The gastroesophageal reflux and/or peptic ulcer diseases are clinical conditions that occur usually accompanied of symptomatic pain. Lansoprazole, a proton pump inhibitor class drug is widely used in clinical practice for treatment of these diseases. However, its efficacy can be improved by combining with spasmolytic and/or visceral analgesic such as hyoscine butylbromide. Since hyoscine butylbromide is barely absorbed and exerts some local effects at gastrointestinal tract which may modify the absorption of lansoprazole, it is important to establish if there is a pharmacokinetic interaction after the oral concomitant administration of both drugs. For this objective, twenty-five subjects received under a crossover design an oral administration of lansoprazole (15 mg) plus placebo or a fixed-dose combination with hyoscine butiylbromide (15 mg + 10 mg, respectively). Plasma samples were obtained at different times during 10 hours. Lansoprazole plasma concentrations were determined by a high performance liquid chromatography method coupled to tandem mass spectrometry. Fixed-dose combination was well tolerated. Lansoprazole pharmacokinetic parameters were: Cmax 621.81 ± 212.79 and 450.38 ± 192.14 ng/mL; AUC 0 - t 1941.36 ± 845.57 and 1454.66 ± 757.28 ng·h/mL; tmax 2.83 ± 0.99 and 3.40 ± 1.82h; t1/2 1.35 ± 0.39 and 1.45 ± 0.51 h, for alone and combined fixed-dose formulation, respectively. Pharmacokinetic parameters were compared by analysis of variance and ratios of AUC 0 - t , Cmax and 90% confidence intervals obtained. Since confidence intervals exceed the 80% - 125% limits for these parameters, we conclude that there is a significantly pharmacokinetic interaction of lansoprazole when it is administered concomitantly with hyoscine butylbromide.
Fock, K., Ang, T., Bee, L. and Lee, J. (2008) Proton Pump Inhibitors: Do Differences in Pharmacokinetics Translate into Differences in Clinical Outcomes? Clinical Pharmacokinetics, 47, 1-6. http://dx.doi.org/10.2165/00003088-200847010-00001
Katz, P., Gerson, L. and Vela, M. (2013) Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease. American Journal of Gastroenterology, 108, 308-328. http://dx.doi.org/10.1038/ajg.2012.444
Blum, R., Hunt, R., Kidd, S., Shi, H., Jennings, D. and Greski-Rose, P. (1998) Dose-Response Relationship of Lansoprazole to Gastric Acid Antisecretory Effects. Alimentary Pharmacology & Therapeutics, 12, 321-327. http://dx.doi.org/10.1046/j.1365-2036.1998.00306.x
Huang, J. and Hunt, R. (2001) Pharmacological and Pharmacodynamic Essentials of H(2)-Receptor Antagonists and Proton pump Inhibitors for the Practising Physician. Best Practice & Research. Clinical Gastroenterology, 15, 355-370. http://dx.doi.org/10.1053/bega.2001.0184
Langtry, H. and Wilde, M. (1997) Lansoprazole. An Update of Its Pharmacological Properties and Clinical Efficacy in the Management of Acid-Related Disorders. Drugs, 54, 473-500. http://dx.doi.org/10.2165/00003495-199754030-00010
Matheson, A. and Jarvis, B. (2001) Lansoprazole. An Update of Its Place in the Management of Acid-Related Disorders. Drugs, 61, 1801-1833. http://dx.doi.org/10.2165/00003495-200161120-00011
Spencer, C. and Faulds, D. (1994) Lansoprazole. A Reappraisal of Its Pharmacodynamic and Pharmacokinetic Properties, and Its Therapeutic Efficacy in Acid-Related Disorders. Drugs, 48, 404-430.
Pichard, L., Curi-Pedrosa, R., Bonfils, C., Jacqz-Aigrain, E., Domergue, J., Joyeux, H., Cosme, J., Guengerich, F.P. and Maurel, P. (1995) Oxidative Metabolism of Lansoprazole by Human Liver Cytochromes P450. Molecular Pharmacology, 47, 410-418. http://dx.doi.org/10.2165/00003495-199448030-00007
Gerloff, J., Mignot, A., Barth, H. and Heintze, K. (1996) Pharmacokinetics and Absolute Bioavailability of Lansoprazole. European Journal of Clinical Pharmacology, 50, 293-297. http://dx.doi.org/10.1007/s002280050111
Howden, C., Metz, D., Hunt, B., Vakily, M., Kukulka, M., Amer, F. and Samra, N. (2006) Dose-Response Evaluation of the Antisecretory Effect of Continuous Infusion Intravenous Lansoprazole Regimens over 48 h. Alimentary Pharmacology & Therapeutics, 23, 975-984. http://dx.doi.org/10.1111/j.1365-2036.2006.02849.x
Fass, R. (2012) Therapeutic Options for Refractory Gastroesophageal Reflux Disease. Journal of Gastroenterology and Hepatology, 27, 3-7. http://dx.doi.org/10.1111/j.1440-1746.2012.07064.x
Mueller-Lissner, S., Tytgat, G., Paulo, L., Quigleys, E., Bubeck, J., Peil, H. and Schaefer, E. (2006) Placebo-and Paracetamol-Controlled Study on the Efficacy and Tolerability of Hyoscine Butylbromide in the Treatment of Patients with Recurrent Crampy Abdominal Pain. Alimentary Pharmacology & Therapeutics, 23, 1741-1748. http://dx.doi.org/10.1111/j.1365-2036.2006.02818.x
Tytgat, G. (2007) Hyoscine Butylbromide. A Review of Its Use in the Treatment of Abdominal Cramping and Pain. Drugs, 67, 1343-1357. http://dx.doi.org/10.2165/00003495-200767090-00007
Koerselman, J., Pursnani, K., Peghini, P., Mohiuddin, M., Katzka, D., Akkermans, L. and Castell, D. (1999) Different Effects of an Oral Anticholinergic Drug on Gastroesophageal Reflux in Upright and Supine Position in Normal, Ambulant Subjects: A Pilot Study. American Journal of Gastroenterology, 94, 925-930. http://dx.doi.org/10.1016/s0002-9270(99)00043-x
Mexican Official Norm (1999) Tests and Procedures to Prove That a Medication Is Interchangeable. Mexican Official Norm, NOM-177-SSA1-1998. Requirement 9.1. Official Journal of the Federation, México City, México.
