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Pharmacokinetics in Morbid Obesity: Influence of Two Bariatric Surgery Techniques on Paracetamol and Caffeine Metabolism

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Abstract

Purpose

The purpose of the study was to study the impact of the two most common bariatric surgery techniques on paracetamol pharmacokinetics (a marker of gastric emptying) and caffeine metabolism (a marker of liver function).

Materials and Methods

In the present prospective study, we studied 24 morbid obese patients before, at 4 weeks, and 6 months after having undergone sleeve gastrectomy (n = 10) or Roux-en-Y gastric bypass (n = 14). For comparative purposes, 28 healthy controls (14 normal weights and 14 overweights) were also included in the study.

Results

Paracetamol pharmacokinetics was altered in the obese participants leading to lower bioavailability. Bariatric surgery resulted in faster absorption and normalized pharmacokinetic parameters, prompting an increase in paracetamol bioavailability. No differences were found between surgical procedures. In the case of caffeine, the ratio paraxanthine/caffeine did not differ between morbid obese and healthy individuals. This ratio remained unmodified after surgery, indicating that the liver function (assessed by cytochrome P450 1A2 activity) was unaffected by obesity or bariatric surgery.

Conclusions

Paracetamol pharmacokinetics and caffeine plasma levels are altered in severely obese patients. The two studied bariatric surgical techniques normalize paracetamol oral bioavailability without impairing the liver function (measured by cytochrome P450 1A2 activity).

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Acknowledgements

This work was supported by a grant from the Instituto de Salud Carlos III, Fondo de Investigaciones Sanitarias, FISS ETS PI08/90638, JR14/00008 to OC, JR15/00005 to CPM, and JR16/00020 to EP. This work was also partially supported by grants MTM2015-64465-C2-1-R of the Ministerio de Economía y Competividad (Spain) and 2014 SGR 464 from the Departament d’Economia i Coneixement de la Generalitat de Catalunya (Spain).

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Author notes

  1. Albert Goday Arno, Magí Farré, and Jose Rodríguez-Morató contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain

    Albert Goday Arno, David Benaiges Boix & Juana Antonia Flores Le Roux

  2. Department of Medicine, Autonomous University of Barcelona, Cerdanyola, Barcelona, Spain

    Albert Goday Arno, David Benaiges Boix & Juana Antonia Flores Le Roux

  3. Cardiovascular Risk and Nutrition Research Group, IMIM, Hospital del Mar Medical Research Institute, Dr. Aiguader 88, 08003, Barcelona, Spain

    Albert Goday Arno, David Benaiges Boix, Olga Castañer Nino & Juana Antonia Flores Le Roux

  4. Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto Salud Carlos III, 28029, Madrid, Spain

    Albert Goday Arno, Jose Rodríguez-Morató, Olga Castañer Nino & Rafael de la Torre

  5. Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM, Hospital del Mar Medical Research Institute, Doctor Aiguader, 88, Office 217, 08003, Barcelona, Spain

    Magí Farré, Jose Rodríguez-Morató, Clara Pérez-Mañá, Esther Papaseit, Ester Civit, Klaus Langohr, Marcel lí Carbó & Rafael de la Torre

  6. Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, Cerdanyola, Badalona, Spain

    Magí Farré, Clara Pérez-Mañá & Esther Papaseit

  7. IGTP, Hospital Universitari Germans Trias i Pujol, Badalona, Spain

    Magí Farré & Esther Papaseit

  8. Section of Gastrointestinal Surgery, Hospital del Mar, Barcelona, Spain

    Jose M. Ramon, Manuel Pera & Luis Grande

  9. Department of Statistics and Operations Research, Polytechnic University of Catalonia, Barcelona, Spain

    Klaus Langohr

  10. Department of Experimental and Health Sciences, CEXS-UPF, Universitat Pompeu Fabra, Dr. Aiguader 80, 08003, Barcelona, Spain

    Marcel lí Carbó & Rafael de la Torre

Authors
  1. Albert Goday Arno
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  2. Magí Farré
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  3. Jose Rodríguez-Morató
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  4. Jose M. Ramon
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  5. Clara Pérez-Mañá
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  6. Esther Papaseit
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  7. Ester Civit
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  8. Klaus Langohr
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  9. Marcel lí Carbó
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  10. David Benaiges Boix
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  11. Olga Castañer Nino
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  12. Juana Antonia Flores Le Roux
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  13. Manuel Pera
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  14. Luis Grande
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  15. Rafael de la Torre
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Corresponding author

Correspondence to Rafael de la Torre.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Clinical Trial Registration

The study was approved by the local Research Ethical Committee (CEIC-Parc de Salut Mar, Barcelona, Spain) and Spanish Medicines Agency (EudraCT 2009-013156-72) and registered as a clinical trial in a public database (ClinicalTrials.gov NCT01086722).

Ethical Statement

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent Statement

Informed consent was obtained from all individual participants included in the study.

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Goday Arno, A., Farré, M., Rodríguez-Morató, J. et al. Pharmacokinetics in Morbid Obesity: Influence of Two Bariatric Surgery Techniques on Paracetamol and Caffeine Metabolism. OBES SURG 27, 3194–3201 (2017). https://doi.org/10.1007/s11695-017-2745-z

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  • DOI: https://doi.org/10.1007/s11695-017-2745-z

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