Drug-alcohol interactions: focus on central-acting drugs and analgesics


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Аннотация

It is known that alcohol abuse is a risk factor of many socially significant diseases like cardiovascular diseases, cirrhosis of the liver, acute pancreatitis, gastrointestinal bleeding, metabolic complications, malignant neoplasms and mental disorders. However, a negative prognosis in patients who regularly abuse alcohol is not only because of a large number of pathological conditions, but also due to complications of pharmacotherapy, drug-drug interactions, insufficient effectiveness against the background of drug-alcohol interaction. For example, there are literature evidence of an increase in the pharmacodynamic effect of amitriptilline, trazodone, gabapentin and other central-acting drugs. Also, a number of publications describe 20% increase in AUC12 after taking a single dose of carbamazepine 400 mg on the first day was noted than AUC after taking carbamazepine for 9 days after ethanol withdrawal in 7 chronic ethanol consumers; an increase in Cmax and AUC of esogabin by 23 and 36%, respectively, in 17 healthy men and women who reported moderate alcohol consumption; an increase in the Cmax and AUC of clobazam by an average of 59 and 54%, respectively, in 8 healthy male subjects who received clobazam (20 mg orally) together with ethanol (as a combination of beer and brandy). Thus, the simultaneous use of alcohol and drugs can potentially be associated with increased risks of ADRs. Healthcare practitioners should take into account the potential pharmacodynamic and pharmacokinetic interactions of alcohol and drugs when prescribing pharmacotherapy, but it is still much better to avoid the simultaneous use of alcohol and drugs.

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Авторлар туралы

A. Pereverzev

Russian Medical Academy of Continuous Professional Education

O. Ostroumova

Russian Medical Academy of Continuous Professional Education; I.M. Sechenov First Moscow State Medical University

Dr. Sci. (Med.), Professor of the Department of Clinical Pharmacology and Propedeutics of Internal Diseases; Professor of the Department of Therapy and Polymorbid Pathology n.a. Academician M.S. Vovsi

D. Sychev

Russian Medical Academy of Continuous Professional Education

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