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Rodríguez-Fonseca L, Llorente-Pendás S, García-Pola M. Risk of Prediabetes and Diabetes in Oral Lichen Planus: A Case-Control Study according to Current Diagnostic Criteria. Diagnostics (Basel) 2023; 13:diagnostics13091586. [PMID: 37174976 PMCID: PMC10178478 DOI: 10.3390/diagnostics13091586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE To estimate the prevalence of prediabetes and diabetes in patients with oral lichen planus (OLP). METHODS Prospective cohort, including consecutive patients diagnosed clinically and histologically with OLP from 2018 to 2022. Patients and controls were matched by age and gender. Fasting plasma glucose value collection from all patients. Multivariate regression analysis evaluated the relationship between prediabetes and diabetes variables according to current diagnostic criteria. RESULTS The sample comprised 275 patients (207 women; 75.3%), mean age 59.60 ± 12.18 years for both groups. Prediabetes was diagnosed according to the American Diabetes Association (ADA, 100-125 mg/dL), in 21.45% of OLP patients (59/275) and 14.55% (40/275) of control patients (p = 0.035). Patients with the atrophic-erosive form exhibited stronger association with taking oral antidiabetics (p = 0.011). Multivariate analysis showed that being over >60 years and having a cutaneous location was associated with ≥3 sites (OR 1.81 and OR 2.43). ADA prediabetes and oral antidiabetics drugs increased the probability of OLP (OR 1.60 (1.04-2.51), p = 0.03 and OR 2.20 (1.18-4.69), p = 0.017) after adjustment for sex and age. CONCLUSIONS Because glycemia 100-125 mg/dL was associated with OLP, testing serum fasting plasma glucose seems reasonable in order to prevent development of diabetes and deal with possible complications until new studies are complete.
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Affiliation(s)
- Lucía Rodríguez-Fonseca
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Sciences of the Health, Oviedo University, 33006 Oviedo, Spain
| | | | - María García-Pola
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Sciences of the Health, Oviedo University, 33006 Oviedo, Spain
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Gyldenkerne C, Olesen KKW, Madsen M, Thim T, Jensen LO, Raungaard B, Sørensen HT, Bøtker HE, Maeng M. Association between anti-diabetes treatments and cardiovascular risk in diabetes patients with and without coronary artery disease. Diab Vasc Dis Res 2019; 16:351-359. [PMID: 30939916 DOI: 10.1177/1479164119836227] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE We examined the risk of myocardial infarction associated with glucose-lowering therapy among diabetes patients with and without obstructive coronary artery disease. METHODS A cohort of patients with type 1 or type 2 diabetes (n = 12,030), who underwent coronary angiography from 2004 to 2012, were stratified by presence of obstructive (any stenosis ⩾50%) coronary artery disease and by type of diabetes treatment: diet, non-insulin treatment and insulin (±oral anti-diabetics). The primary endpoint was myocardial infarction. Adjusted hazard ratios were calculated using diet-treated patients without coronary artery disease as reference. RESULTS In patients without coronary artery disease, risk of myocardial infarction was similar in patients treated with non-insulin medication (adjusted hazard ratio 0.70, 95% confidence interval 0.27-1.81) and insulin (adjusted hazard ratio 0.76, 95% confidence interval 0.27-2.08) as compared to diet only. In patients with coronary artery disease, the risk of myocardial infarction was higher than in the reference group and an incremental risk was observed being lowest in patients treated with diet (adjusted hazard ratio 3.79, 95% confidence interval 1.61-8.88), followed by non-insulin medication (adjusted hazard ratio 5.42, 95% confidence interval 2.40-12.22), and highest in insulin-treated patients (adjusted hazard ratio 7.91, 95% confidence interval 3.51-17.82). CONCLUSION The presence of obstructive coronary artery disease defines the risk of myocardial infarction in diabetes patients. Glucose-lowering therapy, in particular insulin, was associated with risk of myocardial infarction only in the presence of coronary artery disease.
