Drug Interactions

Cited by 9 publications

References 52 publications

Impact of obesity on the pharmacokinetics of levonorgestrel-based emergency contraception: single and double dosing

Impact of obesity on the pharmacokinetics of levonorgestrel-based emergency contraception: single and double dosing

Influence of Vitamin E on the Disposition Kinetics of Florfenicol after single and multiple oral administrations in Broiler Chickens

Beneficial Pharmacokinetic Drug Interactions: A Tool to Improve the Bioavailability of Poorly Permeable Drugs

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