PMID- 7780091
OWN - NLM
STAT- MEDLINE
DCOM- 19950714
LR  - 20191031
IS  - 0962-8479 (Print)
IS  - 0962-8479 (Linking)
VI  - 76
IP  - 2
DP  - 1995 Apr
TI  - Study of the effect of concomitant food on the bioavailability of rifampicin, 
      isoniazid and pyrazinamide.
PG  - 109-13
AB  - SETTING: Concomitant feeding and administration of antituberculosis medication 
      has been proposed to increase compliance (by decreasing pyrazinamide associated 
      nausea) and improve nutritional status. Food may however decrease the oral 
      bioavailability of rifampicin and isoniazid. OBJECTIVE AND METHODS: A 
      triple-crossover pharmacokinetic study in 27 patients with tuberculosis (15 males 
      and 12 females) compared the bioavailability of rifampicin, isoniazid and 
      pyrazinamide without food (control) with that when taken with a high carbohydrate 
      (CHO) or high lipid (LIPID) diet. RESULTS: the CHO diet decreased isoniazid 
      bioavailability. The maximum measured drug concentration (Cm) was decreased by 
      20% (P = 0.0002) and the area under the concentration-time curve to 8 h (AUC8) by 
      19% (P = 0.01). The CHO diet increased the time to maximum measured drug 
      concentration (Tmax) for rifampicin by 21% (P = 0.03). The LIPID diet decreased 
      the Cm of isoniazid by 9% (P = 0.03). Individual patient bioavailability on each 
      meal was compared to the no-food control. A decrease of Cm or AUC8 of greater 
      than 20% was considered significant. The bioavailability of isoniazid and 
      rifampicin was decreased by food in a high percentage (33-56%) of patients. 
      CONCLUSION: Concomitant feeding may thus have an important adverse effect on the 
      therapy of tuberculosis and the desirability of this practice is called into 
      question.
FAU - Zent, C
AU  - Zent C
AD  - Department of Pharmacology, University of Cape Town Medical School, South Africa.
FAU - Smith, P
AU  - Smith P
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Scotland
TA  - Tuber Lung Dis
JT  - Tubercle and lung disease : the official journal of the International Union 
      against Tuberculosis and Lung Disease
JID - 9212467
RN  - 0 (Dietary Carbohydrates)
RN  - 0 (Dietary Fats)
RN  - 2KNI5N06TI (Pyrazinamide)
RN  - V83O1VOZ8L (Isoniazid)
RN  - VJT6J7R4TR (Rifampin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Biological Availability
MH  - Cross-Over Studies
MH  - Dietary Carbohydrates/administration & dosage
MH  - Dietary Fats/administration & dosage
MH  - Female
MH  - *Food
MH  - Humans
MH  - Isoniazid/blood/*pharmacokinetics
MH  - Male
MH  - Middle Aged
MH  - Pyrazinamide/blood/*pharmacokinetics
MH  - Rifampin/blood/*pharmacokinetics
MH  - Tuberculosis, Pulmonary/diet therapy/drug therapy/*metabolism
EDAT- 1995/04/01 00:00
MHDA- 1995/04/01 00:01
CRDT- 1995/04/01 00:00
PHST- 1995/04/01 00:00 [pubmed]
PHST- 1995/04/01 00:01 [medline]
PHST- 1995/04/01 00:00 [entrez]
AID - 0962-8479(95)90551-0 [pii]
AID - 10.1016/0962-8479(95)90551-0 [doi]
PST - ppublish
SO  - Tuber Lung Dis. 1995 Apr;76(2):109-13. doi: 10.1016/0962-8479(95)90551-0.