title: Diosmin pretreatment affects bioavailability of metronidazole.
abstract: OBJECTIVE
  To screen for inhibitory effects of diosmin on cytochrome P(450)-mediated metabolism of metronidazole in healthy volunteers.
  
  
  METHODS
  Before/after non-blinded investigation conducted in healthy male volunteers.
  
  
  METHODS
  After an overnight fast, metronidazole (two 400-mg tablets) was administered to 12 volunteers, either alone or after a 9-day pretreatment period with a once-daily dose of diosmin 500-mg tablets under direct observation. Serum concentrations of metronidazole up to 48 h postdose and urinary concentrations of metronidazole and its two major metabolites up to 24 h postdose were measured using reversed-phase high-performance liquid chromatography.
  
  
  RESULTS
  Metronicazole plasma AUC((0- infinity )) and C(max) were significantly higher after diosmin pretreatment by (mean) 27% and 24%, respectively. However, time to reach peak concentration (t(max)) was not affected significantly. Urinary excretion of acid and hydroxy metabolites in urine was decreased significantly, while excretion of unchanged metronidazole was increased.
  
  
  CONCLUSIONS
  Diosmin pretreatment significantly altered the metabolism of metronidazole, as demonstrated by changes in plasma pharmacokinetics as well as by urinary recovery of both parent drug and its major metabolites. This may be caused by the inhibition of cytochrome P(450) enzymes.
authors.affiliation: Drug Metabolism and Clinical Pharmacokinetics Division, University College of Pharmaceutical Sciences, Kakatiya University, AP-506009, Warangal, India.
authors.forename: K
authors.initials: K
authors.lastname: Rajnarayana
authors.forename: Mada S
authors.initials: MS
authors.lastname: Reddy
authors.forename: Devarakonda R
authors.initials: DR
authors.lastname: Krishna
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000652:urine; D019540:Area Under Curve; D001682:Biological Availability; D065607:Cytochrome P-450 Enzyme Inhibitors; D004145:Diosmin / Q000494:pharmacology*; D004347:Drug Interactions; D006207:Half-Life; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000097:blood / Q000493:pharmacokinetics* / Q000652:urine
chemical_list: D000890:Anti-Infective Agents; D065607:Cytochrome P-450 Enzyme Inhibitors; D008795:Metronidazole; D004145:Diosmin