Rowland, M. and Tozer, T. (1989) Clinical Pharmacokinetics. Concepts and Applications. 3rd Edition, Lea and Febiger, Philadelphia.
Schuirmann, D. (1987) A comparison of the Two One-Sided Tests Procedure and the Power Approach for Assessing the Equivalence of Average Bioavailability. Journal of Pharmacokinetics and Biopharmaceutics, 15, 657-680. http://dx.doi.org/10.1007/BF01068419
Grasela Jr., T.H., Antal, E.J., Ereshefsky, L., Wells, B.G., Evans, R.L. and Smith, R.B. (1987) An Evaluation of Population Pharmacokinetics in Therapeutic Trials. Part II. Detection of a Drug-Drug Interaction. Clinical Pharmacology and Therapeutics, 42, 433-441. http://dx.doi.org/10.1038/clpt.1987.174
Fleisher, D., Li, C., Zhou, Y., Pao, L.H. and Karim, A. (1999) Drug, Meal and Formulation Interactions Influencing Drug Absorption after Oral Administration. Clinical Implications. Clinical Pharmacokinetics, 36, 233-254. http://dx.doi.org/10.2165/00003088-199936030-00004
Channer, K.S., Wolinski, A. and Virjee, J. (1983) The Effect of Hyoscine Butylbromide on the Swallowing of Capsules. British Journal of Clinical Pharmacology, 15, 560-563. http://dx.doi.org/10.1111/j.1365-2125.1983.tb02091.x
El-Bahie, N., Allen, E.M., Williams, J. and Routledge, P.A. (1985) The Effect of Activated Charcoal and Hyoscine Butylbromide Alone and in Combination on the Absorption of Mefenamic Acid. British Journal of Clinical Pharmacology, 19, 836-838. http://dx.doi.org/10.1111/j.1365-2125.1985.tb02724.x
Carrasco-Portugal, M.C., Fernández del Valle, C., Aguilar-Carrasco, J.C., Pati?o-Camacho, S., Reyes-García, J.G. and Flores-Murrieta, F.J. (2012) Evaluation of the Possible Pharmacokinetic Interaction between Ketorolac and Hyoscine Butylbromide in Healthy Volunteers. Clinical Pharmacology in Drug Development, 1, 208.
Ajima, U., Garba, M. and Yakasai, I. (2012) Comparison of the Effects of Cimetidine and Hyoscine-N-Butyl Bromide on Paracetamol Pharmacokinetics in Healthy Volunteers. Der Pharma Chemica, 4, 872-881.
Ayalasomayajula, S., Meyers, D., Koo, P., Salunke, A., Majumdar, T., Rebello, S., Sunkara, G. and Chen, J. (2015) Assessment of Pharmacokinetic Drug-Drug Interaction between Pradigastat and Acetaminophen in Healthy Subjects. European Journal of Clinical Pharmacology, 71, 425-432. http://dx.doi.org/10.1007/s00228-015-1822-2
Tandon, V. (2002) Bioavailability and Bioequivalence. In: Schoenwald, R.C., Ed., Pharmacokinetics in Drug Discovery and Development, CRC Press, Boca Ratón, 98-112. http://dx.doi.org/10.1201/9781420010084.ch5
Schmid, E., Bleichert, A., Uberla, K., Ritter, U. and Fehlhaber, E. (1968) Testing of Orally Administered Spasmolytics Demonstrated by the Effect of Hyoscine-N-Butylbromide on Gastric Motility. Arzneimittel-Forschung, 18, 1449-1453.
Schmid, E., Bleichert, A., Kitzing, J. and Ritter, U. (1969) Inhibition of Small Intestine Motility by Orally Administered Hyoscine-N-Butylbromide. Arzneimittel-Forschung, 19, 998-999.
Schmid, E., Wagner, T. and Ritter, U. (1971) Inhibition of Gastric Motility by Rectal Administration of Hyoscine-N-Butylbromide. Arzneimittel-Forschung, 21, 813-815.
Stacher, G., Bergmann, H., Havlik, E., Schmierer, G. and Schneider, C. (1984) Effects of Oral Cyclotropium Bromide, Hyoscine N-Butylbromide and Placebo on Gastric Emptying and Antral Motor Activity in Healthy Man. Gut, 25, 485-490. http://dx.doi.org/10.1136/gut.25.5.485
Wu, C., Sun, L., Yang, Y., Ren, C., Ai, X., Lian, H. and He, Z. (2013) Profiling Biopharmaceutical Deciding Properties of Absorption of Lansoprazole Enteric-Coated Tablets Using Gastrointestinal Simulation Technology. International Journal of Pharmaceutics, 453, 300-306. http://dx.doi.org/10.1016/j.ijpharm.2013.06.034