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Affiliation(s)
| | - Kevin Kris Warnakula Olesen
- 1 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- 2 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Madsen
- 2 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Troels Thim
- 1 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Bent Raungaard
- 4 Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Toft Sørensen
- 2 Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Erik Bøtker
- 1 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Maeng
- 1 Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
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Fazeli Farsani S, Souverein PC, Overbeek JA, van der Vorst MMJ, Knibbe CAJ, Herings RMC, de Boer A, Mantel-Teeuwisse AK. Long term trends in oral antidiabetic drug use among children and adolescents in the Netherlands. Br J Clin Pharmacol 2015; 80:294-303. [PMID: 25683632 DOI: 10.1111/bcp.12608] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 02/07/2015] [Accepted: 02/10/2015] [Indexed: 12/18/2022] Open
Abstract
AIM The aim of the study was to document long term trends in oral antidiabetic drug (OAD) use among children and adolescents in the Netherlands. METHODS A population-based cohort study was conducted using the Dutch PHARMO Database Network. All patients younger than 20 years old with at least one OAD dispensing were identified. Age-adjusted and age-specific incidence (1999-2011) and prevalence (1998-2011) rates of OAD use were calculated. Trends over time were assessed using joinpoint regression software. A subset of PHARMO Database Network (including community pharmacy dispensing records linked to general practitioner data (OPD-GP database)) was used to assess indications for OADs. RESULTS In 2011, the overall age-adjusted incidence and prevalence rates of OAD use were 20.7/100 000 (95% CI 19.2, 22.1) person-years (PY) and 53.8/100 000 (95% CI 51.5, 56.1) persons, respectively. The average annual percentage change (AAPC) in the overall age-adjusted incidence rates from 1999 to 2011 was 18.9% (95% CI 4.5, 35.2). The incidence and prevalence rates of OAD use were higher among females and older age categories. The increases in rates of OAD use were mainly driven by metformin. For only 50% of the 98 patients in the OPD-GP database, indications for OAD prescriptions were reported with type 1 diabetes (n = 20), type 2 diabetes (n = 16), and overweight/obesity (n = 10). CONCLUSIONS Incidence and prevalence rates of OAD use in children and adolescents substantially increased in the Netherlands, especially among older age categories (10-14 and 15-19 years) and females. The main indications for use of OADs were type 1 and 2 diabetes and overweight/obesity.
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Affiliation(s)
- S Fazeli Farsani
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - P C Souverein
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - J A Overbeek
- PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands
| | - M M J van der Vorst
- Department of Paediatrics, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - C A J Knibbe
- Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, the Netherlands.,Division of Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands
| | - R M C Herings
- PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.,Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - A de Boer
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
| | - A K Mantel-Teeuwisse
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands
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Rojo-Martínez G, Valdés S, Colomo N, Lucena MI, Gaztambide S, Gomis R, Casamitjana R, Carmena R, Catalá M, Martínez-Larrad MT, Serrano-Ríos M, Castaño L, Vendrell J, Girbés J, Franch J, Vázquez JA, Mora-Peces I, Urrutia I, Pascual-Manich G, Ortega E, Menéndez E, Delgado E, Bordiú E, Castell C, López-Alba A, Goday A, Calle A, Bosch-Comas A, Soriguer F. Use of drugs related to the treatment of diabetes mellitus and other cardiovascular risk factors in the Spanish population. The Di@bet.es study. ACTA ACUST UNITED AC 2014; 66:854-63. [PMID: 24773992 DOI: 10.1016/j.rec.2013.05.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/31/2013] [Indexed: 01/10/2023]
Abstract
INTRODUCTION AND OBJECTIVES To assess the patterns of use of 8 therapeutic drug groups for the treatment of diabetes mellitus and other cardiovascular risk factors, and to identify sociodemographic and health determinants of their use in the overall Spanish population. METHODS A representative sample of the Spanish population within the Di@bet.es study, a cross-sectional population-based survey, was included. STUDY VARIABLES sociodemographic, clinical, and lifestyle data; physical examination, and an oral glucose tolerance test in patients without known diabetes mellitus. Furthermore, patients were systematically queried about current medication use, and 8 pharmacotherapeutic groups were evaluated: lipid-lowering therapy, antihypertensives, oral hypoglycemic agents, insulin, thyroid hormone, uricosurics, psychoactive drugs, and nonsteroidal anti-inflammatory drugs. RESULTS Sixty-six percent of the Spanish population was taking at least one medication. Therapeutic drug use was associated with age, independently of the higher prevalence of diabetes mellitus, hypertension, or hyperlipidemia in older patients. Sex disparities were found in the use of lipid-lowering agents, allopurinol, levothyroxine, nonsteroidal anti-inflammatory drugs, and psychoactive drugs. Use of psychoactive drugs was related to education level, work status, physical activity, smoking, and alcohol consumption. Almost 30% of patients with diabetes mellitus were taking 6 or more medications daily. Diabetes mellitus was associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs. CONCLUSIONS Age and sex are the most important factors determining therapeutic drug use. Lifestyle patterns and sociocultural factors have an impact only on psychoactive drug use. Diabetes mellitus is associated with greater use of antihypertensives, lipid-lowering agents, and nonsteroidal anti-inflammatory drugs.
