• Journal of Pharmaceutical Investigation
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• v.33 no.3
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• pp.171-178
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• 2003

Drug interactions with food, on occasion, lead to serious nutritional and functional changes in the body as well as alterations of pharmacological effect. It, therefore, should be necessary to take drug interactions with food into consideration for effective and safe therapeutics. Diabetes mellitus is a heterogeneous group of disorders characterzed by abnormal glucose homeostasis, resulting in hyperglycemia, and is associated with increased risk of microvascular, macrovascular, and neuropathic complications. However, the precise mechanism of diabetes mellitus remains unclear. Three basic objectives in the care of diabetic patients are maintaining optimal nutrition, avoiding hypo- or hyperglycemia and preventing complications. Laminaria japonica is a brown macroalgae which can be used as a functional diet due to high content of diatery fiber. The purpose of this study was to investigate the effect of Laminaria japonica diet on the pharmacokinetics of metformin which are frequently used in the treatment of diabetes. Diabetic rats induced by streptozotocin were employed in this study. Blood concentrations of oral hypoglycemic agent, metformin, were measured by HPLC and resultant pharmacokinetic parameters were calculated by RSTRIP. The mechanisms of drug interaction with food were evaluated on the basis of pharmacokinetic parameters such as $k_{a},\;t_{1/2},\;C_{max},\;t_{max}$, and AUC. Administration of metformin in normal and diabetic rats treated with Laminaria japonica diet showed significant decrease in AUC, $C_{max},\;and\;k_a$, and increase in $t_{max}$, compared to those with normal diet. This might result from adsortion of metformin on components of Laminaria japonica, causing delayed absorption. The oral glucose test showed that Laminaria japonica diet could lower blood glucose level probably through either inhibiting the activity of disaccharidases, intestinal digestive enzymes, or delaying the absorption of glucose. More studies should be followed to fully understand pharmacokinetic changes of metformin caused by long-term Laminaria japonica diet.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.3
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• pp.253-260
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• 2020

Alzheimer's disease (AD) is a chronic and progressive neurodegenerative disease that can be described by the occurrence of dementia due to a decline in cognitive function. The disease is characterized by the formation of extracellular and intracellular amyloid plaques. Amyloid beta (Aβ) is a hallmark of AD, and microglia can be activated in the presence of Aβ. Activated microglia secrete pro-inflammatory cytokines. Furthermore, S100A9 is an important innate immunity pro-inflammatory contributor in inflammation and a potential contributor to AD. This study examined the effects of metformin and α-LA on the inflammatory response and NLRP3 inflammasome activation in Aβ- and S100A9-induced BV-2 microglial cells. Metformin and α-LA attenuated inflammatory cytokines, such as tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). In addition, metformin and α-LA inhibited the phosphorylation of JNK, ERK, and p38. They activated the nuclear factor kappa B (NF-κB) pathway and the NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasome. Moreover, metformin and α-LA reduced the marker levels of the M1 phenotype, ICAM1, whereas the M2 phenotype, ARG1, was increased. These findings suggest that metformin and α-LA are therapeutic agents against the Aβ- and S100A9-induced neuroinflammatory responses.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.165-171
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• 2018

An overdose of antihypertensive agents, such calcium channel blockers (CCBs) and angiotensin II receptor blocker (ARBs), and the antihyperglycemic agent, metformin, leads to hypotension and lactic acidosis, respectively. A 40-year-old hypertensive and diabetic man with hyperlipidemia and a weight of 110 kg presented to the emergency room with vomiting, dizziness, and hypotension following an attempted drug overdose suicide with combined CCBs, ARBs, 3-hydroxy-3-methylglutaryl-coemzyme A reductase inhibitors, and metformins. A conventional medical treatment initially administered proved ineffective. The treatment was then changed to simultaneous extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT), which was effective. This shows that simultaneous ECMO and CRRT can be an effective treatment protocol in cases of ineffective conventional medical therapy for hypotension and lactic acidosis due to an overdose of antihypertensive agents and metformin, respectively.

