Effect of Ponsinomycin on Single-Dose Kinetics and Metabolism of Carbamazepine

Couet, William; Istin, B.; Ingrand, Isabelle; Girault, J.; Fourtillan, J. B.

doi:10.1097/00007691-199003000-00006

Cited by 23 publications

(6 citation statements)

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“…In an acute study in healthy volunteers (Barzaghi et al, 1988), flurithromycin significantly increased CBZ concentration, although to a lesser extent than did erythromycin. Similar results were obtained for ponsinomycin (miocamycin) in a study in normal subjects (Couet et al, 1990), whereas in a group of epileptic patients a 5-day course of ponsinomycin resulted in a minor increase in CBZ concentrations of no clinical relevance (Zagnoni et al, 1995).…”

Section: Case Refortsupporting

confidence: 61%

“…Some new macrolide antibiotics have been tested for their effect on CBZ kinetics, with variable results (Saint-Salvi et al, 1987;Vincon et al, 1987;Barzaghi et al, 1988;Couet et al, 1990;Zagnoni et al, 1991). Clarithromycin (Klacid, Abbott Laboratories) is a new compound of this class, recently marketed in various countries.…”

mentioning

confidence: 99%

“…Experimental studies and clinical case reports have described a clinically relevant pharmacokinetic interaction between the macrolide antibiotics erythromycin and triacetyloleandomycin and the widely used antiepileptic drug carbamazepine (CBZ) (Barzaghi et al, 1987;Macnab et al, 1987;Zitelli et al, 1987;Miles and Tennison, 1989;Ng et al, 1991). Some new macrolide antibiotics have been tested for their effect on CBZ kinetics, with variable results (Saint-Salvi et al, 1987;Vincon et al, 1987;Barzaghi et al, 1988;Couet et al, 1990;Zagnoni et al, 1991). Clarithromycin (Klacid, Abbott Laboratories) is a new compound of this class, recently marketed in various countries.…”

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confidence: 99%

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Clarithromycin‐Carbamazepine Interaction: A Case Report

1993

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We report a clinically relevant interaction between a new macrolide antibiotic, clarithromycin, and carbamazepine (CBZ). In a patient receiving CBZ monotherapy, 10-day antibiotic treatment increased CBZ concentration despite concomitant CBZ dose reduction and doubled the CBZ concentrationldose ratio. Concentration of the CBZ epoxide (CBZ-E) metabolite was reduced, suggesting that the interaction occurs at a metabolic level.

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Section: Case Refortsupporting

confidence: 61%

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confidence: 99%

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confidence: 99%

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Clarithromycin‐Carbamazepine Interaction: A Case Report

1993

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“…Ponsinomycin, previously named miocamycin, is a new semi-synthetic macrolide. It is extensively metabolized in vivo (Couet et al, 1989a(Couet et al, , 1990aFucaya et al, 1981;Schomura et al, 1981), and while it has no or only minor effect on theophylline disposition (Couet et al, 1989b;Principi et al, 1987), it has been shown to alter the kinetics of carbamazepine (Couet et al, 1990b), cyclosporin (Couet et al, 1990c) and dihydroergotamine (Couet et al, 1990d). Limited observations suggested that macrolides may interfere with the pharmacokinetics of oral anticoagulants (Ludden, 1985), and administration of macrolides to patients treated with oral anticoagulants is currently considered to be potentially hazardous.…”

Section: Introduction Methodsmentioning

confidence: 99%

Lack of effect of ponsinomycin on the pharmacokinetics of nicoumalone enantiomers.

Couet

Istin

Decourt

et al. 1990

Brit J Clinical Pharma

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Pharmacokinetic interaction between ponsinomycin‐nicoumalone was studied in six subjects who received an 8 mg oral dose of racemic nicoumalone alone and 4 days into an oral regimen of ponsinomycin 800 mg twice daily. The concentrations of R(+) and S(‐)‐nicoumalone in plasma were measured using a stereospecific h.p.l.c. assay. The disposition characteristics of nicoumalone enantiomers in the control phase of this study were similar to those reported previously with the exception of the data for one subject whose oral clearance for S(‐)‐ nicoumalone was seven times lower than those in the other subjects. A statistically significant effect of ponsinomycin on the kinetics of R(+) and S(‐)‐nicoumalone was not demonstrated.

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“…Ponsinomycin is the 9,3'-diacetylmidecamycin ; it interferes with carbamazepine distribution (Couet et al, 1990), but it.demonstrated no effect on the plasma pharmacokinetics of theophylline (Principi et al, 1987;Couet et al, 1989). The effect of ponsinomycin on DHE pharmacokinetics is now being investigated following single oral administration of this ergot alkaloid in young healthy volunteers.…”

Section: Introductionmentioning

confidence: 99%

Effect of ponsinomycin on the pharmacokinetics of dihydroergotamine administered orally

Couet

Mathieu²,

Fourtillan

1991

Fundamemntal Clinical Pharma

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Ponsinomycin is a new macrolide antibiotic. Its effect on DHE pharmacokinetics was investigated in this study. Twelve young healthy volunteers received a single 9 mg oral dose of DHE before and on the 8th day of treatment (800 mg twice daily) with ponsinomycin. DHE was assayed in plasma by RIA. Because of low plasma levels, only peak concentrations could be accurately compared for a ponsinomycin effect. We observed a 3-40-fold increase in maximum DHE plasma levels in the majority of cases and a much more important effect on one occasion, when DHE was administered in the presence of ponsinomycin. These data are consistent with an increase of DHE bioavailability in the presence of ponsinomycin, probably related to a reduction of its first-pass elimination. This pharmacokinetic interaction is likely to have clinical consequences and administration of ponsinomycin should be avoided in patients treated orally with DHE.

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Effect of Ponsinomycin on Single-Dose Kinetics and Metabolism of Carbamazepine

Cited by 23 publications

References 0 publications

Clarithromycin‐Carbamazepine Interaction: A Case Report

Clarithromycin‐Carbamazepine Interaction: A Case Report

Lack of effect of ponsinomycin on the pharmacokinetics of nicoumalone enantiomers.

Effect of ponsinomycin on the pharmacokinetics of dihydroergotamine administered orally

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