Inhibition of methylprednisolone elimination in the presence of erythromycin therapy |
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| Authors: | Craig F. LaForce Stanley J. Szefler Michael F. Miller William Ebling Manon Brenner |
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| Affiliation: | 1. From the Departments of Pediatrics, Pharmacology and Therapeutics, and Pharmaceutics, School of Medicine and Pharmacy, State University of New York at Buffalo, Buffalo, N. Y. U.S.A.;2. From the Department of Pediatrics, National Jewish Hospital and Research Center, Denver, Colo. U.S.A. |
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| Abstract: | Methylprednisolone elimination is reduced in the presence of treatment with troleandomycin (TAO), a macrolide antibiotic. To assess whether a similar interaction occurs with a more commonly used and less hepatotoxic macrolide antibiotic, erythromycin, we evaluated methylprednisolone pharmacokinetics before and after a 1 wk course of erythromycin base in nine adolescent patients with chronic asthma. These data were compared to results of studies of the troleandomycin methylprednisolone interaction evaluated in 10 adolescent asthmatic patients. Methylprednisolone clearance and apparent volume of distribution were significantly decreased and mean residence time and half-life significantly increased in the presence of both erythromycin and troleandomycin. The latter caused greater inhibition of methylprednisolone elimination. A nonlinear pattern of methylprednisolone disposition was observed in the presence of concomitant macrolide antibiotic administration. Addition of erythromycin base to methylprednisolone therapy results in inhibition of methylprednisolone elimination and may potentially increase the beneficial and adverse effects of this corticosteroid. |
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| Keywords: | AUC Area under the plasma concentration versus time curve AUMC First moment of the area under the plasma concentration vs. time curve MRT Mean residence time Apparent steady-state volume of distribution SGOT Serum glutamic oxaloacetic transaminase SGPT Serum glutamic pyruvic transaminase Half-life |
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