Effect of Timing of Food on Absorption of Cefpodoxime Proxetil

Borin, Marie T.; Driver, Mary R.; Forbes, Kristi K.

doi:10.1002/j.1552-4604.1995.tb04095.x

Cited by 12 publications

(5 citation statements)

References 17 publications

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“…Administration 1 and 2 hours after breakfast reduced relative bioavailability to about 45% of that from the fasted state. Borin et al 15 reported similar cefpodoxime plasma concentration-time profiles when this cephalosporin was administered both fasting and 1 hour before a high-fat breakfast meal. But unlike tacrolimus and didanosine, cefpodoxime plasma concentrations increased~1.4-fold (concomitant with a slightly longer t max ) when the drug was administered either with a meal or 2 hours following a meal.…”

Section: Effect Of Meal Consumption On Tacrolimus Dosementioning

confidence: 89%

Effect of Time of Meal Consumption on Bioavailability of a Single Oral 5 mg Tacrolimus Dose

Bekersky

Dressler

Mekki³

2001

The Journal of Clinical Pharma

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Tacrolimus (FK506, Prograf) is marketed for the prophylaxis of organ rejection following allogenic liver or kidney transplantation. This study investigated the effect of timing of a standardized breakfast meal on both the rate and extent of tacrolimus absorption following a single 5 mg oral dose. The protocol used a randomized, open-label, four-period, four-treatment, four-sequence crossover design in 16 healthy, nonsmoking, drug-free male subjects between the ages of 22 and 45 years who were within 15% of their ideal body weight. The four treatments were the following: (A) fasting for 10 hours, (B) ingestion 1 hour before breakfast, (C) ingestion immediately following consumption of the breakfast, and (D) ingestion 1.5 hours after beginning consumption of the breakfast. The breakfast, which was consumed over 15 minutes, contained 848 kcal, with 30%, 16%, and 54% of calories derived from fat, protein, and carbohydrate, respectively. Tacrolimus absorption in the fasting state provided the greatest relative bioavailability (p < 0.05 compared with all other three treatments). AUC(0-infinity)) averaged 312, 276, 205, and 203 ng x h/mL for treatments A, B, C and D, respectively. In contradistinction to taking the drug 1 hour prior to a meal, which had a relatively minor impact on the relative extent of absorption (approximately 12%) compared to the fasting state, ingestion of tacrolimus immediately after a meal (treatment C) or 1.5 hours subsequent to a meal (treatment D) had a more pronounced influence. Mean AUC(0-infinity) ratios (fasting to either postmeal treatments) were approximately 1.5, indicating that absorption extent was considerably reduced by ingesting tacrolimus capsules immediately after eating or 1.5 hours thereafter. Absorption was also prolonged following drug ingestion after a meal, as indicated by a mean tmax value in the fasting state of 1.84 hours, relative to 3.41 hours (immediately aftermeal, p = 0.0035) and 3.22 hours (1.5 hours postmeal, p = 0.0094). The only discernable difference in parameters between treatments C and D was with Cmax, with values of 7.19 and 9.04 ng/mL, respectively, but was not statistically significantly different (p = 0.231). Based on these results and those from a prior study, it is recommended that under therapeutic conditions, oral tacrolimus be administered in a consistent manner, both with respect to the type of meal as well as timing of ingestion relative to consumption of the meal.

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Section: Effect Of Meal Consumption On Tacrolimus Dosementioning

confidence: 89%

Effect of Time of Meal Consumption on Bioavailability of a Single Oral 5 mg Tacrolimus Dose

Bekersky

Dressler

Mekki³

2001

The Journal of Clinical Pharma

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“…Food has been shown to alter cefpodoxime bioavailability from tablets by increasing the extent of absorption of cefpodoxime proxetil (2,8). This food effect was not associated with meal composition because the increases in cefpodoxime bioavailability were similar in five equicaloric test meals which varied with respect to fat and protein content (8).…”

