PMID: 6978898May 1, 1982Paper

Steroid-specific and anticonvulsant interaction aspects of troleandomycin-steroid therapy

The Journal of Allergy and Clinical Immunology
S J SzeflerW J Jusko

Abstract

Troleandomycin (TAO) is a macrolide antibiotic that has an apparent "steroid-sparing" effect when used in the treatment of severe steroid-dependent asthmatic patients. Recent observations demonstrated the effect of TAO on inhibiting methylprednisolone elimination, possibly contributing to its beneficial effects. Prednisolone and methylprednisolone disposition were studied before and 1 wk after initiation of TAO therapy in three patients. Methylprednisolone elimination was characteristically impaired in the presence of TAO therapy; however, there was no apparent effect on prednisolone elimination. Methylprednisolone elimination was also evaluated before and after initiation of TAO therapy in three patients receiving concomitant anticonvulsant therapy with phenobarbital-1, phenytoin-2. Methylprednisolone clearance before TAO was at least 4 times faster than normal and was probably related to enzyme induction by the anticonvulsant medication. Methylprednisolone clearance was subsequently reduced by approximately 70% in the presence of TAO therapy. The effect of TAO on corticosteroid disposition is steroid-specific and TAO can diminish the effect of certain drugs on the induction of corticosteroid metabolism.

Citations

Jan 1, 1986·European Journal of Clinical Pharmacology·S J SzeflerW J Jusko
Apr 22, 2004·Pharmacotherapy·Stanley W CarsonManuel E Tancer
Dec 1, 1984·The American Journal of Medicine·A W GreenW J Jusko
Jan 1, 1983·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·C J Falliers
Jan 1, 1987·Journal of Adolescent Health Care : Official Publication of the Society for Adolescent Medicine·M Bartoszek, S J Szefler
Jan 28, 2005·Respiratory Medicine·G FerraraL Richeldi
Jun 1, 1990·The Journal of Allergy and Clinical Immunology·S J Szefler
Dec 22, 1999·Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology·J C In 't VeenE H Bel
Nov 1, 1992·Pediatric Pulmonology·A K KamadaS J Szefler
Sep 16, 2015·The Cochrane Database of Systematic Reviews·Kayleigh M KewGiovanni Ferrara

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