2011 Volume 37 Issue 1 Pages 13-19
Some food thickeners and deglutition aid jellies have been reported to be associated with drug-food interactions becausethey contain a lot of saccharides and dietary fiber.
Acetaminophen was used as a model drug and administered to healthy volunteers as one of 3 forms:“drug alone”,“THICKENER”(mixed with 4% solution of a commercially available food thickener) and“JELLY”(mixed with commerciallyavailable deglutition aid jelly).We then monitored their acetaminophen plasma levels.There were no significant differencesin acetaminophen levels between the drug alone and JELLY forms,whereas the THICKENER form brought abouta significant increase in Tmax (0.75 to 1.5 hr).
Next,we tested the effect of the JELLY form on the plasma levels of 3 other drugs (sodium valproate,carbamazepine,and theophylline) in patients and observed comparable plasma concentration-time curves for all of them.
Finally,a dissolution test was performed to further evaluate the effect of the THICKENER form on drug plasma levels.As compared with the drug alone and the JELLY form,the THICKENER form significantly delayed dissolution for alldrugs tested other than a theophylline sustained release preparation.We observed an increase in T80 (time for release of 80% of the total content) for acetaminophen from 2.5 to 25.5 min,in T85 for valproate from 9.8 to 42.8 min,and in T75 forcarbamazepine from 12.0 to 33.8 min.
These results suggest that commercially available food thickeners are likely to be associated with changes in the pharmacokineticprofiles of clinically important drugs,and they therefore need to be carefully used in certain clinical situations.