THE EFFECT OF HYPERLIPIDEMIC STATE ON URINE EXPRESSION OF RIFAMPICIN AND ITS ASSOCIATION WITH PULMONARY TUBERCULOSIS-A PROSPECTIVE PILOT STUDY

Authors

  • Sumanth Madan Undergraduate, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India 576104
  • Meena Kumari K. Dept. of Pharmacology, KMC, Manipal, Manipal University, Karnataka, India
  • Afreen A. Choudhry Dept. of Biochemistry, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India 576104
  • Suhasini Kamath Dept. of Biochemistry, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India 576104
  • Asha Kamath Dept.of Community Medicine, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India 576104
  • Mohan Babu Amberkar Dept. of Pharmacology, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India 576104
  • Pragna Rao Dept. of Biochemistry, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India 576104
  • Rahul Magazine Dept.of Pulmonology, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India 576104
  • Rudra Ramanathan Undergraduate, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India 576104

Keywords:

EGFR, Total cholesterol, Triglycerides, Urine concentration

Abstract

Objectives: Rifampicin is an antibiotic that imparts an orange-red colour to the urine for a few hours after a dose. About 7% of the administered drug is excreted through the urine. This study compared the urine colour expression of rifampicin in normal and hyperlipidaemic subjects.

Methods: A cohort pilot study was conducted at a tertiary care hospital in which eight subjects with tuberculosis with normal lipid profiles and twelve subjects with deranged lipid profiles were given one tablet of rifampicin (450 mg) in the morning on empty stomach over one month. After one month urine samples was collected at 1,3 and 5 hours. The quantity of rifampicin in urine was estimated using a spectrophotometer. The results were analysed using SPSS version 18.

Results: Twenty patients with pulmonary tuberculosis and on rifampicin 450mg were taken for this study. Their urine was analysed for concentration of rifampicin and correlated to their total cholesterol and triglycerides values. The median total cholesterol in the study group was 345.5 mg/dL whereas in control group was 145.5 mg/dL. The median triglycerides in study group was 436 mg/dL in comparison to control group 113.5 mg/dl. The mean urine concentration of rifampicin in study group at 1hr,3h and 5 h was (47.08 ±17.17),(102.5±134.57) and (63.75±38.027)mcg/dl respectively in comparison to control group (53.13±14.126),(199.38±146.2) and (215.63±164.825) mcg/dL respectively at 1,3 and 5 h.

Conclusion: The study shows that hyperlipidemia may be associated with decreased level of rifampicin, leading to therapeutic failure in tuberculosis patients.

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References

Paramasivan CN and VenkataramanP. Drug resistance in tuberculosis in India. Indian J Med Res 2004;120:377-86.

Niemi M, Backman JT, Fromm MF, Neuvonen PJ, Kivistö KT. Pharmacokinetic interactions with rifampicin:clinical relevance. J Clin Pharmacokinet 2003;42:819-50.

Acocella G. Clinical Pharmacokinetics of Rifampicin. J Clin Pharmacokinet 1978;3 (2):108-27.

Hardman JG, Limbird LE, and Gilman AG, eds. "Rifampin." The Pharmacological Basis of Therapeutics. 10th ed. United States of America:The McGraw-Hill Companies, 2001. pp. 1277-79.

Deck DH and Winston.Antimycobacterial drugs.In:Katzung BG,Masters SB, Trevor AJ,Basic and Clinical Pharmacology. 12thed,NewYork,McGraw Hill;2012.p841.

Wasan KM, Brocks DR, Lee SD, Sachs-Barrable K and Thornton SJ. Impact of lipoproteins on the biological activity and disposition of hydrophobic drugs:implications for drug discovery. J Nat Rev Drug Discov 2008;7:84-99.

Eliot LA, Foster RT, Jamali F. Effects of Hyperlipidemia on the Pharmacokinetics of Nifedipine in the Rat. J Pharm Res1999;16(2):309-13.

Gadkowski LB and Stout JE, Pharmacokinetics of Rifampicin. J Clin Infect Dis 2007;44:618-19.

Mehta JB, Shantaveerapa H, Byrd RP, Morton SE, Fountain F, Roy TM. Utility of Rifampin Blood Levels in the Treatment and Follow-up of Active Pulmonary Tuberculosis in Patients who Were Slow to Respond to Routine Directly Observed Therapy. J Chest 2001;120(5):1520-24.

Panchagnula R, Sood A, Sharda N, Kaur K, Kaul CL.Determination of rifampicin and its main metabolite in plasma and urine in presence of pyrazinamide and isoniazid by HPLC method. J Pharm Biomed Anal 1999;18 (6):1013-20.

Burman WJ, Gallicano K, Peloquin C. Comparative Pharmacokinetics and Pharmacodynamics of the Rifamyc in Antibacterials. J Clin Pharmacokinet2001;40 (5):327-41.

Third Report of the National Cholesterol Education Program (NCEP).Detection, Evaluation and treatment of High Blood Cholesterol in Adults. http:// www.nhlbi.nih.gov/ guidelines/ cholesterol/atp3full.pdf accessed on 20 th January 2014.

Binda G, Domenichini E, Gottardi A, Orlandi B, Ortelli E, Pacini B et al.Rifampicin, a general review. J Arzneimittelforschung 1971;21(12):1907-77.

Ian Phillips.Clinical uses and control of rifampicin and clindamycin. J Clin Pathol 1971;24:410-18.

Acocella G, Mattiussi R, Segre G. Multicompartmental analysis of serum, urine and bile concentrations of rifampicin and desacetyl-rifampicin in subjects treated for one week. J Pharmacol Res Commun 1978;10:271-88.

Chan K. In Vitro Protein Binding Characteristics of Isoniazid, Rifampicin and Pyrazinamide to Whole Plasma, Albumin, and α-1-Acid Glycoprotein. J Clin Biochem 1996;29:1-3.

Holdiness MR. Clinical Pharmacokinetics of the Antituberculosis Drugs. J Clin Pharmacokinet. 1984;9( 6):511-44.

Published

01-07-2014

How to Cite

Madan, S., M. K. K., A. A. Choudhry, S. Kamath, A. Kamath, M. B. Amberkar, P. Rao, R. Magazine, and R. Ramanathan. “THE EFFECT OF HYPERLIPIDEMIC STATE ON URINE EXPRESSION OF RIFAMPICIN AND ITS ASSOCIATION WITH PULMONARY TUBERCULOSIS-A PROSPECTIVE PILOT STUDY”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 6, no. 7, July 2014, pp. 99-102, https://www.innovareacademics.in/journals/index.php/ijpps/article/view/1271.

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