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Reduction of Paracetamol and Aspirin Metabolism During Viral Hepatitis

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Summary

The single-dose pharmacokinetics of two analgesic drugs, paracetamol (acetaminophen) and aspirin, were studied in healthy volunteers and in patients with viral hepatitis during the acute and the convalescent phase. Impaired elimination of paracetamol and aspirin was found in hepatitis patients, while plasma peak concentrations were unaffected. Recovered patients were not different from healthy controls in the rate of drug elimination. The data suggest normal single dosage for these drugs in acute viral hepatitis, and dosage modification only in severe cases.

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References

  • Arnman R, Olsson R. Elimination of paracetamol in chronic liver disease. Acta Hepato-Gastroenterologica 25: 283–286, 1978

    PubMed  CAS  Google Scholar 

  • Belaieff J, Cochet B, Allaz AF, Rudhardt M, Balant L, et al. Etude pharmacocinétique d’une cephalosporine, la cefopérazone, dans l’insuffisance hépatique. Schweizerische Medizinische Wochenschrift 111: 502–508, 1981

    PubMed  CAS  Google Scholar 

  • Benson GD. Acetaminophen in chronic liver disease. Clinical Pharmacology and Therapeutics 33: 95–101, 1983

    Article  PubMed  CAS  Google Scholar 

  • Brazier JL, Ritter J, Latour JF, Enoch F, Khenfer D, et al. Allongement de la demi-vie du paracétamol et l’hexobarbital en cas de cirrhose compensée et decompensée. Therapie 37: 275–280, 1982

    PubMed  CAS  Google Scholar 

  • Breimer DD, Zilly W, Richter E. Pharmacokinetics of hexobarbital in acute hepatitis and after apparent recovery. Clinical Pharmacology and Therapeutics 18: 433–440, 1975

    PubMed  CAS  Google Scholar 

  • Brodie BB, Burns JJ, Weiner M. Metabolism of drugs in subjects with Laennec’s cirrhosis. Medicina Experimentalis 1: 290–292, 1959

    PubMed  CAS  Google Scholar 

  • Buch Andreasen P, Hutters L. Paracetamol clearance in patients with cirrhosis of the liver. Acta Medica Scandinavica 624 (Suppl.): 99–105, 1979

    CAS  Google Scholar 

  • Burch J, Stanford N, Majerus P. Inhibition of platelet prostaglandin synthetase by oral aspirin. Journal of Clinical Investigation 61: 314–319, 1978

    Article  PubMed  CAS  Google Scholar 

  • Burnett DA, Barak AJ, Tuma DJ, Sorrell MF. Altered elimination of antipyrine in patients with acute viral hepatitis. Gut 17: 341–344, 1976

    Article  PubMed  CAS  Google Scholar 

  • Das Gupta V. Simultaneous quantitation of acetaminophen, aspirin, caffeine, codeine phosphate, phenacetin and salicylamide by high-pressure liquid chromatography. Journal of Pharmaceutical Sciences 69: 110–115, 1980

    Article  PubMed  CAS  Google Scholar 

  • Douglas AP, Savage RL, Rawlins MD. Paracetamol kinetics in patients with Gilbert’s syndrome. European Journal of Pharmacology 13: 209–212, 1978

    Article  CAS  Google Scholar 

  • Farrell GC, Cooksley WG, Hart P, Powell LW. Drug metabolism in liver disease, identification of patients with impaired hepatic drug metabolism. Gastroenterology 75: 580–588, 1978

    PubMed  CAS  Google Scholar 

  • Farrell GC, Cooksley WG, Powell LW. Drug metabolism in liver disease. Activity of hepatic microsomal metabolizing enzymes. Clinical Pharmacology and Therapeutics 26: 483–492, 1979

    PubMed  CAS  Google Scholar 

  • Forrest JAH, Finlayson NDC, Adjepon-Yamoah KK, Prescott LF. Antipyrine, paracetamol and lignocaine elimination in chronic liver disease. British Medical Journal 1: 1384–1387, 1977

    Article  PubMed  CAS  Google Scholar 

  • Forrest J, Adriaenssens P, Finlayson N, Prescott L. Paracetamol metabolism in chronic liver disease. European Journal of Clinical Pharmacology 15: 427–431, 1979

    Article  PubMed  CAS  Google Scholar 

  • Gabrielle L, Leterrier F, Molinié C, Essioux H, Cristau P, Laverdant C. Determination of human liver cytochrome P-450 by a micromethod using the electron paramagnetic resonance. Gastroentérologie Clinique et Biologique 1: 775–782, 1977

    PubMed  CAS  Google Scholar 

  • Gazzard B, Ford-Hutchinson A, Smith M, Williams R. The binding of paracetamol to plasma proteins of man and pig. Journal of Pharmacy and Pharmacology 25: 964–967, 1973

    Article  PubMed  CAS  Google Scholar 

  • Gugler R, Von Unruh GE. Clinical pharmacokinetics of valproic acid. Clinical Pharmacokinetics 5: 67–83, 1980

    Article  PubMed  CAS  Google Scholar 

  • Levy G. Comparative pharmacokinetics of aspirin and acetaminophen. Archives of Internal Medicine 141: 279–281, 1981

    Article  PubMed  CAS  Google Scholar 

  • Levy G, Tsuchiya T. Salicylate accumulation kinetics in man. New England Journal of Medicine 287: 430–432, 1972

    Article  PubMed  CAS  Google Scholar 

  • McHorse TS, Wilkinson GR, Johnson RF, Schenker S. Effect of acute viral hepatitis in man on the disposition and elimination of meperidine. Gastroenterology 68: 775–780, 1975

