Effect of Alcoholic Beverages on Drug Absorption
Abstract
Consumption of alcohol concomitantly with a drug may increase absorption of the active ingredients, leading to dose dumping. In this study, ibuprofen was administered to mice along with rice wine or beer. Blood concentrations of ibuprofen were lower when taken with alcohol than when taken with water. The ibuprofen formulation was suspended in rice wine, beer, 15% ethanol, or 20% mannitol, and then administered to male ddY mice. In a separate experiment, mice were pretreated with rice wine per os (p.o.) or loperamide (p.o.) 30 min before administering ibuprofen with water. Ibuprofen doses for oral administration and tail vein injection were 40 mg/kg and 0.75 mg/kg, respectively. Maximum blood concentrations (Cmax) were lower in mice pretreated with rice wine or beer. There were no significant differences in ibuprofen clearance between animals pretreated with rice wine by tail vein injection and controls. Pretreatment with 20% mannitol or loperamide lowered the blood concentration of ibuprofen. These results suggest that alcoholic beverages affect drug pharmacokinetics. In particular, absorption may be affected by an increase in osmotic pressure and inhibition of gastrointestinal transit.
Introduction
Consumption of Over- the-Counter (OTC) formulations with beverages other than water is not uncommon. There are many routine scenarios involving consumption of medications, especially during dinner, when drugs are taken along with alcoholic beverages. Some of our patients have reported taking medications with alcoholic beverages such as beer (e.g., during a business meeting). Consumption of medications with an alcoholic beverage can increase solubility of the active ingredients; the active ingredients are then largely dissolved in ethanol, resulting in a condition that has been termed as “dose dumping”.
The effects of dose dumping on the absorption of active ingredients have been previously described [1,5]. Two of these reports are studies on agents a acting the central nervous system [3,4] and one examined controlled-release formulations such as hydromorphone [4]. The review by Lennernas discussed ethanol-drug absorption and cited many studies using an ethanol solution [5], but few examining the effects or mechanisms associated with consumption of an alcoholic beverage. In this report, we focus on alcoholic beverages and discuss their effects on ibuprofen absorption in mice.
1Department of Pharmacy Practice and Sciences, Setsunan University, Hirakata, Osaka, 573-0101, Japan 2Department of Medical Pharmacy, Setsunan University, Hirakata, Osaka, 573-0101, Japan
*Corresponding author: Koji Komori, Faculty of Pharmaceutical Sciences, Department of Pharmacy Practice and Sciences, Setsunan University, 45-1 Nagaotogecho, Hirakata, Osaka 573-0101, Japan, Tel: +81-72-800-1124; Fax: +81-72-800-1124; E-mail: [email protected]