Decreased bioavailability of prednisone due to antacids in patients with chronic active liver disease and in healthy volunteers

Uribe, Misael; Casian, Carlos; Rojas, Sonia; Sierra, JoséG.; Go, Vian L.W.; Rosa, Monica; Muñóz,; Gil, Sofia

doi:10.1016/0016-5085(81)90122-0

Cited by 33 publications

(5 citation statements)

References 12 publications

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“…8,18 These compounds were found to impair the absorp tion of prednisone and probably other cortico steroids used to treat symptoms of allergic reac tions; therefore, their extensive use may signifi cantly decrease corticosteroid activity. 5,6 In this study, we addressed the question of the useful ness of calcium preparations in allergy related skin reactions by using objective and restric tive principles of a randomized controlled tri al in a reliable research model. 19 We found that calcium supplements given at a single dose or as a 3 day treatment did not reduce the size of the wheal or pruritus compared with placebo in a human SPT model.…”

Section: Methodsmentioning

confidence: 99%

Calcium prepartions do not inhibit allergic reactions. A randomized controlled trial

Matysiak¹,

Matuszewski²,

Feleszko³

2017

Polish Archives of Internal Medicine

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INTRODUCTION Massive consumption of dietary supplements, including vitamins and minerals, has recently become a serious health issue in Europe. Their use may negatively affect the pharmacological activity of various medications, including antiallergic drugs. Calcium preparations are commonly used in some European countries as a popular remedy for allergy‑related skin reactions, such as itching, erythema, and wheals, as well as insect bites. However, so far there have been no reliable studies to prove their action. OBJECTIVES The aim of this randomized, double‑blind, placebo‑controlled study was to investigate the efficacy of calcium salts in allergic reactions, using an allergen‑induced skin prick test (SPT). PATIENTS AND METHODS Forty adult volunteers with allergic rhinoconjunctivitis or asthma (or both) were recruited to receive oral calcium carbonate (1000 mg) or placebo 3 times a day for 3 days. SPTs were performed with 11 aeroallergen extracts at baseline and at 4 and 72 hours after drug administration. The wheal diameter was measured. We also used the visual analog scale to evaluate the intensity of pruritus. RESULTS There was no difference in the wheal size or pruritus between patients receiving calcium or placebo at any of the time points (P >0.05). Calcium preparations were well tolerated. CONCLUSIONS We found no evidence to support the efficacy of calcium preparations in allergy‑related skin reactions associated with itching and wheals. Calcium preparations do not suppress SPT responses; moreover, their use in allergic patients should be discouraged due to their possible interference with the absorption of antiallergic drugs.

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Section: Methodsmentioning

confidence: 99%

Calcium prepartions do not inhibit allergic reactions. A randomized controlled trial

Matysiak¹,

Matuszewski²,

Feleszko³

2017

Polish Archives of Internal Medicine

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“…Other factors, such as corticosteroid-impaired cellular uptake (Robles et aI., 1978) or pharmacokinetic interaction with antacids (Uribe et a\., 1981) or cimetidine (Sierra et a\., 1980), may be implicated. Further, patients in treatment failure due to severe liver damage exhibit low albumin concentrations and this abnormality corresponds with an increase of unbound (active) prednisolone (Uribe and Go, 1979).…”

Section: Therapeutic Implicationsmentioning

confidence: 97%

Comparative Serum Prednisone and Prednisolone Concentrations Following Administration to Patients with Chronic Active Liver Disease

Uribe¹,

Summerskill

1982

Clinical Pharmacokinetics

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Following administration of equivalent oral doses (30mg) of either prednisone or prednisolone to 5 patients with chronic active liver disease who had failed to respond to therapy, 5 patients with chronic active liver disease in remission induced by prednisone, and 7 healthy volunteers, corticosteroid concentrations were measured in both serum and urine by radioimmunoassay. Prednisone and prednisolone concentrations in the urine were very similar in all groups, regardless of the drug given. After either treatment, the peak serum concentration and area under the prednisolone serum concentration-time curve were 4 to 5 times those of prednisone. Slight differences among the 3 groups studied were seen in prednisone and prednisolone pharmacokinetics, but none was significant. It is concluded that the use of prednisone instead of prednisolone to treat chronic active liver disease can not be implicated as a cause of treatment failure. Indeed, this study suggests that either medication is effective, and this is supported by serum concentrations which suggest a rapid interconversion equilibrium between the 2 corticosteroids.

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“…Concomitant use of glucocorticoids and fluoroquinolones increases the risk of tendonitis and tendon rupture [ 12 ]. There are inconsistent reports regarding drug interaction between glucocorticoids and antacids; while some studies reported that concomitant antacid use may decrease glucocorticoid’s bioavailability by 40–75%, [ 13 , 14 ] others reported no change in bioavailability [ 15 , 16 ]. Careful monitoring of the international normalized ratio (INR) is required with concomitant use of warfarin and glucocorticoids, as glucocorticoids may increase the INR [ 17 ].…”

Section: Glucocorticoidsmentioning

confidence: 99%

Clinical Pharmacology in Sarcoidosis: How to Use and Monitor Sarcoidosis Medications

Kwon,

Judson

2024

JCM

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When sarcoidosis needs treatment, pharmacotherapy is usually required. Although glucocorticoids work reliably and relatively quickly for sarcoidosis, these drugs are associated with numerous significant side effects. Such side effects are common in sarcoidosis patients, as the disease frequently has a chronic course and glucocorticoid treatment courses are often prolonged. For these reasons, corticosteroid-sparing and corticosteroid-replacing therapies are often required for sarcoidosis. Unfortunately, many healthcare providers who care for sarcoidosis patients are not familiar with the use of these agents. In this manuscript, we provide a review of the pharmacotherapy of sarcoidosis. We discuss the mechanism of action, dosing, side-effect profile, approach to monitoring and patient counselling concerning glucocorticoids, and the common alternative drugs recommended for use in the recent European Respiratory Society (Lausanne, Switzerland) Sarcoidosis Treatment Guidelines. We also discuss the use of these agents in special situations including hepatic insufficiency, renal insufficiency, pregnancy, breastfeeding, vaccination, and drug–drug interactions. It is hoped that this manuscript will provide valuable practical guidance to clinicians who care for sarcoidosis patients.

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Decreased bioavailability of prednisone due to antacids in patients with chronic active liver disease and in healthy volunteers

Cited by 33 publications

References 12 publications

Calcium prepartions do not inhibit allergic reactions. A randomized controlled trial

Calcium prepartions do not inhibit allergic reactions. A randomized controlled trial

Comparative Serum Prednisone and Prednisolone Concentrations Following Administration to Patients with Chronic Active Liver Disease

Clinical Pharmacology in Sarcoidosis: How to Use and Monitor Sarcoidosis Medications

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