| Dapsone, trimethoprim, and sulfamethoxazole plasma levels during treatment of Pneumocystis pneumonia in patients with the acquired immunodeficiency syndrome (AIDS). Evidence of drug interactions. | |
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MedLine Citation:
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PMID: 2784648 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY OBJECTIVE: To examine the interaction between dapsone and trimethoprim in patients with the acquired immunodeficiency syndrome (AIDS). DESIGN: Measurement of drug levels as part of an open study of dapsone alone and randomized, double-blind comparison of trimethoprim-dapsone with trimethoprim-sulfamethoxazole in treating Pneumocystis carinii pneumonia in patients with AIDS. SETTING: County hospital and AIDS clinic. PATIENTS: Eighteen patients treated with dapsone alone, 30 with trimethoprim-dapsone, and 30 with trimethoprim-sulfamethoxazole. INTERVENTION: Dapsone, 100 mg/d; trimethoprim, 20 mg/kg body weight per day, and sulfamethoxazole, 100 mg/kg.d; administered for 21 days. MEASUREMENTS AND MAIN RESULTS: Concentrations of dapsone were 40% higher in patients treated with trimethoprim-dapsone than in those treated with dapsone alone (2.1 compared with 1.5 micrograms/mL; P less than 0.05). Trimethoprimdapsone-treated patients had fewer treatment failures but more side effects and treatment terminations due to toxicity than those treated with dapsone alone. The concentration of trimethoprim was 48.4% higher in patients treated with trimethoprim-dapsone than in those treated with trimethoprim-sulfamethoxazole, (18.4 compared with 12.4 micrograms/mL; P less than 0.05). Discontinuation of therapy due to toxicity was commoner in the trimethoprim-sulfamethoxazole group (57% compared with 30%). CONCLUSIONS: A bidirectional drug interaction exists between dapsone and trimethoprim, resulting in higher concentrations of each in the presence of the other. |
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Authors:
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B L Lee; I Medina; N L Benowitz; P Jacob; C B Wofsy; J Mills |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Annals of internal medicine Volume: 110 ISSN: 0003-4819 ISO Abbreviation: Ann. Intern. Med. Publication Date: 1989 Apr |
Date Detail:
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Created Date: 1989-04-26 Completed Date: 1989-04-26 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0372351 Medline TA: Ann Intern Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 606-11 Citation Subset: AIM; IM; X |
Affiliation:
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San Francisco General Hospital Medical Center, California. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acetylation Acquired Immunodeficiency Syndrome / complications* Adult Dapsone / administration & dosage, adverse effects, blood* Drug Interactions Drug Therapy, Combination Female Humans Male Phenotype Pneumonia, Pneumocystis / drug therapy*, etiology Prospective Studies Random Allocation Sulfamethoxazole / administration & dosage, adverse effects, blood* Trimethoprim / administration & dosage, adverse effects, blood* |
| Grant Support | |
ID/Acronym/Agency:
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FDR-000137-01-1/FD/FDA HHS; GM-07546/GM/NIGMS NIH HHS |
| Chemical | |
Reg. No./Substance:
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723-46-6/Sulfamethoxazole; 738-70-5/Trimethoprim; 80-08-0/Dapsone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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