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Archives 2015
Myanmar Health Sciences Research Journal
Volume 27, Number 3
TITLE: Effects of Diclofenac and Ibuprofen on Pharmacokinetics of Ciprofloxacin in Myanmar Healthy Volunteers
AUTHOR: Aye Pwint Phyu, Nang Hla Hla Win, Khin Thein Oo, Khin Chit, Khin Hnin Pwint & Thinzar Myo
SOURCE: Myanmar Health Sciences Research Journal, Vol. 27, No. 3, 2015
ABSTRACT: The present study was done to explore the pharmacokinetics of cipro-floxacin that was altered by co-administration of either diclofenac or ibuprofen. The study was conducted on twelve Myanmar healthy volunteers and divided into three phases with a wash out period of one week in between phases. In phase, ciprofloxacin 500 mg was given to all volunteers, ciprofloxacin 500 mg with diclofenac 50 mg was given to same volunteers in phase 2 and ciprofloxacin 500 mg with ibuprofen 400 mg was given in phase 3. Blood samples were collected at 0, 0.5, 1, 2, 3, 4, 6 and 8 hours after drugs administration and ciprofloxacin concentrations in plasma samples were analyzed by HPLC with UV detection. It was found that mean clearance was reduced from 0.38±0.11 Lhr-1kg-1 in ciprofloxacin alone to 0.30±0.07 Lhr-1kg-1 and 0.28±0.09 Lhr-1kg-1 in ciprofloxacin with diclofenac and ciprofloxacin with ibuprofen (p=0.019). Similarly, the mean elimination rate constants (Kel) was significantly reduced from 0.24±0.03 hr-1 in ciprofloxacin alone to 0.18±0.024 hr-1 in ciprofloxacin with diclofenac and 0.12±0.03 hr-1 in ciprofloxacin with ibuprofen co-administration (p=0.000). Increase in AUC of ciprofloxacin was founded that AUC of ciprofloxacin alone was 13.51±1.91 µgml-1.hr, ciprofloxacin with diclofenac was 17.36±2.67 µgml-1.hr and with ibuprofen was 18.43±4.08 µgml-1.hr, respectively (p=0.001). The mean elimination half-life (T½el) of ciprofloxacin alone and ciprofloxacin with diclofenac or ciprofloxacin with ibuprofen were 2.85±0.46 hrs vs. 3.79±0.49 hrs and 2.85±0.46 hrs vs. 3.61±0.57 hrs, respectively (p=0.000). In comparison with ciprofloxacin alone study, the elimination parameters of the present study were altered significantly after diclofenac or ibuprofen co-administration. These findings suggested that it should be cautious in use of analgesics (diclofenac or ibuprofen) together with ciprofloxacin especially in elderly and renal function impaired patients in clinical practice. On the other hand, increased concentration (AUC) of ciprofloxacin may enhance bactericidal effect and can result better outcome in treating pathogenic organisms.
SUBJECT HEADINGS: Pharmacokinetics, Ciprofloxacin, HPLC
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