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Effects of Itraconazole or Grapefruit Juice on the Pharmacokinetics of Telithromycin
Author(s) -
Shi Jun,
Montay Guy,
Leroy Bruno,
Bhargava Vijay O.
Publication year - 2005
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.25.1.42.55621
Subject(s) - telithromycin , pharmacokinetics , grapefruit juice , itraconazole , crossover study , pharmacology , concomitant , oral administration , cyp3a4 , cmax , medicine , chemistry , antibacterial agent , antibiotics , cytochrome p450 , dermatology , biochemistry , metabolism , placebo , antifungal , alternative medicine , pathology
Study Objective. To determine whether coadministration of the cytochrome P450 3A4 (CYP3A4) inhibitors itraconazole or grapefruit juice will modify the pharmacokinetic profile of telithromycin, and to assess the safety of telithromycin. Design. Two single‐center, open‐label studies; the itraconazole study was nonrandomized, sequential, and multiple dose, and the grapefruit juice study was randomized, two‐period crossover, and single dose. Setting. Two clinical investigative centers in the United States. Subjects. Thirty‐four healthy, nonsmoking male volunteers aged 18–45 years. Intervention. All patients received telithromycin 800 mg/day; 18 patients received concomitant itraconazole 200 mg/day, and 16 received concomitant single‐dose, single‐strength grapefruit juice. Measurements and Main Results. Standard pharmacokinetic and safety measurements were performed. Itraconazole given concomitantly with telithromycin increased the steady‐state area under the plasma concentration‐time curve from 0–24 hours of telithromycin by 53.8% (p<0.0001). Coadministration of grapefruit juice did not affect telithromycin pharmacokinetic parameters, and telithromycin was well tolerated in both studies. Conclusion. Only modest changes in the pharmacokinetics of telithromycin were seen with concomitant administration of itraconazole. Telithromycin pharmacokinetics were unaffected by concomitant administration of grapefruit juice.