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Related Experiment Videos

Rifampicin kinetics in undernutrition.

K Polasa, K J Murthy, K Krishnaswamy

    British Journal of Clinical Pharmacology
    |April 1, 1984
    PubMed
    Summary

    Undernourished individuals show altered rifampicin pharmacokinetics, with reduced peak concentrations but increased free drug levels. Dosage adjustments are likely unnecessary for these patients.

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    Area of Science:

    • Pharmacology
    • Clinical Nutrition
    • Infectious Diseases

    Background:

    • Undernutrition can significantly alter drug metabolism and disposition.
    • Rifampicin is a cornerstone medication for tuberculosis treatment.
    • Understanding rifampicin pharmacokinetics in undernourished populations is crucial for effective treatment.

    Purpose of the Study:

    • To investigate the pharmacokinetic profile of rifampicin in undernourished subjects.
    • To compare rifampicin absorption, clearance, and protein binding in well-nourished versus undernourished individuals.
    • To determine if dosage adjustments are necessary for undernourished patients receiving rifampicin.

    Main Methods:

    • A single 10 mg/kg dose of rifampicin was administered to undernourished subjects, well-nourished subjects, and undernourished patients on antituberculosis therapy.
    • Plasma drug concentrations were measured over time to determine pharmacokinetic parameters.
    • Plasma protein binding of rifampicin was assessed in different subject groups.

    Main Results:

    • Both undernourished groups exhibited significantly reduced area under the plasma concentration-time curve (AUC0–infinity) and peak concentrations.
    • Apparent oral and renal clearances of rifampicin were increased in undernourished individuals.
    • Significantly reduced plasma protein binding of rifampicin was observed in undernourished subjects, leading to higher free drug concentrations.

    Conclusions:

    • Reduced absorption and/or altered total body clearance contribute to lower overall rifampicin exposure in undernourished individuals.
    • Increased free drug concentration due to reduced protein binding may maintain therapeutic efficacy despite lower total drug levels.
    • Current evidence suggests that alterations in rifampicin dosage regimens may not be necessary for undernourished patients.

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