Medication and supplement pharmacokinetic changes following bariatric surgery: a systematic review and meta-analysis
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Authors
Lajeunesse‐Trempe, Fannie
Okroj, Dominika
Ostarijas, Eduard
Ramalho, Alan
Tremblay, Eve‐Julie
Llewellyn, David
Harlow, Chris
Chandhyoke, Nikhil
Chew, Nicholas W. S.
Vincent, Royce P.
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Issue Date
2024
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Article
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Abstract
OBJECTIVES: To evaluate the impact of bariatric surgery on the pharmacokinetic (PK) parameters of orally administered medications and supplements. METHODS: Systematic searches of bibliographic databases were conducted to identify studies. Pooled effect estimates from different surgical procedures were calculated using a random-effects model. RESULTS: Quantitative data were synthesized from 58 studies including a total of 1985 participants. Whilst 40 medications and 6 supplements were evaluated across these studies, heterogeneity and missing information reduced the scope of the meta-analysis to the following medications and supplements: atorvastatin, paracetamol, omeprazole, midazolam, vitamin D, calcium, zinc, and iron supplements. There were no significant differences in PK parameters post-surgery for the drugs atorvastatin and omeprazole, and supplements calcium, ferritin, and zinc supplements. Paracetamol showed reduced clearance (mean difference [MD] = -15.56 L/hr, p = 0.0002, I CONCLUSION: This study demonstrates heterogeneity in practice and could not reach conclusive findings for most PK parameters. Prospective studies are needed to inform best practice and enhance patient healthcare and safety following bariatric surgery.
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Journal
Obesity Reviews
Volume
25
Issue
8