Site and quantitative importance of alcohol first-pass metabolism
The main impact of liver disease is on phase I enzymes, which will affect both clearance and first-pass metabolism
Although some investigators have reported no significant pharmacokinetic interactions when these cannabinoids were coadministered to humans in vivo (15), others have suggested that CBD inhibits cytochrome P450 (CYP) 2C (16) and 3A (17) enzymes, reducing first-pass metabolism
In general, probably only a small fraction (perhaps 10 percent) of ingested alcohol is eliminated from the body by first-pass metabolism
after consumption of low doses of alcohol.
Avoiding first-pass metabolism
in the liver prevents the production of metabolites that can alter the drug's safety and side effect profile, said Dr.
Consideration should also be given to the possibility that some of the sublingual formulation may have been swallowed, resulting in first-pass metabolism
of DHT to AG.
But the complex structure of therapeutic proteins on which their efficacy depends require special formulation and delivery strategies to avoid first-pass metabolism
, extend therapeutic half-life and prevent these expensive drugs from drawing the attention of the immune system - all issues that diminish or eliminate their therapeutic value and potential.
Considered by many to be a niche delivery technology, transdermal drug patches offer the advantages of ease of use, painlessness, disposability, control of drug delivery and avoidance of first-pass metabolism
by the liver.
In the enriched patient population, this corresponded with evidence of earlier efficacy for the LS in comparison with a 50-mg tablet; the lower dose size for the former was consistent with oral mucosal drug absorption, and evasion of first-pass metabolism
Transdermal drug delivery patches offer the advantages of ease of use, painlessness, disposability, control of drug delivery and avoidance of first-pass metabolism
by the liver.
The first-pass metabolism
of a parenteral enhances its bioavailability.
Complicating matters, dose-absorbing food, first-pass metabolism
, and safety-driven dose-reduction and stoppage protocols further reduce lung dose and interrupt maintenance therapy.