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Effects of metronidazole on hepatic CYP3A4 activity
C E Haas1, D C Kaufman, R C DiCenzo
1Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, The State University of New York, 14260-1200, USA. haas@acsu.buffalo.edu
Study Objective:
To evaluate the effect of a short course of oral metronidazole, commonly used for bowel-preparation regimens, on hepatic cytochrome P450 (CYP) 3A4 activity, as measured by the [14C N-methyl]-erythromycin breath test (ERMBT) in healthy volunteers.
Design:
Prospective, nonrandomized, interventional study
Setting:
University-affiliated, community, teaching hospital.
Subjects:
Five healthy male volunteers.
Intervention:
Subjects underwent a baseline ERMBT in the morning before receiving three oral doses of metronidazole 500 mg administered at 3 P.M., 7 P.M., and 11 P.M. Repeat ERMBTs were performed at 24, 72, and 96 hours after the initial ERMBT. Changes in ERMBT values were compared with baseline results using Freidman's repeated-measures analysis of variance on ranks.
Measurements And Main Results:
The ERMBT values did not change significantly compared with baseline (p=0.82). Median (range) ERMBT values expressed as a percentage of baseline at 24, 72, and 96 hours were 110.3 (96.2-136.9), 101.3 (99.3-115.0), and 101.8 (95.5-116.3), respectively
Conclusion:
A short course of oral metronidazole does not result in a significant change in hepatic CYP3A4 activity as measured by the ERMBT.