Paracetamol goes bad with GS

Paracetamol goes bad with Gilbert's Syndrome

4.8 ValidityScore

Valid or Invalid? Login to vote or flag.

Parallel Biolinks

Be aware! From other researches we also know that

2.6
Paracetamol goes well with Gilbert's Syndrome
(BioMindmap Proof Quality is Acceptable.)

Paracetamol, with its well-known hepatotoxicity in overdose, has been studied in this area. A subgroup of those with GS have been found to shift metabolism to an oxidative pathway over a glucuronidation pathway, thereby increasing the toxic metabolites of paracetamol, namely cysteine and mercapturic acid conjugates. There have, however, been no reported cases of liver injury in this setting in the literature. Therefore, there is no good quality evidence that those with GS should avoid paracetamol use or alter the recommended dosage.

Proofs

2019

Overview of Gilbert's syndrome.
King D and Armstrong MJ
The, mainly theoretical, concern is that glucuronidation
in the metabolism of drugs may not be optimal and therefore lead
to toxic metabolite build-up. Paracetamol, with its well-known
hepatotoxicity in overdose, has been studied in this area. A subgroup of those with GS have been found to shift metabolism to an oxidative pathway over a glucuronidation pathway, thereby increasing the toxic metabolites of paracetamol, namely cysteine and mercapturic acid conjugatese. Therefore, there is no good quality evidence that those with GS should avoid paracetamol use or alter the recommended dosage.
#Citation search, Entrez, Journal Articles, MEDLINE, Medical Journals, NCBI, NLM, National Center for Biotechnology Information, PubMed, United States National Library of Medicine, pub med
ncbi.nlm.nih.gov/pubmed/30709860
Read 10.1136/dtb.2018.000028

From this research we know that
8.7
Gilbert's Syndrome promotes Cholelithiasis
+13
4.8
Paracetamol goes bad with Gilbert's Syndrome
0.6
Gilbert's Syndrome may slow Proteinuria
(BioMindmap Proof Quality is Very Light.)
0.9
Nicotinic acid may worsen Gilbert's Syndrome
(BioMindmap Proof Quality is Very Light.)
2.7
Atazanavir may worsen Gilbert's Syndrome
(BioMindmap Proof Quality is Acceptable.)
1.5
Gilbert's Syndrome may prevent Mortality
(BioMindmap Proof Quality is Low.)
-1.6
Perhaps, Gilbert's Syndrome may cause Splenomegaly
(BioMindmap Proof Quality is Negative.)
-0.4
Perhaps, Sulfasalazine goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Negative.)
-0.7
Perhaps, Methyldopa goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Negative.)
-0.7
Perhaps, Erythromycin goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Negative.)
-0.7
Perhaps, Oestrogens goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Negative.)
-0.4
Perhaps, Rifampicin goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Negative.)
-1.3
Perhaps, Gilbert's Syndrome may slow Autonomic neuropathy
(BioMindmap Proof Quality is Negative.)
-1.6
Perhaps, Gilbert's Syndrome may prevent Hodgkin’s lymphoma
(BioMindmap Proof Quality is Negative.)
-1.4
Perhaps, Gilbert's Syndrome may prevent Cancer
(BioMindmap Proof Quality is Negative.)
-0.4
Perhaps, Gilbert's Syndrome does not affect Chronic liver disease
(BioMindmap Proof Quality is Negative.)
-1.4
Perhaps, Phenobarbital may improve Gilbert's Syndrome
(BioMindmap Proof Quality is Negative.)

