Triazolam kinetics: interaction with cimetidine, propranolol, and the combination. 1988

H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
Department of Psychiatry, Tufts University School of Medicine, Boston, Massachusetts 02111.

Nineteen healthy volunteers received a single 0.5-mg oral dose of triazolam on four occasions under the following conditions: (1) triazolam alone; (2) triazolam with cimetidine, 300 mg four times daily; (3) triazolam with propranolol, 40 mg four times daily; (4) triazolam with both cimetidine and propranolol. Triazolam kinetics were determined from multiple plasma concentrations measured during 24 hours after each dose. Compared with control, peak plasma triazolam concentration (Cmax) was significantly increased by cimetidine (5.4 versus 3.9 ng/mL), total area under the plasma concentration curve (AUC) increased (21.3 versus 16.1 ng/mL X hr), and oral clearance decreased (485 versus 668 mL/min). However triazolam half-life was not increased. During propranolol alone, triazolam Cmax (4.1 ng/mL), AUC (14.3 ng/mL X hr), and clearance (759 mL/min) did not differ significantly from control, whereas kinetic variables for triazolam with cimetidine plus propranolol were similar to those with cimetidine alone. Plasma free fraction for triazolam (17 to 18% unbound) did not differ significantly among the four treatment conditions. Mean steady-state plasma cimetidine concentrations during trials 2 and 4 were similar (1.04 versus .98 micrograms/mL), whereas plasma propranolol was significantly higher during cimetidine plus propranolol than with propranolol alone (47 versus 29 ng/ml, P less than .001). Thus cimetidine coadministration significantly inhibits triazolam clearance, causing increased triazolam AUC and Cmax, but without a prolongation in half-life. Propranolol itself does not impair triazolam clearance, nor does propranolol potentiate the inhibitory effect of cimetidine alone.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011433 Propranolol A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs. Dexpropranolol,AY-20694,Anaprilin,Anapriline,Avlocardyl,Betadren,Dociton,Inderal,Obsidan,Obzidan,Propanolol,Propranolol Hydrochloride,Rexigen,AY 20694,AY20694,Hydrochloride, Propranolol
D002927 Cimetidine A histamine congener, it competitively inhibits HISTAMINE binding to HISTAMINE H2 RECEPTORS. Cimetidine has a range of pharmacological actions. It inhibits GASTRIC ACID secretion, as well as PEPSIN and GASTRIN output. Altramet,Biomet,Biomet400,Cimetidine HCl,Cimetidine Hydrochloride,Eureceptor,Histodil,N-Cyano-N'-methyl-N''-(2-(((5-methyl-1H-imidazol-4-yl)methyl)thio)ethyl)guanidine,SK&F-92334,SKF-92334,Tagamet,HCl, Cimetidine,Hydrochloride, Cimetidine,SK&F 92334,SK&F92334,SKF 92334,SKF92334
D004347 Drug Interactions The action of a drug that may affect the activity, metabolism, or toxicity of another drug. Drug Interaction,Interaction, Drug,Interactions, Drug
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014229 Triazolam A short-acting benzodiazepine used in the treatment of insomnia. Some countries temporarily withdrew triazolam from the market because of concerns about adverse reactions, mostly psychological, associated with higher dose ranges. Its use at lower doses with appropriate care and labeling has been reaffirmed by the FDA and most other countries. Apo-Triazo,Gen-Triazolam,Halcion,Trilam,U-33,030,Apo Triazo,Gen Triazolam,U 33,030,U33,030

Related Publications

H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
January 1983, Psychopharmacology,
H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
January 1986, Biopharmaceutics & drug disposition,
H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
September 1981, Lancet (London, England),
H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
April 1983, British journal of clinical pharmacology,
H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
September 1985, Drug intelligence & clinical pharmacy,
H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
December 1984, Drug intelligence & clinical pharmacy,
H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
November 1982, Klinische Wochenschrift,
H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
January 1979, Verhandelingen - Koninklijke Academie voor Geneeskunde van Belgie,
H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
December 1982, Clinical pharmacology and therapeutics,
H Friedman, and D J Greenblatt, and E S Burstein, and J M Scavone, and J S Harmatz, and R I Shader
April 1988, Journal of clinical pharmacology,
Copied contents to your clipboard!