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Drug absorption in celiac disease.
Tran H Tran1, Candace Smith, Robert A Mangione
1Tran H. Tran, Pharm.D., BCPS, is Assistant Clinical Professor, College of Pharmacy and Health Sciences, St. John's University, Queens, NY, and Clinical Pharmacy Manager, New York Presbyterian Hospital/Columbia Medical Center, New York. Candace Smith, Pharm.D., is Associate Clinical Professor and Chair, Clinical Pharmacy Practice Department; and Robert A. Mangione, Ed.D., B.S.Pharm., is Provost and Professor of Pharmacy, College of Pharmacy and Health Sciences, St. John's University.
Celiac disease may affect how the body absorbs oral medications due to intestinal changes. More research is needed to understand these drug absorption and pharmacokinetic effects in celiac patients.
Area of Science:
- Pharmacology
- Gastroenterology
- Clinical Pharmacy
Background:
- Celiac disease involves intestinal villi damage, potentially affecting oral drug absorption.
- Patients with celiac disease often require oral medications for associated gastric disorders.
Purpose of the Study:
- To review existing evidence on the effects of celiac disease on drug absorption and pharmacokinetics.
- To identify knowledge gaps and guide future research in this area.
Main Methods:
- Literature review of English-language articles published between 1970 and August 2012.
- Analysis of studies reporting on drug absorption mechanisms and pharmacokinetic alterations in adult celiac disease patients.
Main Results:
- Celiac disease may alter gastric emptying, intestinal permeability, pH, surface area, and drug-metabolizing enzymes.
- Studies suggest potential impacts on serum concentrations of propranolol, acetaminophen, practolol, levothyroxine, and antibiotics.
- Existing studies are limited by small sample sizes, poor controls, and conflicting results.
Conclusions:
- Celiac disease can influence drug absorption and pharmacokinetics, impacting medication efficacy and safety.
- Cautious medication selection, dosage adjustments, and close monitoring are recommended for celiac patients.
- Larger, well-controlled pharmacokinetic studies are necessary to clarify these effects.
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