Evaluation of promotility agents to limit the gut bioavailability of extended-release acetaminophen.
BACKGROUND
Erythromycin and neostigmine have both been shown to act as gastrointestinal promotility agents.


OBJECTIVE
The purpose of this study was to determine whether either erythromycin or neostigmine, administered parenterally, would result in lower serum levels of a recently ingested drug, when compared with placebo.


METHODS
Ten volunteers ingested 1300 mg of extended-release acetaminophen on each of three occasions. They were then given an intravenous dose of erythromycin (200 mg), neostigmine (2 mg), or placebo. Each volunteer received all three treatments in a counterbalanced fashion, each separated from the next by at least two weeks. Blood for serum acetaminophen concentration was drawn at 1, 2, 4, 6 and 8 h after treatment, and the serum acetaminophen elimination curves were compared for the three treatments.


RESULTS
The elimination phase of the curves did not differ among the treatments as a result of administration of the prokinetic agents.


CONCLUSIONS
Under the present conditions, administration of erythromycin and neostigmine as prokinetic agents failed to alter the kinetics of an ingested dose of sustained-release acetaminophen.
Amato
Christopher S
CS
Morristown Memorial Hospital, Morristown, New Jersey, USA.
Wang
Richard Y
RY
Wright
Robert O
RO
Linakis
James G
JG
D000082:Acetaminophen / Q000097:blood / Q000493:pharmacokinetics*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000097:blood / Q000493:pharmacokinetics*; D001682:Biological Availability; D003692:Delayed-Action Preparations; D004064:Digestive System / Q000378:metabolism*; D004347:Drug Interactions; D004917:Erythromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009388:Neostigmine / Q000008:administration & dosage / Q000627:therapeutic use*
D018712:Analgesics, Non-Narcotic; D003692:Delayed-Action Preparations; D000082:Acetaminophen; D009388:Neostigmine; D004917:Erythromycin