Abstract

BackgroundThe use of enteral nutrients plays a highly important role in accurate nutrition management, but limited information is currently available on the cautionary points of semi-solid enteral nutrients.AimIn this study, we examined whether the pharmacokinetic profiles of sodium valproate (SVA), levetiracetam (LEV), and carbamazepine (CBZ) are affected by altering the dosing time of RACOL®-NF Semi Solid for Enteral Use (RASS), a prescribed semi-solid formula. We also investigated whether the pharmacokinetic interaction observed in this study can be avoided by staggered dosing of the chemical drug and semi-solid enteral nutrient.MethodsThe plasma concentration of SVA, LEV and CBZ after oral administration was measured by LC-MS/MS method.ResultsThere was no difference in pharmacokinetic characteristics of SVA and LEV when the dosing time of RASS was altered. On the other hand, the plasma concentration of CBZ after oral administration at all sampling points decreased with the extension of the dosing time of RASS, which was consistent with the Cmax and AUC. However, no significant difference was observed in the pharmacokinetic profiles or parameters of CBZ between the short-term and long-term RASS dosing groups by prolonging the administered interval of CBZ and RASS for 2 hr.ConclusionWe concluded that the pharmacokinetic profiles of CBZ, but not SVA and LEV, after its oral administration are affected by the dosing time of RASS, but staggered administration of CBZ and RASS prevented their interaction.

Highlights

  • Sufficient feeding is essential for critically ill patients, and helps to prevent malnutrition and accompanying complications [1, 2]

  • We examined whether the pharmacokinetic profiles of sodium valproate (SVA), levetiracetam (LEV), and carbamazepine (CBZ) are affected by altering the dosing time of RACOL®-NF Semi Solid for Enteral Use (RASS), a prescribed semi-solid formula

  • The plasma concentration of CBZ after oral administration at all sampling points decreased with the extension of the dosing time of RASS, which was consistent with the Cmax and AUC

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Summary

Introduction

Sufficient feeding is essential for critically ill patients, and helps to prevent malnutrition and accompanying complications [1, 2]. Liquid and semi-solid products are commercially available as enteral nutrients, and have are frequently used for nutritional management. The use of liquid enteral nutrients is occasionally accompanied by adverse effects, which develop over a long clinical course. The semi-solidification of enteral nutrients is available as a strategy to prevent the adverse events associated with liquid enteral nutrients [6, 7]. Limited information is currently available on the cautionary points of semi-solid enteral nutrients such as drug-drug interactions. The use of enteral nutrients plays a highly important role in accurate nutrition management, but limited information is currently available on the cautionary points of semi-solid enteral nutrients

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