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confidence: 99%

Effect of food on absorption of cefpodoxime proxetil oral suspension in adults

Borin

Forbes

1995

Antimicrob Agents Chemother

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The effect of a high-fat meal on absorption of a 200-mg dose of cefpodoxime proxetil oral suspension was evaluated in 20 healthy, male volunteers in a randomized, two-way crossover study. The concentrations of cefpodoxime in plasma and in urine were determined by sensitive and specific high-performance liquid chromatography methods. The area under the plasma drug concentration-time curve, time to peak concentration, and urinary excretion of cefpodoxime were significantly greater (P Յ 0.05) after administration of cefpodoxime proxetil oral suspension with food than under fasting conditions. However, the difference in the areas under the curve between fed and fasted treatments was only 11%, and application of the two one-sided tests procedure showed bioequivalence between treatments for this parameter. The slight increase in the extent of drug absorption and the slower rate of absorption which results when cefpodoxime proxetil is given with food are unlikely to be of clinical importance.

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“…However, by increasing their lipophilicity, their aqueous solubility was reduced, thus being classified in group IV of the BCS (Biopharmaceutical Classification System). The higher the dose of CP prescribed, the greater the benefit of taking it with a meal [39,40].…”

Section: Molecule T Max On Uneaten (H) T Max During Meal (H)mentioning

confidence: 99%

Drug-Food Interactions: The Influence on the Patient’s Therapeutic Plan

ZIANI¹

2022

FARMACIA

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Diet influences tolerance to drugs and their effectiveness by attenuating, slowing down, or, on the contrary, reinforcing their effects. The interaction often involves drug absorption through the digestive tract, but some nutrients alter drug metabolism and elimination (e.g. grapefruit juice) interferes with the hepatic clearance of many drugs. This review will not be limited only to the interactions relating to absorption and will develop by highlighting the pharmaco-dynamic interactions, which cause the potentiation or antagonism of the pharmacological effect at the origin, of an increased risk of toxicity, in particular, in elderly patients, poly-medicated, transplant recipients, cancer patients, HIV-seropositive patients, malnourished patients, and those patients which are on enteral nutrition and theoretically are the most exposed. The present work offers the most exhaustive possible synthesis of the various drug-food interactions observed or demonstrated in clinical practice, their potential risk and the key messages for the internist ment on the major role of grapefruit, its derivatives, St. John's wort (Hypericum perforatum), and other medicinal plants in common drug-food interactions. RezumatDieta influențează toleranța la medicamente și eficacitatea acestora prin atenuarea, inhibarea sau, dimpotrivă, stimularea efectelor acestora. Interacțiunea presupune adesea absorbția medicamentului prin tractul digestiv, dar unii nutrienți modifică metabolismul medicamentului și eliminarea (de exemplu, sucul de grepfrut) interferând cu clearance-ul hepatic al multor medicamente. Acest review nu se limitează doar la interacțiunile legate de absorbție și evidențiază interacțiunile farmacodinamice, care cauzează potențarea sau antagonismul efectului farmacologic la origine, a riscului crescut de toxicitate, în special, la pacienții vârstnici, cu polimedicație, beneficiarii de transplant, pacienții cu cancer, pacienții HIVseropozitivi, pacienții malnutriți, acei pacienți care urmează o nutriție enterală și, care teoretic, sunt cei mai expuși. Lucrarea de față oferă o sinteză exhaustivă a diferitelor interacțiuni medicament-aliment observate sau demonstrate în practica clinică, riscul potențial al acestora și mesajele cheie pentru specialiști cu privire la rolul major al grepfrutului, al derivaților săi, al sunătoarei (Hypericum perforatum) și alte plante medicinale în interacțiunile comune medicament-aliment.

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Effect of Timing of Food on Absorption of Cefpodoxime Proxetil

Cited by 12 publications

References 17 publications

Effect of Time of Meal Consumption on Bioavailability of a Single Oral 5 mg Tacrolimus Dose

Effect of Time of Meal Consumption on Bioavailability of a Single Oral 5 mg Tacrolimus Dose

Effect of food on absorption of cefpodoxime proxetil oral suspension in adults

Drug-Food Interactions: The Influence on the Patient’s Therapeutic Plan

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