Tolfenamic acid Metoclopramide

METOCLOPRAMIDE NS AIDS 1. Metodopramide speeds up the onset of action of tolfenamic acid 2. Metodopramide 1 efficacy of ketoprofen Metodopramide promotes gastric emptying 1. Tolfenamic acid reaches its main site of absorption in the small intestine more rapidly 2. Ketoprofen has low solubility and has less time to dissolve in the stomach therefore less ketoprofen is absorbed 1. This interaction can be used beneficially to hasten the onset of analgesia 2. Take ketoprofen at least 2 hours before metodopramide... 

Metoclopramide increases the rate of absorption of aspirin and tolfenamic acid. Conversely, metoclopramide reduces the bioavailability of ketoprofen. 

Rectal metoclopramide 20 mg, given to 8 healthy subjects 30 minutes before oral tolfenamie aeid 300 mg, eaused a threefold increase in the serum tolfenamie aeid levels at 45 minutes. There was no change in the maximum level or the AUC. In another study, rectal metoclopramide similarly enhanced the rate of oral absorption of tolfenamic acid when given during a migraine attack. ... 

Metoclopramide speeds up gastric emptying. The relatively poorly soluble ketoprofen spends less time in the stomach where it dissolves, and as a result less is available for absorption in the small intestine. Conversely, the absorption rate of tolfenamic acid is increased, without a change in the extent of absorption. 

The clinical importance of the reduction in ketoprofen levels is unknown, but the authors of the study recommend that ketoprofen (and possibly other NSAIDs that are poorly soluble) should be t en 1 to 2 hours before metoclopramide. Conversely, for aspirin, tolfenamic acid, and other NSAIDs, metoclopramide can be used to increase the rate of absorption, and therefore possibly speed up the onset of analgesic effect in conditions such as migraine. 

Tokola RA, Anttila V-J, Neuvonen PJ. The effect of metoclopramide on the absorption of tolfenam ic acid. IntJ CUn Pharmacol Ther Tcacicol (1982) 20,465-8. 

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See also in sourсe #XX -- [ ]

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