EFFECTS OF DISODIUM-CROMOGLYCATE ON DEXAMETHASONE METABOLISM

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Abstract
The effect of disodium cromoglycate on dexamethasone metabolism was studied in 4 patients with bronchial asthma before and after 3 wk of treatment. Labeled dexamethasone was injected i.v. and serial blood samples were collected during the next 6 h. Transport kinetics of labeled dexamethasone were determined using a 2-compartment model. Baseline plasma equilibrated half-life values ranged from 133-258 min, and metabolic clearance rate ranged from 134-912 l/day. After disodium cromoglycate therapy a small decrease in labeled dexamethasone clearance occurred. There was a mean increase in half-life of 20 min (9%), being 201 .+-. 51 (mean .+-. SD) before therapy and 220 .+-. 57 min after therapy. This was not significant. Metabolic clearance rate decreased 13% (59 l/day), being 441 .+-. 334 l/day before and 382 .+-. 304 l/day after treatment (P < 0.05). Other transport kinetics of labeled dexamethasone were not significantly different with therapy. Disodium cromoglycate produces small but probably not significant changes in dexmethasone metabolism. The investigation supports the thesis that the steroid-sparing effect of disodium cromoglycate is not the result of depression of corticosteroid plasma clearance with longer duration of steroid action, but most likely is the result of the effect of disodium cromoglycate on cellular mechanisms and and inhibition of mediator release.

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