Sports Medicine

, Volume 41, Issue 3, pp 177–183 | Cite as

Transdermal Patch Drug Delivery Interactions with Exercise

Leading Article

Abstract

Transdermal drug delivery systems, such as the transdermal patch, continue to be a popular and convenient way to administer medications. There are currently several medications that use a transdermal patch drug delivery system. This article describes the potential untoward side effects of increased drug absorption through the use of a transdermal patch in individuals who exercise or participate in sporting events. Four studies have been reported that demonstrate a significant increase in the plasma concentration of nitroglycerin when individuals exercise compared with rest. Likewise, several case reports and two studies have been conducted that demonstrate nicotine toxicity and increased plasma nicotine while wearing a nicotine patch in individuals who exercise or participate in sporting events compared with rest. Healthcare providers, trainers and coaches should be aware of proper transdermal patch use, especially while exercising, in order to provide needed information to their respective patients and athletes to avoid potential untoward side effects. Particular caution should be given to individuals who participate in an extreme sporting event of long duration. Further research that includes more medications is needed in this area.

References

  1. 1.
    Lenz TL, Lenz NJ, Faulkner MA. Potential interactions between exercise and drug therapy. Sports Med 2004; 34 (5): 293–306PubMedCrossRefGoogle Scholar
  2. 2.
    Mason WD, Kopchak G, Winer N, et al. Effect of exercise on the renal clearance of atenolol. J Pharm Sci 1980; 69: 344–5PubMedCrossRefGoogle Scholar
  3. 3.
    Van Baak MA, Mooij JM, Schiffers PM. Exercise and the pharmacokinetics of propranolol, verapamil and atenolol. Eur J Clin Pharmacol 1992; 43: 547–50PubMedCrossRefGoogle Scholar
  4. 4.
    Henry JA, Iliopoulou A, Kaye CM, et al. Changes in plasma concentrations of acebutolol, propranolol, and indomethocinduring physical exercise. Life Sci 1981; 28: 1925–9PubMedCrossRefGoogle Scholar
  5. 5.
    Hurwitz GA, Webb JG, Walle SA, et al. Exercise-induced increments in plasma levels of propranolol and noradrenaline. Br J Clin Pharmacol 1983; 16: 599–608PubMedCrossRefGoogle Scholar
  6. 6.
    Mooy J, Arends B, Kemenade JV, et al. Influence of prolonged submaximal exercise on the pharmacokineticsof verapamil in humans. J Cardiovasc Pharmacol 1986; 8: 940–2PubMedCrossRefGoogle Scholar
  7. 7.
    Joreteg T, Jorestrand T. Physical exercise and binding of digoxin to skeletal muscle: effect of muscle activation frequency. Eur J Clin Pharmacol 1984; 27: 567–70PubMedCrossRefGoogle Scholar
  8. 8.
    Schlaeffer F, Engelberg I, Kaplanski J, et al. Effect of exercise and environmental heat on theophylline kinetics. Respiration 1984; 45: 438–42PubMedCrossRefGoogle Scholar
  9. 9.
    Koivisto VA, Felig P. Effects of leg exercise on insulin absorption in diabetic patients. N Engl J Med 1978; 298: 79–83PubMedCrossRefGoogle Scholar
  10. 10.
    Micromedex Healthcare Series [online]. Available from URL: http://www-thromsonhc-com.cuhsl.creighton.edu [Accessed 2010 Jun 23]
  11. 11.
    Prausnitz MR, Langer R. Transdermal drug delivery. Nat Biotechnol 2008; 26 (11): 1261–8PubMedCrossRefGoogle Scholar
  12. 12.
    Tom W-C. Characteristics of transdermal patches. Pharmacists Letter 2008 July; 24 (7): 240711 [online]. Available from URL: http://www.phamacistsletter.com [Accessed2010 Jun 23]Google Scholar
  13. 13.
    Venkatraman S, Gale R. Skin adhesives and skin adhesion 1. Transdermal drug delivery systems. Biomaterials 1998; 19: 1119–36PubMedCrossRefGoogle Scholar
  14. 14.
    Barkve TF, Langseth-Manrique K, Bradesen JE, et al. Increased uptake of transdermal glyceryl trinitrate duringphysical exercise and during high ambient temperature. Am Heart J 1986; 112 (3): 537–41PubMedCrossRefGoogle Scholar
  15. 15.
    Weber S, de Luture D, Rey E, et al. The effects of moderate sustained exercise on the pharmacokinetics of nitroglycerine. Br J Clin Pharmacol 1987; 23: 103–5PubMedCrossRefGoogle Scholar
  16. 16.
    Lefebvre RA, Bogaert MG, Teirlynck O, et al. Influence of exercise on nitroglycerin plasma concentrations aftertransdermal application. Br J Clin Pharmacol 1990; 30: 292–6PubMedCrossRefGoogle Scholar
  17. 17.
    Gjesdal K, Klemsdal TO, Rykke EO, et al. Transdermal nitrate therapy: bioavailability during exercise increasestransiently after the daily change of patch. Br J Clin Pharmacol 1991; 31: 560–2PubMedCrossRefGoogle Scholar
  18. 18.
    Health Canada. Canadian adverse drug reaction newsletter. Can Med Assoc 1996; 6 (1)154: 61–3Google Scholar
  19. 19.
    Klemsdal TO, Gjesdal K, Zahlsen K. Physical exercise increases plasma concentrations of nicotine during treatmentwith a nicotine patch. Br J Clin Pharmacol 1995; 39: 677–9PubMedCrossRefGoogle Scholar
  20. 20.
    Bur A, Joukhadar C, Klein N, et al. Effects of exercise on transdermal nicotine release in healthy habitual smokers. Int J Clin Pharmacol Ther 2005; 43 (5): 239–43PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2011

Authors and Affiliations

  1. 1.Department of Pharmacy PracticeCreighton UniversityOmahaUSA

Personalised recommendations