Caffeine as a potential indicator for acetylator status

R. B. Rankin, S A Hudson, A. F. Fell

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The identification of patients as 'fast acetylators' or 'slow acetylators' is used in clinical practice to help recognize those at risk from toxicity and in guiding the dosage of N-acetylated drugs. Caffeine has been proposed as a marker for drug acetylation on the basis of a ratio of urinary metabolites (5-acetylamino-6-formylamino-3-methyl uracil and 1-methylxanthine, AFMU:MX) determined by high-performance liquid chromatography. The caffeine test was studied in 26 subjects by reference to the use of sulphamidine as the test substance. The distribution of urinary AFMU:MX ratios allowed assignment of subjects to 'slow' and 'fast' acetylator status (AFMU:MX < 2.1 and > 2.3 respectively). The results showed accordance with those from the sulphadimidine test with the exception of one subject. The possible interference of concurrent administration of sulphadimidine (as an example of a drug known to undergo metabolism by N-acetylation) was also studied in 11 of the subjects. The interference was found to be small (apparent mean bias 11%) but of possible clinical significance.

Original languageEnglish
Pages (from-to)47-51
Number of pages5
JournalJournal of Clinical Pharmacy and Therapeutics
Issue number1
Publication statusPublished - 1987

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