PMID- 21853881
OWN - NLM
STAT- MEDLINE
DCOM- 20110907
LR  - 20110822
IS  - 0342-9601 (Print)
IS  - 0342-9601 (Linking)
VI  - 34
IP  - 8
DP  - 2011 Aug
TI  - [Evaluation of pharmacokinetic drug-drug-interactions. Critical considerations of 
      the relevance of pharmacokinetic drug-drug interactions of proton pump inhibitors 
      in self medication].
PG  - 270-8
AB  - Mechanisms and evaluation of pharmacokinetic drug interactions are discussed in 
      general, including mechanisms beyond the hepatic phase-I reactions, and 
      especially for the example of proton pump inhibitors (PPI), preferentially 
      omeprazole. Particular attention is paid to the use of PPI as self-prescribed 
      drugs. The sequelae of pharmacokinetic drug interactions can be serious. However, 
      only the evidence of clinical consequences will convert such an interaction from 
      a laboratory finding into a possible adverse effect. Without this, interacting 
      drugs can still be co-administered if the specific characteristics of the 
      concerned drugs, quantitative aspects of the interaction, and especially severity 
      and frequency of possible clinical correlates are taken into consideration. It is 
      encouraging that the laboratory findings reported for the PPI--in vitro or ex 
      vivo from volunteer studies--have hardly found equivalents in clinical 
      consequences. As of today, this is also true of the widely discussed interaction 
      with clopidogrel. Regarding the safety of use of PPI as self-prescribed drugs, it 
      also needs to be emphasized that a sizable number of interactions reported for 
      omeprazole and/or pantoprazole were observed at higher dose levels than the 20 mg 
      licensed for self medication. In conjunction with the temporal limitation of PPI 
      self-prescription (14 days), it can be expected that pharmacokinetic drug 
      interactions will generally be no critical factor in the usage of PPI in 
      self-medication. However clinically relevant interactions can occur, e.g. when 
      PPI are combined with extracts from St. John's wort, methotrexat or some 
      inhibitors of HIV-protease with pH-dependent absorption.
FAU - Petersen, Karl-Uwe
AU  - Petersen KU
AD  - Pharmakologe und Toxikologe, Medizinische Fakultat, Rheinisch-Westfalische TH 
      Aachen, Oberdorfstrasse 22, 52072 Aachen. KarIUwe.Petersen@post.rwth-aachen.de
LA  - ger
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Pharmakokinetische Interaktionen und ihre Beurteilung. Kritische Betrachtungen 
      zur Relevanz von Interaktionen der Protonenpumpenhemmer Omeprazol und Pantoprazol 
      in der Selbstmedikation.
PL  - Germany
TA  - Med Monatsschr Pharm
JT  - Medizinische Monatsschrift fur Pharmazeuten
JID - 7802665
RN  - 0 (Pharmaceutical Preparations)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - *Drug Interactions
MH  - Humans
MH  - Intestinal Absorption/drug effects
MH  - Pharmaceutical Preparations/metabolism
MH  - *Pharmacokinetics
MH  - Proton Pump Inhibitors/*adverse effects/*therapeutic use
MH  - Self Medication
EDAT- 2011/08/23 06:00
MHDA- 2011/09/08 06:00
CRDT- 2011/08/23 06:00
PHST- 2011/08/23 06:00 [entrez]
PHST- 2011/08/23 06:00 [pubmed]
PHST- 2011/09/08 06:00 [medline]
PST - ppublish
SO  - Med Monatsschr Pharm. 2011 Aug;34(8):270-8.