Lahner E, Annibale B, Delle Fave G
Systematic Review: Heliocobacter Pylori Infection and Impaired Drug Absorption. [JOURNAL ARTICLE]
Aliment Pharmacol Ther 2008 Nov 26.
Abstract
Context: Impaired acid secretion may affect drug absorption and may be consequent to corporal H pylori-gastritis, which may affect the absorption of orally administered drugs.
Objective: To focuse on the evidence of impaired drug absorption associated with H pylori infection. Data Sources: Systematic search of MEDLINE/EMBASE/SCOPUS databases (1980-April 2008) for English-articles using the keywords: drug malabsorption/absorption, stomach, Helicobacter pylori, gastritis, gastric acid, gastric pH, hypochlorhydria, gastric hypoacidity. Study Selection: From 2,099 retrieved articles, 5 studies were identified. Data Extraction: From selected papers, investigated drugs, study type, main features of subjects, study design, intervention type, and results were extracted.
Results: 5 studies investigated impaired absorption of L-dopa, thyroxine, and delavirdine in H pylori infection. Eradication treatment led to 21-54% increase of L-dopa in Parkinon's disease. Thyroxine requirement was higher in hypochlorhydric goiter with H pylori-gastritis and thyrotropin levels decreased by 94% after treatment. In H pylori- and HIV-positive hypochlorhydric subjects delavirdine absorption increased by 57% with orange juice adminstration and by 150% after eradication.
Conclusions: A plausible mechanism of impaired drug absorption is reduced acid secretion in H pylori-gastritis patients. H pylori infection and hypochlorhydria should be considered in prescribing drugs whose absorption is potentially affected by intragastric pH.
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