![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Anna P. on August 12, 2000, at 17:23:57
Hello Cam. I need to ask you again for help. Is there a drug
interaction between Neurontin and Sulpiride?
All I was able to find was the drug interaction between
Neurontin-Zyprexa on Dr Koop drug checker. Thank you in advance.Anna
Posted by Cam W. on August 12, 2000, at 18:40:19
In reply to Cam W./drug interaction, posted by Anna P. on August 12, 2000, at 17:23:57
Anna - As a disclaimer, I really know very little about sulpiride. This said, I do know that both sulpiride and Neurontin™ (gabapentin) are not metabolized to any appreciable extent. Neither drug really reacts with any other drug (perhaps there is an interaction between antacids and sulpiride).
I do not think there is any pharmacokinetic interactions, but I am not sure about pharmacodynamic interactions. Someone else may know for sure. Seek a second opinion on this, please.
Sorry - Cam,
Posted by Sunnely on August 12, 2000, at 21:32:08
In reply to Cam W./drug interaction, posted by Anna P. on August 12, 2000, at 17:23:57
> Hello Cam. I need to ask you again for help. Is there a drug
> interaction between Neurontin and Sulpiride?
> All I was able to find was the drug interaction between
> Neurontin-Zyprexa on Dr Koop drug checker. Thank you in advance.
>
> AnnaJust for the record, every time drugs are taken in combination, drug interactions are bound to occur, from clinically insignificant to toxic, sometimes deadly consequences. The likelihood of an adverse drug reaction rises exponentially with any increase in the number of drugs administered. (From: A Little Book of Doctors' Rules by CK Meador, MD, 1992.)
Both Neurontin (gabapentin) and sulpiride (Sulpital, Dogmatil?) are generally resistant to liver metabolism. Therefore, drug-drug interactions via liver metabolism between these 2 drugs seem unlikely. Both drugs are excreted largely unchanged by the kidneys. This means that a person should have good working kidneys to tolerate the "normal" recommended doses of these drugs. For those with kidney impairment, reduced doses or longer interval of dosing is recommended to avoid toxic effects.
On the other hand, I can't say for sure that there are no drug-drug interaction via "pharmacodynamic" mechanism (effects of drugs on the site of action) such as drowsiness, unsteadiness, tremor, etc. These effects are usually dose-dependent. IMHO, however, with the usual recommended doses, this drug combination should pose no serious "pharmacodynamic" drug-drug interactions.
FYI, sulpiride is an antipsychotic that belongs in the substituted benzamide group. As a group, they are known to have selective antagonism of D2/D3 receptors. They are relatively more specific for the limbic versus the striatal D2 receptors, therefore, less frequent extrapyramidal symptoms (EPS) and potential for TD. Incidentally, the first drug to represent this group (not antipsychotic) is procainamide (Pronestyl), drug for irregular heart rhythm. Another well-known drug that belongs in this group but without antipsychotic effect is metoclopramide (Reglan), for gastroesophageal reflux disease or GERD.
Sulpiride was developed in France; first used in the field of gastroenterology in 1966. It is the oldest and most widely used antipsychotic of the substituted benzamides. It is widely available in Europe as an antipsychotic but never exported in the U.S. Other antipsychotics that belong in this group are amisulpride, raclopride, emonapride, eticlopride, and remoxipride (Roxiam). Remoxipride, a very promising antipsychotic, almost made it to the US shores. Unfortunately, with 8 cases of aplastic anemia (serious blood disease) reported in Europe, Merck & Co. withdrew its NDA (new drug application) with the US FDA in Dec. 1993.
Just my own 2 cents. Incidentally, here's one that make you go Hmmm...: When someone asks you, "A penny for your thoughts," and you put your two cents worth in, what happens to the other penny?
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.