2015

Case Report

Unusual presentation of Gilbert disease with high levels of unconjugated bilirubin. Report of two cases.
Flores-Villalba E, et al.
Once diagnosis is made, the most important aspect is to notify the patients on the benign course of the disease and instruct them on the circumstances that may precipitate an elevation of bilirubin and appearance of jaundice. Also is very important to inform the patient on side effects or unexpected toxicity due to some drugs which metabolism is due to hepatic glucoronidation:
Tolbutamide Aminopyrine Menthol Estradiol Lamotrigine Irinotecan NSAID (included acetaminophen) HIV protease inhibitors
Organism: Humans
#Adolescent, Bilirubin, Genetic Testing, Gilbert Disease, Humans, Hyperbilirubinemia, Male, Young Adult
ncbi.nlm.nih.gov/pubmed/26181050
Read 10.17235/reed.2015.3719/2015

From this research we know that
8.8
Irinotecan goes bad with Gilbert's Syndrome
+5
4.8
Paracetamol goes bad with Gilbert's Syndrome
2.1
NSAID goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Low.)
1.5
Aminopyrine goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Low.)
1.8
Menthol goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Low.)
1.8
Estradiol goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Low.)
1.5
Lamotrigine goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Low.)
1.5
HIV protease inhibitors goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Low.)
1.5
Tolbutamide goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Low.)

2013

Case Report

Genetics of drug-induced hepatotoxicity toxicity in Gilbert's syndrome.
Raza A, et al.
He was homozygous for A(TA)7TAA promoter mutation consistent with GS. Two months prior to evaluation, he began ingesting six Excedrin caplets (acetaminophen 250 mg, aspirin 250 mg, and caffeine 65 mg) daily for migraine headache. Abnormal levels of aminotransferases had been noted previously while using simvastatin and gemfi brozil. Discontinuation of these medications in the past led to normalization of aminotransferase levels. On the basis of these observations, a diagnosis of drug-induced liver injury was made. Th e patient discontinued Excedrin, and aminotransferase levels normalized in 1 month.
Organism: Humans
#Acetaminophen, Anti-Inflammatory Agents, Aspirin, Caffeine, Chemical and Drug Induced Liver Injury, Drug Combinations, Gilbert Disease, Humans, Male, Middle Aged, Non-Steroidal
ncbi.nlm.nih.gov/pubmed/24300875
Read 10.1038/ajg.2013.293

From this research we know that
4.8
Paracetamol goes bad with Gilbert's Syndrome
1.8
Excedrin goes bad with Gilbert's Syndrome
(BioMindmap Proof Quality is Low.)

1999

Heterogeneity of paracetamol metabolism in Gilbert's syndrome.
Esteban A and Pérez-Mateo M
«Gilbert's syndrome (GS) is an inherited bilirubin UDP-glucuronosyl transferase deficiency. The object of this study was to investigate the possible effects of this disorder on the metabolism of a drug, such as paracetamol, which is basically eliminated by hepatic glucuronidation. We studied 32 healthy volunteers and 18 people with GS, all of whom were given 1.5 g of paracetamol orally. In the 24 h urine collected, we determined the elimination of free paracetamol, the conjugates (glucuronide, sulphate) and the oxidation products (cysteine, mercapturic acid) by high pressure liquid chromatography (HPLC). The results are given as a percentage of the total quantity of paracetamol eliminated. The patients with GS were divided into 2 subgroups (GS-I and GS-II) according to whether glucuronidation was more or less than 50%. The overall results of the GS group showed no significant difference in the urinary elimination of metabolites as compared to the control group. However, in subgroup GS-I, a reduction in glucuronidation (P = 0.0012) and an increase in oxidation (P = 0.0051) was seen, as compared with the other 2 groups. There was inverse correlation between the glucuronide produced by conjugation and the oxidation products (r = -0.8718; P<0.005). People with GS are a heterogeneous group with respect to the metabolism of paracetamol. In one subgroup this was normal. In the other subgroup there was a marked reduction in glucuronidation and an increase in oxidation. These changes could mean that people in this subgroup are more liable to liver damage after an overdose of paracetamol.»
#Acetaminophen, Adult, Analgesics, Chromatography, Female, Gilbert Disease, High Pressure Liquid, Humans, Male, Middle Aged, Non-Narcotic, Oxidation-Reduction
ncbi.nlm.nih.gov/pubmed/10412886
Read 10.1007/BF03190005

From this research we know that
4.8
Paracetamol goes bad with Gilbert's Syndrome

Add Biolink with same Proofs

Add extra Proof

ranked