Pharmacy Department, Infanta LeonorUniversity Hospital, Madrid, Spain.
Hum Vaccin Immunother. 2022 Nov 30;18(5):2051414. doi: 10.1080/21645515.2022.2051414. Epub 2022 Mar 31.
According to the current European medicines legislation, on the labeling is mandatory a warning contraindicating for hereditary fructose intolerance (HFI) patients medicines with oral or parenteral fructose and sorbitol, and oral sucrose, invert sugar, isomaltitol, lactitol and maltitol, but parenteral sucrose is not mentioned. Intravenous administration of sucrose does not increase blood glucose concentrations, because sucrose is poorly oxidized to CO and mainly excreted in the urine as a disaccharide; absence of enzimatic activity outside the gut explains why there is not a warning for parenteral sucrose presentations. For this reason, parenteral drugs with sucrose are allowed in HFI patients. Nevertheless, due to interindividual variability and the fact that not all parenterally administered sucrose is recovered in urine, HFI patients need to be closely monitored after parenteral administration of sucrose-containing drugs, especially when the amount exceeds the maximum permissible thresholds.
根据现行的欧洲药品法规，标签上必须有一个警告，表明遗传性果糖不耐受（HFI）患者禁用含口服或肠胃外果糖和山梨糖醇的药物，以及口服蔗糖、转化糖、异麦芽糖醇、乳糖醇和麦芽糖醇，但肠胃外蔗糖则未被提及。肠胃外给予蔗糖不会增加血糖浓度，因为蔗糖很难氧化成 CO，主要以二糖的形式从尿液中排出；肠外缺乏酶活性解释了为什么没有对肠胃外蔗糖制剂进行警告。出于这个原因，HFI 患者可以使用含有蔗糖的肠胃外药物。然而，由于个体间的差异，以及并非所有肠胃外给予的蔗糖都能在尿液中回收，因此 HFI 患者在肠胃外给予含蔗糖的药物后需要密切监测，特别是当用量超过最大允许阈值时。
