Food significantly reduces plasma concentrations of first-line anti-tuberculosis drugs.

Kumar, Agibothu Kupparam Hemanth and Chandrasekaran, Vedachalam and Kumar, Angadi Kiran and Kawaskar, M and Lavanya, J and Swaminathan, Soumya and Ramachandran, Geetha (2017) Food significantly reduces plasma concentrations of first-line anti-tuberculosis drugs. The Indian journal of medical research, 145 (4). pp. 530-535. ISSN 0971-5916

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Abstract

BACKGROUND & OBJECTIVES Concomitant feeding and anti-tuberculosis (TB) drug administration are likely to reduce nausea and enhance compliance to treatment. However, food could lower plasma drug concentrations. This study was undertaken to examine the effect of food on two-hour plasma concentrations of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA), and pharmacokinetics of these drugs in adult TB patients. METHODS Newly diagnosed adult TB patients were recruited from the Revised National Tuberculosis Control Programme (RNTCP) treatment centres in Chennai Corporation, Chennai, India. Two-hour post-dosing plasma concentrations were determined in 25 patients, and a semi-intensive pharmacokinetic study was undertaken in six patients. RMP, INH and PZA concentrations were determined by high-performance liquid chromatography. RESULTS The geometric mean two-hour concentrations with food and under fasting conditions were 2.2 and 5.5 μg/ml for RMP (P<0.001), 3.9 and 11.3 μg/ml for INH (P<0.001), and 18.0 and 28.2 μg/ml for PZA (P<0.001), respectively. Drug administration with food caused the plasma concentration to decrease by 50, 45 and 34 per cent for RMP, INH and PZA, respectively. Significant decreases in peak concentrations and exposures of drugs and delay in time to attain peak concentrations of drugs when taken with food were also observed. INTERPRETATION & CONCLUSIONS Our findings showed that food lowered anti-TB drug concentrations significantly and delayed absorption. Patients may be explained the beneficial effects of taking anti-TB drugs in a fasting state and advised to do so. There is a need for more research on optimization of dosing to maximize efficacy and safety of currently used drugs.

Affiliation:	ICMR-National Institute for Research in Tuberculosis
Item Type:	Article
Uncontrolled Keywords:	Anti-tuberculosis drug concentrations - food - pharmacokinetics - tuberculosis
Subjects:	Tuberculosis > Laboratory Research > Biochemical Tuberculosis > Laboratory Research > Pharmacological
Divisions:	Basic Science Research > Biochemistry Basic Science Research > Clinical Pharmacology
Depositing User:	Dr. Rathinasabapati R
Date Deposited:	19 Oct 2022 11:01
Last Modified:	19 Oct 2022 11:01
URI:	http://eprints.nirt.res.in/id/eprint/1521

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