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Affiliation(s)
- Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Sergio Valdés
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Natalia Colomo
- Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - M Isabel Lucena
- Departamento de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Facultad de Medicina, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Sonia Gaztambide
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Ramón Gomis
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Unidad de Endocrinología y Diabetes, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Roser Casamitjana
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Centro de Diagnóstico Biomédico, Hospital Clínic, Barcelona, Spain
| | - Rafael Carmena
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departamento de Medicina y Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Miguel Catalá
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Departamento de Medicina y Endocrinología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - María T Martínez-Larrad
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Manuel Serrano-Ríos
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Joan Vendrell
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitàries Pere Virgili, Tarragona, Spain
| | - Juan Girbés
- Unidad de Diabetes, Hospital Arnau de Vilanova, Valencia, Spain
| | - Josep Franch
- EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Atención Primaria, Unitat de Suport a la Recerca (IDIAP-Fundació Jordi Gol), Barcelona, Spain
| | - José A Vázquez
- Plan Nacional de Diabetes, Ministerio de Sanidad, Madrid, Spain
| | | | - Inés Urrutia
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Grupo de Investigación de Diabetes, Hospital Universitario de Cruces, UPV-EHU, Baracaldo, Vizcaya, Spain
| | - Gemma Pascual-Manich
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain
| | - Emilio Ortega
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Unidad de Endocrinología y Diabetes, Hospital Clínic, Barcelona, Spain
| | - Edelmiro Menéndez
- Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Elias Delgado
- Departamento de Medicina-Endocrinología y Nutrición, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Elena Bordiú
- Laboratorio de Endocrinología, Hospital Universitario San Carlos, Madrid, Spain
| | - Conxa Castell
- Departament de Salut Pública, Conselleria de Sanitat, Generalitat de Catalunya, Barcelona, Spain
| | | | - Alberto Goday
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, Spain
| | - Alfonso Calle
- Servicio de Endocrinología y Nutrición, Hospital Universitario San Carlos, Madrid, Spain
| | - Anna Bosch-Comas
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Federico Soriguer
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Spain; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario Carlos Haya, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain.