• Journal of Pharmacopuncture
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• v.17 no.1
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• pp.13-19
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• 2014

Objectives: The present study investigated the protective effect of Wattakaka (W.) volubilis leaf extract against streptozotocin (STZ)-induced diabetes in rats. Methods: Male Wistar rats were divided into five groups (with six rats in each group) and were fed ad libitum. The rats were fasted for sixteen hours before diabetes was induced by injecting a single dose of 90 mg/kg body weight of STZ in 0.9-percent normal saline through an intraperitoneal route. The five groups were as follows: Group 1: normal control (saline-treated), Group 2: untreated diabetic rats, Groups 3 and 4: diabetic rats treated orally with petroleum ether cold maceration extract (PEME) of W. volubilis (50 and 100 mg/kg body weight), and Group 5: diabetic rats treated orally with metformin (250 mg/kg body weight). All rats received treatment for 21 days. For the STZ-induced diabetic rats, the blood-glucose, ${\alpha}$-amylase, total protein and alanine transaminase (ALT) levels were measured on days 7, 14 and 21 of the treatment with PEME of W. volubilis and the treatment with metformin. Histopathological changes in the liver were examined with hematoxylin-eosin staining. Morphological changes in the liver were also examined with glutaraldehyde fixation. Results: The treatments with PEME of W. volubilis and with metformin in experimental rats by oral injections for 21 days produced reductions in the levels of serum biochemical markers. Histopathology and scanning electron microscopy results showed that the administrations of PEME of W. volubilis and of metformin suppressed the generation of abnormal liver cells in the STZ-treated rats. Conclusion: These results suggest that both PEME of W. volubilis and metformin have a protective effect against STZ-induced diabetes.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2351-2354
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• 2015

In this study, the antiproliferative effects of the metformin was evaluated on MCF-7 Cells (human breast adenocarcinoma cell line). For this purpose cell kinetic parameters including cell proliferation assay, mitotic index and labelling index analysis were used. $30{\mu}M$, $65{\mu}M$ and $130{\mu}M$ Metformin doses were applied to cells for 24, 48 and 72 hours. The results showed that there was a significant decrease in cell proliferation, mitotic index and labelling index for all experimental groups (p<0.05) for all applications.

• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.74-79
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• 2015

Objective: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. Methods: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin $A_{1c}$ ($HbA_{1c}$) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for $HbA_{1c}$ values, amounts of $HbA_{1c}$ changes, and rates of $HbA_{1c}$ changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. Results: SU group showed larger $HbA_{1c}$ changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable $HbA_{1c}$ <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable $HbA_{1c}$ <6.5% was not significantly different, but time to achieve stable $HbA_{1c}$ <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. Conclusion: DPP-4 inhibitors were as effective as sulfonylureas in achieving the $HbA_{1c}$ goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.99-104
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• 2017

Objectives: This study aimed to compare effects on glycemic control and weight loss between the metformin/dapagliflozin combination and the metformin/sitagliptin combination in type 2 diabetic patients. Methods: This study retrospectively reviewed the medical records, from January $1^{st}$ 2015 to March $31^{st}$ 2016, of type 2 diabetic patients who were older than 18 and were prescribed with dapagliflozin or sitagliptin in combination with metformin. Hemoglobin $A_{1c}$ ($HbA_{1c}$) levels and weights were measured every 3 months. Results: The dapagliflozin group showed a greater decrease in $HbA_{1c}$ levels after 3 months (-0.75% vs. 0.01%, P<0.001), 6 months (-0.36% vs. 0.08%, P=0.029), and 9 months (-0.53% vs. 0.08%, P=0.046) compared to the sitagliptin group. Also, the dapagliflozin group showed a greater significant decrease in the rate of change in $HbA_{1c}$ levels after 3 months (-0.09 vs. 0.01, P<0.001), 6 months (-0.04 vs. 0.01, P=0.031), 9 months (-0.07 vs. 0.02, P=0.029), and 12 months (-0.05 vs. 0.05, P=0.047). Furthermore, the dapagliflozin group showed a greater decrease in amount of weight change after 3 months (-2.46 kg vs. 0.37 kg, P<0.001), 6 months (-3.02 kg vs. 0.13 kg, P<0.001), and 9 months (-2.27 kg vs. 0.50 kg, P=0.002). Finally, the dapagliflozin group showed a greater decrease in the rate of change in weight after 3 months (-3.10% vs. 0.52%, P<0.001), 6 months (-3.83% vs. 0.21%, P<0.001), 9 months (-2.84% vs. 0.79%, P=0.002), and 12 months (-4.91% vs. 0.44%, P<0.001). Conclusions: It was concluded that dapagliflozin is more effective than sitagliptin for type 2 diabetic patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.3
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• pp.215-222
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• 2020