    PubMed  CAS  Google Scholar 

  • Menguy R, Desbaillets L, Okabe S, Masters YF. Abnormal aspirin metabolism in patients with cirrhosis and its possible relationship to bleeding in cirrhotics. Annals of Surgery 176: 412–418, 1972

    Article  PubMed  CAS  Google Scholar 

  • Mitchell J, Thorgeirsson S, Potter W, Jollow D, Keiser H. Acetaminophen-induced hepatic injury. Clinical Pharmacology and Therapeutics 16: 676–684, 1974

    PubMed  CAS  Google Scholar 

  • Mutschler E, Gilfrich HJ, Knauf H, Möhrke W, Völger K-D. Pharmacokinetics of triamterene. Clinical and Experimental Hypertension 2: 249–269, 1983

    Article  Google Scholar 

  • Narang AP, Datta DV, Nath N, Mathur VS. Impairment of hepatic drug metabolism in patients with acute viral hepatitis. European Journal of Drug Metabolism and Pharmacokinetics 7: 255–258, 1982

    Article  PubMed  CAS  Google Scholar 

  • Ohnhaus EE, Münch U, Meier J. Elimination of pindolol in liver disease. European Journal of Clinical Pharmacology 22: 247–251, 1982

    Article  PubMed  CAS  Google Scholar 

  • Prescott LF, Roscoe P, Wright N, Brown SS. Plasma paracetamol half-life and hepatic necrosis in patients with paracetamol overdosage. Lancet 1: 519–522, 1971

    Article  PubMed  CAS  Google Scholar 

  • Roth G, Majerus P. The mechanism of the effect of aspirin on human platelets. Journal of Clinical Investigation 56: 624–632, 1975

    Article  PubMed  CAS  Google Scholar 

  • Schoene B, Fleishmann R, Remmer H, von Oldershausen H. Determination of drug metabolizing enzymes in needle biopsies of human liver. European Journal of Clinical Pharmacology 4: 65–73, 1972

    Article  PubMed  CAS  Google Scholar 

  • Shamszad M, Soloman H, Mobarhan S, Iber FL. Abnormal metabolism of acetaminophen in patients with alcoholic liver disease. Gastroenterology 69: 865, 1975

    Google Scholar 

  • Shull HJ, Wilkinson GR, Johnson R, Schenker S. Normal disposition of oxazepam in acute viral hepatitis and cirrhosis. Annals of Internal Medicine 84: 420–425, 1976

    PubMed  CAS  Google Scholar 

  • Staib AH, Shuppan D, Lissner R, Zilly W, v. Bomhard G, et al. Pharmacokinetics and metabolism of theophylline in patients with liver diseases. International Journal of Clinical Pharmacology, Therapy and Toxicology 18: 500–502, 1980

    CAS  Google Scholar 

  • Starko KM, Ray G, Dominguez LB, Stromberg WL, Woodall DF. Reye’s syndrome and salicylate use. Pediatrics 66: 859–864, 1980

    PubMed  CAS  Google Scholar 

  • Weiss H, Aledort L, Kochwa S. The effects of salicylates on the hemostatic properties of platelets in man. Journal of Clinical Investigation 47: 2169–2180, 1968

    Article  PubMed  CAS  Google Scholar 

  • Williams RL, Senary WL, Blaschke TF, Meffin PJ, Melmon KL, et al. Influence of acute viral hepatitis on disposition and pharmacologic effect of warfarin. Clinical Pharmacology and Therapeutics 20: 90–97, 1976a

    PubMed  CAS  Google Scholar 

  • Williams RL, Blaschke TF, Meffin PJ, Melmon KL, Rowland M. Influence of viral hepatitis on the disposition of two compounds with high hepatic clearance; Lidocaine and indocyanine green. Clinical Pharmacology and Therapeutics 20: 290–299, 1976b

    PubMed  CAS  Google Scholar 

  • Wåhlin-Boll E, Brantmark B, Hanson A, Melander A, Nilsson C. High pressure liquid Chromatographic determination of acetylsalicylic acid, salicylic acid, diflunisal, indomethacin, indoprofen and indobufen. European Journal of Clinical Pharmacology 20: 375–378, 1981

    Article  PubMed  Google Scholar 

  • Zimmerman HJ. Effects of aspirin and acetaminophen on the liver. Archives of Internal Medicine 141: 333–342, 1981

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Infectious Diseases, Danderyd Hospital, S-182 88, Danderyd, Sweden

    C. Jorup-Rönström, B. Beermann, E. Wåhlin-Boll, A. Melander & S. Britton

  2. Department of Medicine, Karolinska Institute, Huddinge Hospital, Huddinge, Sweden

    C. Jorup-Rönström, B. Beermann, E. Wåhlin-Boll, A. Melander & S. Britton

  3. Division of Clinical Pharmacology, Lund University Health Sciences Centre, Dalby, Australia

    C. Jorup-Rönström, B. Beermann, E. Wåhlin-Boll, A. Melander & S. Britton

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  1. C. Jorup-Rönström
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  2. B. Beermann
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  3. E. Wåhlin-Boll
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  4. A. Melander
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  5. S. Britton
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Jorup-Rönström, C., Beermann, B., Wåhlin-Boll, E. et al. Reduction of Paracetamol and Aspirin Metabolism During Viral Hepatitis. Clin-Pharmacokinet 11, 250–256 (1986). https://doi.org/10.2165/00003088-198611030-00006

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  • DOI: https://doi.org/10.2165/00003088-198611030-00006

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