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. 2019 Apr;44(2):289-294.
doi: 10.1007/s13318-018-0508-4.

The Influence of Diabetes Mellitus on Glucuronidation and Sulphation of Paracetamol in Patients With Febrile Neutropenia

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Free PMC article

The Influence of Diabetes Mellitus on Glucuronidation and Sulphation of Paracetamol in Patients With Febrile Neutropenia

Anna Stachowiak et al. Eur J Drug Metab Pharmacokinet. .
Free PMC article

Abstract

Background and objectives: Numerous studies have confirmed the influence of diabetes mellitus on the pharmacokinetics of drugs. Paracetamol (APAP) is an antipyretic that is commonly used in febrile neutropenia (FN) therapy. APAP is chiefly metabolised by glucuronidation and sulphation. This study assessed the influence of diabetes on the pharmacokinetics of paracetamol and its metabolites: glucuronide (APAP-glu) and sulfate (APAP-sulfate) in FN patients.

Methods: Patients with FN received single intravenous dose 1000 mg of APAP. The FN patients were allocated to one of two groups: diabetics (DG, n = 7) or non-diabetics (NDG, n = 11). The plasma concentrations of paracetamol and its metabolites were measured with the validated high-performance liquid chromatography (HPLC) with ultraviolet (UV) detection.

Results: Pharmacokinetic parameters (mean [SD]) of APAP in the DG and NDG groups were as follows: Cmax (maximum comcentration) = 21.50 [11.23] vs. 23.42 [9.79] mg/L, AUC0-t (area under the concentration-time curve) = 44.23 [17.93] vs. 41.43 [14.57] mg·h/L, t1/2kel (elimination half-life) = 2.28 [0.80] vs. 2.11 [0.80] h. In both groups the exposure to APAP was comparable. The study did not reveal differences between the two groups in the pharmacokinetics of APAP-glu and APAP-sulfate. The Cmax and AUC0-t ratio between the metabolites and APAP were similar.

Conclusions: No differences in the pharmacokinetics of APAP, APAP-glu and APAP-sulfate in patients with FN indicates that diabetes does not influence glucuronidation and sulfatation of paracetamol.

Conflict of interest statement

Conflicts of interest

Anna Stachowiak, Edyta Szałek, Agnieszka Karbownik Joanna Porażka, Iwona Przewoźna, Tomasz Grabowski, Anna Wolc, Edmund Grześkowiak have no conflict of interest.

Ethics approval

The research was approved by the Bioethics Committee, University of Medical Sciences, Poznan, Poland (437/16). All procedures in this study were in accordance with the 1964 Helsinki declaration (and its amendments).

Informed consent

Written informed consent was obtained from all patients participating in the study.

Figures

Fig. 1
Fig. 1
Paracetamol (APAP) plasma concentration vs. time profiles following single intravenous administration of paracetamol to patients with febrile neutropenia (diabetic vs. non-diabetic group). Plots represent the arithmetic mean with standard deviation
Fig. 2
Fig. 2
Paracetamol glucuronide (APAP-glu) and paracetamol sulphate (APAP-sulfate) plasma concentrations vs. time profiles following single intravenous (i.v.) administration of paracetamol to patients with febrile neutropenia (diabetic vs. non-diabetic group). Plots represent the arithmetic mean with standard deviation

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