Effect of a cola beverage on the bioavailability of itraconazole in the presence of H2 blockers

Thirty-three healthy individuals participated in an open-label, randomized, three-way crossover study designed to compared the bioavailability of a single 200-mg oral dose of itraconazole when administered alone or after treatment with ranitidine, both with and without coadministration of a cola beverage. Each treatment phase was separated by a 2-week washout period. Participants pretreated with ranitidine were required to have a gastric pH of at least 6.0 before receiving itraconazole. An analysis of the area under the curve (AUC) and peak plasma concentration (Cmax) data indicated that the bioavailability of itraconazole was significantly reduced when the gastric pH was increased by pretreatment with ranitidine but showed that this effect was counteracted by the coadministration of an acidic solution (e.g., a cola beverage) that transiently reduced the gastric pH. These findings suggest that the coadministration of an acidic beverage with itraconazole may be an effective approach in improving the bioavailability of itraconazole in patients who are hypochlorhydric or who are taking gastric acid suppressants.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				G. Krishna, A. Moton, L. Ma, M. M. Medlock, and J. McLeod Pharmacokinetics and Absorption of Posaconazole Oral Suspension under Various Gastric Conditions in Healthy Volunteers Antimicrob. Agents Chemother., March 1, 2009; 53(3): 958 - 966. [Abstract] [Full Text] [PDF]

				D. Andes, A. Pascual, and O. Marchetti Antifungal Therapeutic Drug Monitoring: Established and Emerging Indications Antimicrob. Agents Chemother., January 1, 2009; 53(1): 24 - 34. [Full Text] [PDF]

				J. W. Mouton, A. van Peer, K. de Beule, A. Van Vliet, J. P. Donnelly, and P. A. Soons Pharmacokinetics of Itraconazole and Hydroxyitraconazole in Healthy Subjects after Single and Multiple Doses of a Novel Formulation Antimicrob. Agents Chemother., December 1, 2006; 50(12): 4096 - 4102. [Abstract] [Full Text] [PDF]

				A. Palanisamy, S. D. Chao, M. Fouts, and D. Kerr Central nervous system aspergillosis in an immunocompetent patient: Cure in a hospice setting with very high-dose itraconazole American Journal of Hospice and Palliative Medicine, March 1, 2005; 22(2): 139 - 144. [Abstract] [PDF]

				R. Courtney, E. Radwanski, J. Lim, and M. Laughlin Pharmacokinetics of Posaconazole Coadministered with Antacid in Fasting or Nonfasting Healthy Men Antimicrob. Agents Chemother., March 1, 2004; 48(3): 804 - 808. [Abstract] [Full Text] [PDF]

				B. D. Damle, V. Mummaneni, S. Kaul, and C. Knupp Lack of Effect of Simultaneously Administered Didanosine Encapsulated Enteric Bead Formulation (Videx EC) on Oral Absorption of Indinavir, Ketoconazole, or Ciprofloxacin Antimicrob. Agents Chemother., February 1, 2002; 46(2): 385 - 391. [Abstract] [Full Text] [PDF]