厄洛替尼和泮托拉唑：存在相关相互作用？还是没有？
Erlotinib and pantoprazole: a relevant interaction or not?
机构信息
Department of Pharmacy, Meander Medical Center, Amersfoort, the Netherlands.
出版信息
Br J Clin Pharmacol. 2010 Dec;70(6):908-11. doi: 10.1111/j.1365-2125.2010.03748.x.
Abstract
AIMS
There is increasing evidence that erlotinib exposure correlates well with treatment outcome. In this report we present a case of therapeutic drug monitoring of erlotinib in a patient with a gastric ulcer, treated with the proton pump inhibitor pantoprazole. This agent may cause an unwanted, but not always unavoidable, interaction since absorption of erlotinib is pH dependent.
METHODS
Erlotinib trough concentrations were monitored in a patient during treatment with orally and intravenously administered pantoprazole.
RESULTS
Erlotinib trough concentrations were diminished during high dose intravenously administered pantoprazole, but returned to normal when the dose was reduced and pantoprazole was administered orally.
CONCLUSIONS
More studies are needed to assess the dose dependency of the interaction between pantoprazole and erlotinib. Furthermore, we advise to monitor closely erlotinib plasma concentrations and adjust the erlotinib dose accordingly when a clinically relevant interaction is suspected and no proper dosing guidelines are available.
摘要
目的
越来越多的证据表明，厄洛替尼的暴露量与治疗效果密切相关。在本报告中，我们介绍了一例在使用质子泵抑制剂泮托拉唑治疗胃溃疡的患者中进行厄洛替尼治疗药物监测的案例。由于厄洛替尼的吸收依赖于 pH 值，因此该药物可能会引起不必要但并非总是不可避免的相互作用。
方法
在使用口服和静脉注射泮托拉唑治疗期间，监测患者的厄洛替尼谷浓度。
结果
高剂量静脉注射泮托拉唑时，厄洛替尼谷浓度降低，但当剂量减少并口服泮托拉唑时，浓度恢复正常。
结论
需要更多的研究来评估泮托拉唑和厄洛替尼之间相互作用的剂量依赖性。此外，我们建议在怀疑存在临床相关相互作用且没有适当的剂量指南时，密切监测厄洛替尼的血浆浓度并相应调整厄洛替尼剂量。
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