Metformin is a recommended first-line therapy drug for type 2 diabetes patients. However, compared to other oral antidiabetic drugs (OAD), metformin has a large unit dosage, with bioavailability of 40-60%. This limiting bioavailability is because metformin is absorbed only in the upper gastrointestinal tract as a BCS class 3 drug. Hence, we propose that applying the Gastroretentive Drug Delivery System (GRDDS) and extending drug release time in the stomach will result in improved bioavailability. We selected the swelling type delivery system, as it is considered the most stable gastroretention technology compared to other GRDDSs. We modified the swelling excipient by using a natural swelling excipient to form a swelling tablet made of carrageenan and hydroxypropyl methylcellulose (HPMC). Our results indicate that the swelling complex tablet made of carrageenan and HPMC has a good swelling ability and shows required sustained release in a dissolution pattern. In addition, the carrageenan complex has a better swelling ability than the marketed metformin tablet, as determined by the ratio, (swelling ability)/(excipient weight). Taken together, our results indicate that the carrageenan complex can be developed as a good swelling excipient. Further optimizations are required for the commercialization of the carrageenan complex.

• The Monthly Diabetes
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• s.140
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• pp.74-75
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• 2001

• Proceedings of the Korean Environmental Health Society Conference
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• 2005.06a
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• pp.345-350
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• 2005

Acute toxicities of five pharmaceutical products were evaluated with aquatic microbes, invertebrates, and fish. The test pharmaceuticals, i.e., cimetidine, carbamazepine, diltiazem, acetaminophene, and metformin have been often detected in aquatic environment, but theire cological hazard on receptors of various trophic levels has seldom been evaluated. In the present study, we conducted acute toxicity assays with a marine bacterium, Vibrio fischeri, an invertebrate, Daphnia magna, and a fish, Japanese medake (Oryzias latipes). In general, D. magna, showed the most sensitive response to the test chemicals. Diltiazem exhibited the lowest EC50 value after 96 hr of exposure at 7.6 mg/L, followed by cimetidine >acetaminophen > metformin = carbamazepine in an order of decreasing susceptibility. With the fish, diltiazem and carbamazepine showed the 96 hr EC50 values at 14.1${\sim}$35.4 mg/L while acetaminophen, cimetidine, and metformin did not cause 50% mortality at 100 mg/L. Similar pattern was noted with the Microtox Assay, with which the median effective concentrations for acetaminophen, cimetidine, and metformin were found at the range between 301.8 and 755.4 mg/L. Carbamazepine and diltiazem exposure to the microbes resulted in EC50 values around 50 mg/L. Predicted no effect concentrations (PECs) of these pharmaceuticals derived from the EC5O values obtained from this study, and predicted environmental concentrations (PECs) obtained from available literatures were utilized to estimate ecological risks of the test compounds. No test pharmaceuticals resulted in risk quotients (PEC/PNEC) greater than 1, which suggests no serious potential ecological concerns. It should be noted however that further studies including the refinement of PEC derivation, identification and toxicity assessment of the metabolites and/or their interactions with other stressors may be warranted to better understand the environmental consequences of the residual pharmaceutical discharge to the waterway.