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ARTICLE |

Increased Rate of Tolbutamide Metabolism in Alcoholic Patients FREE

Roderick M. H. Kater, MB, MRACP; Fabio Tobon, MD; Frank L. Iber, MD
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JAMA. 1969;207(2):363-365. doi:10.1001/jama.1969.03150150075025
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In a controlled human study the biological half-life of tolbutamide was found to be reduced more than twofold in alcoholic patients. We suggest that this effect is the result of stimulation by alcohol of a hepatic microsomal enzyme system in the human liver responsible for the metabolism of tolbutamide. The metabolism of other therapeutic agents could be similarly affected by alcohol, and this might lead to irregularities in response to drug treatment.

REFERENCES

Kater, R.M.H.; Iber, F.L.; and Carulli, N.C.:  Differences in Ethanol Metabolism in Alcoholic and Non-alcoholic Subjects , Amer J Clin Nutr 21:532 ( (May) ) 1968;.
Lieber, C.S., and DeCarli, L.M.:  Hepatic Microsomes: A New Site for Ethanol Oxidation , J Clin Invest 47:62a-63a ( (June) ) 1968;.
Rubin, E.; Hutterer, F.; and Lieber, C.S.:  Ethanol Increases Hepatic Smooth Endoplasmic Reticulum and Drugmetabolizing Enzymes , Science 159:1469-1470 ( (March 29) ) 1968;.
Conney, A.H.:  Pharmacological Implications of Microsomal Enzyme Induction , Pharmacol Rev 19:317-366 ( (Sept) ) 1967;.
Spingler, H.:  Über eine Möglichkeit zur colorimetrischen Bestimmung von N-(4-methyl-benzolsulfonyl)-N'-butyl-harnstoff in Serum , Klin Wschr 35:533-535 ( (May 15) ) 1957;.
Rubin, E., and Lieber, C.S.:  Early Fine Structural Changes in the Human Liver Induced by Alcohol , Gastroenterology 52:1-13 ( (Jan) ) 1967;.
Rubin, E., and Lieber, C.S.:  Alcohol-Induced Hepatic Injury in Nonalcoholic Volunteers , New Eng J Med 278:869-876 ( (April 18) ) 1968;.
Mehnert, H.; Camerini-Davalos, R.; and Marble, A.:  Results of Long-Term Use of Tolbutamide (Orinase) in Diabetes Mellitus , JAMA 167:818-827 ( (June 14) ) 1958;.

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Kater, R.M.H.; Iber, F.L.; and Carulli, N.C.:  Differences in Ethanol Metabolism in Alcoholic and Non-alcoholic Subjects , Amer J Clin Nutr 21:532 ( (May) ) 1968;.
Lieber, C.S., and DeCarli, L.M.:  Hepatic Microsomes: A New Site for Ethanol Oxidation , J Clin Invest 47:62a-63a ( (June) ) 1968;.
Rubin, E.; Hutterer, F.; and Lieber, C.S.:  Ethanol Increases Hepatic Smooth Endoplasmic Reticulum and Drugmetabolizing Enzymes , Science 159:1469-1470 ( (March 29) ) 1968;.
Conney, A.H.:  Pharmacological Implications of Microsomal Enzyme Induction , Pharmacol Rev 19:317-366 ( (Sept) ) 1967;.
Spingler, H.:  Über eine Möglichkeit zur colorimetrischen Bestimmung von N-(4-methyl-benzolsulfonyl)-N'-butyl-harnstoff in Serum , Klin Wschr 35:533-535 ( (May 15) ) 1957;.
Rubin, E., and Lieber, C.S.:  Early Fine Structural Changes in the Human Liver Induced by Alcohol , Gastroenterology 52:1-13 ( (Jan) ) 1967;.
Rubin, E., and Lieber, C.S.:  Alcohol-Induced Hepatic Injury in Nonalcoholic Volunteers , New Eng J Med 278:869-876 ( (April 18) ) 1968;.
Mehnert, H.; Camerini-Davalos, R.; and Marble, A.:  Results of Long-Term Use of Tolbutamide (Orinase) in Diabetes Mellitus , JAMA 167:818-827 ( (June 14) ) 1958;.
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