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Vora J, Caputo S, Damci T, Orozco-Beltran D, Pan C, Svendsen AL, Sølje KS, Khunti K. Effect of once-daily insulin detemir on oral antidiabetic drug (OAD) use in patients with type 2 diabetes. J Clin Pharm Ther 2013; 39:136-43. [PMID: 24329524 DOI: 10.1111/jcpt.12116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 11/05/2013] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE There are acknowledged benefits to continuing metformin when initiating insulin, but there appears to be growing concern over the role of sulphonylureas and thiazolidinediones when used in combination with insulin. This analysis investigates the effects of continuing or discontinuing oral antidiabetic drugs (OADs) following the initiation of once-daily insulin detemir. METHODS SOLVE is a 24-week, multinational observational study of insulin detemir initiation in patients with type 2 diabetes mellitus treated with one or more OADs. RESULTS In the total cohort (n = 17 374), there were significant improvements in HbA1c (-1·3%, 95% CI -1·34; -1·27%) and weight (-0·6 kg, 95% CI -0·65; -0·47 kg), with an increase in the incidence rate of minor hypoglycaemia (+0·256 events ppy, P < 0·001), but not severe hypoglycaemia (-0·038 events ppy, P < 0·001). Study participants had information on OAD use either prior to (n = 17 086) or during insulin initiation (n = 16 346). HbA1c reductions were significantly greater in patients continuing treatment with metformin (-1·3% vs. -1·1%, P < 0·01), thiazolidinediones (-1·3% vs. -1·0%, P < 0·01) and DPP-IV inhibitors (-1·3% vs. -0·9%, P < 0·001). Final insulin doses were significantly greater in patients discontinuing treatment with sulphonylureas (0·29 vs. 0·26 IU/kg, P < 0·001), glinides (0·28 vs. 0·26 IU/kg, P < 0·01), thiazolidinediones (0·31 vs. 0·26 IU/kg, P < 0·001) and DPP-IV inhibitors (0·35 vs. 0·29 IU/kg, P < 0·001) compared with patients continuing these respective agents. All patient subgroups had a mean weight loss irrespective of OAD continuation, apart from those continuing thiazolidinediones (+0·2 kg). The largest improvements in weight were seen following the withdrawal of sulphonylureas and thiazolidinediones (-1·1 and -1·1 kg, respectively). WHAT IS NEW AND CONCLUSION Discontinuation (or switching) of OADs at the time of insulin initiation appears to be governed principally by concerns about hypoglycaemia and weight. HbA1c improvements were smaller in patients discontinuing OADs at the time of insulin initiation and may be associated with insufficient insulin titration.
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Affiliation(s)
- J Vora
- Department of Diabetes and Endocrinology, Royal Liverpool University Hospital, Liverpool, UK
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Lal J, Jain GK. Effect of centchroman coadministration on the pharmacokinetics of metformin in rats. Indian J Pharmacol 2011; 42:146-9. [PMID: 20871764 PMCID: PMC2937314 DOI: 10.4103/0253-7613.66836] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 03/25/2010] [Accepted: 05/31/2010] [Indexed: 12/20/2022] Open
Abstract
Objectives: To study the effect of centchroman, a non-steroidal oral contraceptive, coadministration on the pharmacokinetics of metformin in rats. Materials and Methods: The pharmacokinetic interaction of metformin was studied in normal Sprague-Dawley female rats with and without centchroman coadministration. Blood samples were analyzed using a validated high-performance liquid chromatography method to generate the pharmacokinetic profile of metformin. The Cmax and tmax were directly read from the concentration–time data. Other pharmacokinetic parameters were estimated using non-compartmental analyses. Results: Metformin was monitored up to 10 h, and it exhibited a double-peak phenomenon. The Cmax 1, 2.62 ± 0.32 μg/ml, and Cmax 2, 2.96 ± 0.65 μg/ml, occurred after 0.75 and 3 h post-dose, respectively. The mean residence time (MRT), AUC0-4 h and volume of distribution (Vd/F) were 4.20 ± 0.30 h, 8.53 ± 1.89 μg.h/ml and 14.24 ± 5.42 L/kg, respectively. Following centchroman coadministration, metformin showed significantly (P < 0.05) higher Cmax (Cmax 1, 3.96 ± 0.55 μg/ml and Cmax 2, 5.21 ± 0.59 μg/ml), AUC0-4 h (12.28 ± 0.73 μg.h/ml) and Vd/F (18.29 ± 1.19 L/kg), but lower MRT (3.19 ± 0.36 h) than the values obtained after metformin dosing alone. However, AUC0-t (17.74 ± 5.58 μg.h/ml) and clearance (3.76 ± 0.80 L/h/kg) remained unchanged. Conclusions: The results indicate that centchroman coadministration increases the rate but not the extent of absorption of metformin in rats. However, it does not seem to alter the pharmacokinetics of metformin to clinically significant levels.
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Affiliation(s)
- Jawahar Lal
- Pharmacokinetics & Metabolism Division, Central Drug Research Institute, CSIR, Lucknow - 226 001, India
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