Interaction of erythromycin and clarithromycin with orange juice.

dc.contributor.authorSetiawati, Arini
dc.contributor.authorWiria, Metta Sinta Sari
dc.contributor.authorSuyatna, Franciscus D
dc.contributor.authorSion, Juan Tjiu
dc.contributor.authorHamadian, Marina
dc.date.accessioned2013-11-07T09:00:44Z
dc.date.available2013-11-07T09:00:44Z
dc.date.issued2005-04
dc.description.abstractConcomitant administration of orange juice with fexofenadine has been found to decrease the bioavailability of fenofenadine to less than 30% via inhibition of organic-anion transporting polypeptide (OATP), a drug uptake transporter expressed in organs such as liver, kidney and intestine. Erythromycin and clarithromycin are substrates and inhibitors of CYP3A4, a drug metabolizing enzyme in the liver and enterocytes, and P-glycoprotein (P-gp), a drug efflux transporter expressed in the same organs as OATP. Since an extensive overlap exists between substrates and inhibitors of CYP3A4, P-gp and OATP transporters, we want to study the effect of coadministration of our local orange (Siam orange) juice on the bioavailability of the above antibacterials. We conducted two 2-way cross-over randomized studies, one study for each antibacterial (500 mg), crossed between administration with orange juice (200 ml) and with water, in 12-13 healthy subjects per study. The serum concentrations of the antibacterials were assayed by microbiological method. The mean (range) ratio of AUC0-t with orange juice/with water were as follows : erythromycin : total (n=13) 81.7 (9.7-193.8)%, unchanged (n=4) 96.4 (80.5-107.9)%, decreased (n=6) 31.9 (9.7-49.0)%, increased (n=3) 161.8 (134.6-193.8)%; clarithromycin : total (n=12) 91.4 (20.6-158.3)%, unchanged (n=5) 103.1 (80.9-123.0)%, decreased (n=4) 34.8 (20.6-64.3)%, increased (n=3) 147.2 (132.9-158.3)%. It was concluded that coadministration of Siam orange juice with erythromycin or clarithromycin produced unpredictable effects on the bioavailability of these antibacterials in individual subjects, with marked decreases in almost half of the subjects, although in totals the effects were not statistically significant.en_US
dc.identifier.citationSetiawati Arini, Wiria Metta Sinta Sari, Suyatna Franciscus D, Sion Juan Tjiu, Hamadian Marina. Interaction of erythromycin and clarithromycin with orange juice. Medical Journal of Indonesia. 2005 Apr; 14(2): 78-86.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/149149
dc.language.isoenen_US
dc.source.urihttps://mji.ui.ac.id/journal/index.php/mji/article/view/573en_US
dc.subjectinteractionen_US
dc.subjecterythromycinen_US
dc.subjectclarithromycinen_US
dc.subjectorange juiceen_US
dc.subject.meshCitrus sinensisen_US
dc.subject.meshCell Communicationen_US
dc.subject.meshErythromycinen_US
dc.subject.meshClarithromycinen_US
dc.titleInteraction of erythromycin and clarithromycin with orange juice.en_US
dc.typeArticleen_US
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