Pharmacokinetics in Morbid Obesity: Influence of Two Bariatric Surgery Techniques on Paracetamol and Caffeine Metabolism

Albert Goday Arno, Magí Farré, Jose Rodríguez-Morató, Jose M. Ramon, Clara Pérez-Mañá, Esther Papaseit, Ester Civit, Klaus Langohr, Marcel lí Carbó, David Benaiges Boix, Olga Castañer Nino, Juana Antonia Flores Le Roux, Manuel Pera, Luis Grande, Rafael de la Torre

Research output: Contribution to journalArticleResearchpeer-review

13 Citations (Scopus)

Abstract

© 2017, Springer Science+Business Media New York. Purpose: The purpose of the study was to study the impact of the two most common bariatric surgery techniques on paracetamol pharmacokinetics (a marker of gastric emptying) and caffeine metabolism (a marker of liver function). Materials and Methods: In the present prospective study, we studied 24 morbid obese patients before, at 4 weeks, and 6 months after having undergone sleeve gastrectomy (n = 10) or Roux-en-Y gastric bypass (n = 14). For comparative purposes, 28 healthy controls (14 normal weights and 14 overweights) were also included in the study. Results: Paracetamol pharmacokinetics was altered in the obese participants leading to lower bioavailability. Bariatric surgery resulted in faster absorption and normalized pharmacokinetic parameters, prompting an increase in paracetamol bioavailability. No differences were found between surgical procedures. In the case of caffeine, the ratio paraxanthine/caffeine did not differ between morbid obese and healthy individuals. This ratio remained unmodified after surgery, indicating that the liver function (assessed by cytochrome P450 1A2 activity) was unaffected by obesity or bariatric surgery. Conclusions: Paracetamol pharmacokinetics and caffeine plasma levels are altered in severely obese patients. The two studied bariatric surgical techniques normalize paracetamol oral bioavailability without impairing the liver function (measured by cytochrome P450 1A2 activity).
Original languageEnglish
Pages (from-to)3194-3201
JournalObesity Surgery
Volume27
Issue number12
DOIs
Publication statusPublished - 1 Dec 2017

Keywords

  • Caffeine
  • Clinical trial
  • Gastric bypass
  • Metabolism
  • Morbid obesity
  • Paracetamol
  • Sleeve gastrectomy

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