a placebo-controlled study, 10 healthy subjects were given oral triazolam 0.5 mg before and  after rifampicin 600 mg daily for 5 days. Rifampicin reduced the triazolam AUC by 95% and  decreased its maximum plasma levels by 88%, when compared with placebo. The elimination half- life was reduced from 2.8 hours to 1.3 hours. Pharmacodynamic tests (drowsiness, sway, Maddox  wing, etc.) showed that rifampicin abolished the effects of triazolam. a) Why is the AUC of triazolam reduced in the presence of rifampicin? b) Given the above scenario, if you were to accommodate this situation by dosage adjustment  strategies, in the presence rifampicin what dose of triazolam would you have recommended,  keeping dosage interval the same as when there was no rifampicin?   answer part b

Curren'S Math For Meds: Dosages & Sol
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Chapter16: Adult And Pediatric Dosages Based On Body Surface Area
Section: Chapter Questions
Problem 4.5P
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In a placebo-controlled study, 10 healthy subjects were given oral triazolam 0.5 mg before and 
after rifampicin 600 mg daily for 5 days. Rifampicin reduced the triazolam AUC by 95% and 
decreased its maximum plasma levels by 88%, when compared with placebo. The elimination half-
life was reduced from 2.8 hours to 1.3 hours. Pharmacodynamic tests (drowsiness, sway, Maddox 
wing, etc.) showed that rifampicin abolished the effects of triazolam.

a) Why is the AUC of triazolam reduced in the presence of rifampicin?

b) Given the above scenario, if you were to accommodate this situation by dosage adjustment 
strategies, in the presence rifampicin what dose of triazolam would you have recommended, 
keeping dosage interval the same as when there was no rifampicin?

 

answer part b

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A. Rifampicin induces the activity of drug-metabolizing enzymes, including cytochrome P450 3A4 (CYP3A4), which is responsible for the metabolism of triazolam. The induction of CYP3A4 by rifampicin leads to increased metabolism of triazolam, resulting in decreased plasma levels and reduced AUC

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