Metabolize symptoms and conditions

Here is one for you Artie. Maybe you can go find the statistical profile of studies regarding montelukast and CYP2C8. Originally it was hypothetized that montelukast would inhibit CYP2C8 thus inhibiting steroid (as an example) metabolize. In vitro studies predicted that. Then studies in vivo didn't confirm. Here is another one done in 2006.

Conclusions: Telithromycin increases the plasma concentrations and blood glucose–lowering effect of repaglinide by inhibiting its CYP3A4-catalyzed biotransformation and may increase the risk of hypoglycemia. Unexpectedly, montelukast has no significant effect on repaglinide pharmacokinetics, suggesting that it does not significantly inhibit CYP2C8 in vivo. The low free fraction of montelukast in plasma may explain the lack of effect on CYP2C8 in vivo, despite the low in vitro inhibition constant, highlighting the importance of incorporating plasma protein binding to interaction predictions.

http://www.nature.com/clpt/journal/v79/n3/abs/clpt2006320a.html

The question would be is that always the case or are there genetic variations among people that influence the outcome? Or is there potentially something else that we should be recognizing and we aren't doing that.

I thought of that again when I read this post. We obviously have many questions that should be answered especially when something that we don't expect happens.

Posted by Mindy Miller
Monday, April 14, 2008 4:39 AM EST

I am a pharmacy student and a mother of two sons that take Singular daily. My six year old has been taking it for 4 years, and my three year old for two years. They both have well controlled asthma. I wanted to reply to the questions many have posted about how long it takes to "get out of your system". The half life of Singular is 3-6 hours, so it is gone in a maximum of 18 hours. I came to this website while searching for information about recent FDA warnings. As far as I can tell, there are very few cases documented of mood changes and suicidal thoughts. There are many reasons why children have mood changes, and not feeling well because they have asthma and allergies could also be the source. I wonder if many who start Singular are also taking Prednisone, a steroid, to treat an asthma flare up. Steroids are definitely known to cause mood changes and is one of the reasons they can't be used long term. Please talk to your doctor or pharmacist before taking your children off of medication that may be helping them feel better in the long run.

http://www.injuryboard.com/national-news/fda-issues-early-warning-on-singulair-and-suicides.aspx?googleid=30278

If we had all of the answers, then there would not be such a wide range of symptoms that manifest themselves as a result of Singulair. So I am not trying to spread any conclusions that may be misleading. These are questions and not answers.

I was prescribed Metoprolol and broke out in hives. My doctor then switched me lisinopril. I took it for the first time yesterday and I had a very bad sore throat to the point I could hardly swallow, diarrhea and I feel very blue (not myself). Is this common after only one dose?

I was prescribed 500mgs. levaquin x five days. On the 3rd day I developed cotton mouth, bitter taste on my lips and no matter what I eat it tastes bland at best, bitter usually. I also have a very annoying dry cough that drives me and my husband crazy especially during the nighttime. I also have been experiencing insomnia which has left me the knowledge that night time TV sucks. However, when I do fall asleep its like I'm at the movies. My dreams are vivid and long lasting. They are not fragmented as dreams should be as a result of the cyclic nature of human sleep patterns. When I dream it is literally like I'm watching a movie. I have noticed that even though I get minimal hours of sleep, whenever I wake up I feel like I am fully rested. I usually require 7-8 hours to feel this rested. Interesting how this happened. I wonder if a sleep lab might take a look at this phenomena. I have also developed pain in my rt. knee with an accompanying clicking sound which was never there before. I also have blurring of my vision which made me feel like I need a new prescription for my glasses. This seemed strange since I had a new presription only 4months ago.
So let's tally; systems involved
sensory (taste, vision), respiratory, musculoskeletal and CNS. Gee I got all of this just because I had a UTI. On the more serious side, I was never warned of potential side efffects either by my physician nor my pharmacist. This I feel is a great disservice to the public. If anyone had the bitter taste thing how long did it last? Please comment on other side effects with advice for recovery. As patients taking this drug, we should know what the half-life is, how long it takes to metabolize and how long to detox after discontinuing. Let's hope we will be ourselves again soon, Deb