Pharmacokinetic Drug Interactions of Multivitamins and Proton-pump Inhibitors

Abstract

Background: To recognize and comprehend how various medications can interact with one another when taken concurrently or quickly after one another is the goal of investigating drug drug interactions. It's crucial to know this because drug interactions might harm the security and efficiency of the medications involved, possibly resulting in hazardous drug responses, unsuccessful treatment attempts, or other undesirable effects. Healthcare practitioners can take action to reduce the risk of patient injury and maximize the advantages of their prescription regimens by recognizing and analyzing potential drug interactions. Due to the increased rapid use of various drugs co-administration, either complementary or alternative medicine, the possibility of drug-drug interactions increased. This may cause severe organ damage or toxic effects in our bodies. Aims: To find potential interactions between proton pump inhibitors (PPIs) and multivitamins, researchers study the drug-drug interactions of these two drugs. Proton pump inhibitors function by lessening the quantity of acid produced in the stomach. They are frequently used to treat illnesses, including gastroesophageal reflux disease (GERD) and peptic ulcer disease. Multivitamins are designed to provide a convenient way for people to obtain the recommended daily intake of essential vitamins and minerals necessary for normal bodily functions. This type of research still needs to be observed based on the pharmacokinetics interactions between proton pump inhibitors and multivitamins in vivo and in vitro studies; the current research was carried out to investigate such potential interactions. Pantoprazole (PNT) and a vitamin B (VTB) complex were given to the participants in this trial. The vitamin B complex consisted vi of VTB1, VTB6, and VTB12 in this investigation. This study aimed to determine the effect of the combination of these two drugs on the pharmacokinetics of pantoprazole (PNT). Methods: First, based on prescription analysis in the local area, considering government and private hospitals, age, and disease pattern. Based on the prescription survey, pantoprazole with vitamins B1, B6, and B12 were observed both in vitro and in vivo. Pantoprazole and vitamin B complex were investigated in single and combined form under XRPD, DSC, and FT-IR. Further study validated all components under High Performance Liquid Chromatography (HPLC). Additionally, pharmacokinetics parameters were investigated in healthy volunteers after 0 hours, 0.5 hours, 1 hour, 2 hours, 3 hours, 5 hours, and 6 hours after administration. In this research, sensitive and effective procedures for simultaneous determination in human plasma using HPLC were developed in line with the bioanalytical standards established by the US Food and Drug Administration. Results: PPI and multivitamins were only included in 200 of the total 500 prescriptions. According to the findings of this study, those between the ages of 30 and 50 received the highest frequency of PPI and multivitamin prescriptions. According to the results of a prescription survey, PNT, VTB1, VTB6, and VTB12 should be investigated in both in vitro and in vivo studies to determine any possible drug interactions. The linearity of the PNT, VTB1, VTB6, and VTB12 validated parameters was evaluated, and the results showed that the plasma PNT, VTB1, VTB6, and VTB12 retention durations, throughout the range of 1–100 µg/mL, were 6.8 0.2, 2.7 0.4, 4.50.5, and 3.8 0.1 min; respectively. This information was discovered when the linearity of these validated parameters was evaluated. For every analyte, the intra assay and inter-assay biases were within 15% and 13.5%, respectively, for the lower limit of quantification and all other values. This study investigated the pharmacokinetic properties of PNT, VTB1, VTB6, and VTB12 when the medications were taken individually or combined vii with other vitamins. We could not assess the pharmacokinetic profile of VTB12 in an in vivo trial despite an in vitro examination revealing that both interactions were minor. After analyzing the AUC curve, we found that the PNT, VTB1, and VTB6 single-dose concentrations were, respectively, 3.88 ± 1.239, 8.44 ± 0.514 and 62.91 ± 3.046 μg/mL*h. Following the combination, the AUC curves exhibited respective values of 3.56 ± 0.356, 7.90 ± 0.130 and 56.52 ± 6.816 µg/mL*h. In every instance, the p-value indicated that the deal was less than 0.99. When the PNT and VTB samples were evaluated in vitro in various physical combinations, there were scarcely any interactions between the two types of models. In the pharmacokinetics investigation, the administration of VTB did not significantly alter the pharmacokinetic parameters of PNT. An approach to analyzing drug-drug interactions was devised as a result of the outcomes of the experimental investigation that was carried out. Investigations into bioequivalence and therapeutic medication monitoring are two possible applications for this approach. Conclusion: When PNT was administered with VTB1, VTB6, and VTB12, it showed no interactive properties and did not reduce any of their activity. It also maintained average AUC profiles, which may represent a stable Cmax and tmax both in single and combined form. Hence, this combination therapy may be a cost-effective, less toxic, and potential remedy for general uses.