The effect of sex and cardiac failure on the pharmacokinetics of a slow-release theophylline formulation in the elderly

Cuzzolin, Laura; Schinella, Michele; Tellini, U; Pezzoli, Laura; Lippi, U; Benoni, Giuseppina

doi:10.1016/1043-6618(90)90846-6

Cited by 12 publications

(11 citation statements)

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“…Nafziger and Bertino (24) reported that the clearance of theophylline is faster in young women than in young man. As theophylline is metabolised by several pathways (CYP lA2, CYP 3A4, CYP 2D6) it remains to be investigated, in a detailed manner, which of the pathways may be responsible for the gender difference, in as much as in elderly patients no clear gender difference was observed (25). The picture is additionally confused by the finding that the increase of theophylline metabolism by smoking, which particularly influences the activity of CYP lA isozymes, is more pronounced in males than in females (26).…”

Section: Cyp La2mentioning

confidence: 99%

Gender differences in pharmacokinetics

Gundert‐Remy

1996

European Journal of Drug Metabolism and Pharmacokinetics

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There is growing awareness that the underrepresentation of women in clinical trials and in particular in phase I studies may lead to incorrect handling of drugs. Despite the fact that investigations are not informed in a systematic way, there are a number of examples showing pharmacokinetic differences between gender. From the data actually presented, it can be concluded that the activity of CYP 3A4 activity as measured by elimination in vivo is higher in women compared to men. CYP isoenzymes other than CYP 3A4 seem to be more active in men than in woman, as are conjugation reactions, such as glucuronidation. The influence of changing hormonal levels during the lifetime of a woman has been looked at in some drugs but deserves further systematic investigation. The use of oral contraceptives can interfere with the metabolism of many drugs whereas, in pregnancy, the elimination of antiepileptics is increased which, without dose adjustment, leads to an increased number of seizures. The impacts of hormonal replacement therapy (HRT) on the pharmacokinetics of concomitantly given drugs is an important issue, as HRT is increasingly used, but more research is needed in this field.

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Section: Cyp La2mentioning

confidence: 99%

Gender differences in pharmacokinetics

Gundert‐Remy

1996

European Journal of Drug Metabolism and Pharmacokinetics

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“…Two studies also reported a significantly longer (between +84% and +267%) elimination half‐life of the drug in HF . By contrast, the volume of distribution was similar to that of controls . Theophylline undergoes significant metabolism in the liver and only a minimal fraction of the unchanged drug is eliminated in the urine (Table S1).…”

Section: Resultsmentioning

confidence: 95%

“…A total of 59 studies (49 on cardiovascular drugs) investigating 36 drugs (31 cardiovascular) were identified (Tables ). Twelve studies were published in the period 1970–1979 , 20 in the period 1980–1989 , 12 in the period 1990–1999 , 10 in the period 2000–2009 , and five in the period 2010–2018 .…”

Section: Resultsmentioning

confidence: 99%

“…A total of 59 studies (49 on cardiovascular drugs) investigating 36 drugs (31 cardiovascular) were identified (Tables 1-6). Twelve studies were published in the period 1970-1979 [37][38][39][40][41][42][43][44][45][46][47][48], 20 in the period 1980-1989 [49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68], 12 in the period 1990-1999 [69][70][71][72][73][74][75][76][77][78][79][80], 10 in the period 2000-2009 [81][82][83][84][85]…”

Section: Resultsmentioning

confidence: 99%

“…Theophylline, 700 mg, oral [79] HF: n = 11, NYHA II-III, age 77 years, 5M/6FC: n = 15, age 75 years, 8M/7F n/a n/a…”

Section: -16 Mg Oral [87]mentioning

confidence: 99%

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The influence of heart failure on the pharmacokinetics of cardiovascular and non‐cardiovascular drugs: a critical appraisal of the evidence

Mangoni

Jarmuzewska

2018

Brit J Clinical Pharma

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Prescribing in heart failure (HF), a common disease state that predominantly affects the older population, is often a challenging task because of the dynamic nature of the condition, requiring frequent monitoring and medication review, the presence of various comorbidities, and the frailty phenotype of many patients. The significant alterations in various organs and tissues occurring in HF, particularly the reduced cardiac output with peripheral hypoperfusion and the structural and functional changes of the gastrointestinal tract, liver and kidney, might affect the pharmacokinetics of several drugs. This review critically appraises the results of published studies investigating the pharmacokinetics of currently marketed cardiovascular and selected non-cardiovascular drugs in HF patients and control groups, identifies gaps in the current knowledge, and suggests avenues for future research in this complex patient population.

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