Abstract
The interaction of chlorpromazine and promethazine in vivo has been investigated. The drugs were administered to the rabbit orally as a single dose (100 mg of each drug) as well as simultaneously with an interval of 15 min. The presence of multiple peaks at the separate administration of promethazine and chlorpromazine on the one hand, and increase of number of peaks, symbathic character of kinetic curves of mentioned drugs and its prolonged appearance in the systemic circulation of the blood by simultaneous administration on the other hand, may be explained by the intensive presystem metabolism and surfaceโactivity ability of these drugs, and by the periodic โlassitudeโ of liver for their capture and elimination (either presystem or systemic). The micelle formation from these drugs in the gastroโintestinal tract and formation of the mixed micelles on simultaneous administration were also taken into consideration. Chlorpromazine is more strongly captured by the liver at its ๏ฌrst pass through it than promethazine, from comparison of pharmacokinetics of these drugs administered separately. Therefore, chlorpromazine on simultaneous administration occupies the sites of the liver which were covered by promethazine at single dose, thereby substituting promethazine and promoting its transferral into the systemic blood circulation. This results in a large increase in promethazine content in blood, additional peaks appear and the presence of promethazine in the blood is prolonged. The in๏ฌuence of chlorpromazine on the kinetics of promethazine is especially obvious when chlorpromazine enters the organism ๏ฌrst and more easily occupies those sites in the liver which participate in the capture and elimination of both drugs. Concerning in๏ฌuence of promethazine on the kinetics of chlorpromazine, promethazine reinforces in some way the ability of liver to capture chlorpromazine, thereby intensifying the presystem metabolism of chlorpromazine and inhibiting its own metabolism. The analogous effect was observed in the study of the in๏ฌuence of promethazine on the kinetics of carbamazepine. Copyright ยฉ 2004 John Wiley & Sons, Ltd.