Rifampicin Alters Metformin Plasma Exposure but Not Blood Glucose Levels in Diabetic Tuberculosis Patients
The pharmacokinetic (PK) and clinical implications of combining metformin with rifampicin are relevant to increasing numbers of patients with diabetic tuberculosis ( TB) across the world and are yet unclear. We assessed the impact of rifampicin on metformin PKs and its glucose‐lowering effect in patients with diabetic TB by measuring plasma metformin and blood glucose during and after TB treatment. Rifampicin increased metformin exposure: plasma area under the plasma concentration‐time curve from time point 0 to the end of the dosing interval ( AUC0–τ) and peak plasma concentration (C max) geometric mean ratio (GMR; during vs. after TB treatment) were 1.28 (90% confidence interval ( CI) 1.13–1.44) and 1.19 (90% CI1.02–1.38; n = 22). The metformin glucose‐lowering efficacy did not change (Δglucose − C max; P = 0.890; n = 18). Thus, we conclude that additional glucose monitoring in this population is not warranted. Finally, 57% of patients on metformin and rifampicin, and 38% of patients on metformin alone experienced gastrointestinal adverse effects. Considering this observation, we advise patients to take metformin and rifampicin with food and preferably separated in time. Clinicians could consider metoclopramide if gastrointestinal adverse effects occur..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2019 |
|---|---|
| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:105 |
|---|---|
| Enthalten in: |
Clinical Pharmacology & Therapeutics - 105(2019), 3, Seite 730-737 |
| Beteiligte Personen: |
te Brake, Lindsey H.M. [VerfasserIn] |
|---|
| BKL: |
|---|
| Anmerkungen: |
© 2019 American Society for Clinical Pharmacology and Therapeutics |
|---|
| Umfang: |
8 |
|---|
| doi: |
10.1002/cpt.1232 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
WLY003997049 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | WLY003997049 | ||
| 003 | DE-627 | ||
| 005 | 20230307132957.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 230214s2019 xx |||||o 00| ||und c | ||
| 024 | 7 | |a 10.1002/cpt.1232 |2 doi | |
| 028 | 5 | 2 | |a CPT_CPT1232.xml |
| 035 | |a (DE-627)WLY003997049 | ||
| 035 | |a (WILEY)CPT1232 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rda | ||
| 082 | 0 | 4 | |a 610 |q ASE |
| 084 | |a 44.38 |2 bkl | ||
| 084 | |a 44.40 |2 bkl | ||
| 100 | 1 | |a te Brake, Lindsey H.M. |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rifampicin Alters Metformin Plasma Exposure but Not Blood Glucose Levels in Diabetic Tuberculosis Patients |
| 264 | 1 | |c 2019 | |
| 300 | |a 8 | ||
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a © 2019 American Society for Clinical Pharmacology and Therapeutics | ||
| 520 | |a The pharmacokinetic (PK) and clinical implications of combining metformin with rifampicin are relevant to increasing numbers of patients with diabetic tuberculosis ( TB) across the world and are yet unclear. We assessed the impact of rifampicin on metformin PKs and its glucose‐lowering effect in patients with diabetic TB by measuring plasma metformin and blood glucose during and after TB treatment. Rifampicin increased metformin exposure: plasma area under the plasma concentration‐time curve from time point 0 to the end of the dosing interval ( AUC0–τ) and peak plasma concentration (C max) geometric mean ratio (GMR; during vs. after TB treatment) were 1.28 (90% confidence interval ( CI) 1.13–1.44) and 1.19 (90% CI1.02–1.38; n = 22). The metformin glucose‐lowering efficacy did not change (Δglucose − C max; P = 0.890; n = 18). Thus, we conclude that additional glucose monitoring in this population is not warranted. Finally, 57% of patients on metformin and rifampicin, and 38% of patients on metformin alone experienced gastrointestinal adverse effects. Considering this observation, we advise patients to take metformin and rifampicin with food and preferably separated in time. Clinicians could consider metoclopramide if gastrointestinal adverse effects occur. | ||
| 700 | 1 | |a Yunivita, Vycke |4 aut | |
| 700 | 1 | |a Livia, Resvi |4 aut | |
| 700 | 1 | |a Soetedjo, Nanny |4 aut | |
| 700 | 1 | |a Ewijk‐Beneken Kolmer, Eleonora |4 aut | |
| 700 | 1 | |a Koenderink, Jan B. |4 aut | |
| 700 | 1 | |a Burger, David M. |4 aut | |
| 700 | 1 | |a Santoso, Prayudi |4 aut | |
| 700 | 1 | |a Crevel, Reinout |4 aut | |
| 700 | 1 | |a Alisjahbana, Bachti |4 aut | |
| 700 | 1 | |a Aarnoutse, Rob E. |4 aut | |
| 700 | 1 | |a Ruslami, Rovina |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical Pharmacology & Therapeutics |g 105(2019), 3, Seite 730-737 |w (DE-627)WLY003995666 |x 15326535 |7 nnns |
| 773 | 1 | 8 | |g volume:105 |g year:2019 |g number:3 |g pages:730-737 |g extent:8 |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_WLY | ||
| 912 | |a SSG-OPC-PHA | ||
| 912 | |a SSG-OPC-ASE | ||
| 936 | b | k | |a 44.38 |q ASE |
| 936 | b | k | |a 44.40 |q ASE |
| 951 | |a AR | ||
| 952 | |d 105 |j 2019 |e 3 |h 730-737 |g 8 | ||