Effects of medicines used to treat gastrointestinal diseases on the pharmacokinetics of coadministered drugs: A PEARRL Review

Chara Litou, Angela Effinger, Edmund S. Kostewicz, Karl J. Box, Nikoletta Fotaki, Jennifer B. Dressman

Research output: Contribution to journalReview articlepeer-review

9 Citations (SciVal)
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Objectives: Drugs used to treat gastrointestinal diseases (GI drugs) are widely used either as prescription or over-the-counter (OTC) medications and belong to both the 10 most prescribed and 10 most sold OTC medications worldwide. The objective of this review article is to discuss the most frequent interactions between GI and other drugs, including identification of the mechanisms behind these interactions, where possible. Key findings: Current clinical practice shows that in many cases, these drugs are administered concomitantly with other drug products. Due to their metabolic properties and mechanisms of action, the drugs used to treat gastrointestinal diseases can change the pharmacokinetics of some coadministered drugs. In certain cases, these interactions can lead to failure of treatment or to the occurrence of serious adverse events. The mechanism of interaction depends highly on drug properties and differs among therapeutic categories. Understanding these interactions is essential to providing recommendations for optimal drug therapy. Summary: Interactions with GI drugs are numerous and can be highly significant clinically in some cases. While alterations in bioavailability due to changes in solubility, dissolution rate, GI transit and metabolic interactions can be (for the most part) easily identified, interactions that are mediated through other mechanisms, such as permeability or microbiota, are less well-understood. Future work should focus on characterising these aspects.

Original languageEnglish
Pages (from-to)643-673
Number of pages31
JournalPharmacy and Pharmacology Communications
Issue number4
Early online date30 Jul 2018
Publication statusPublished - 1 Apr 2019


  • Drug-drug interaction
  • GI motility
  • GI pH
  • Metabolism
  • Permeability
  • permeability
  • metabolism
  • drug-drug interaction

ASJC Scopus subject areas

  • Pharmacology
  • Pharmaceutical Science


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