Frågedatum: 2000-08-21
RELIS database 2000; id.nr. 16509, DRUGLINE
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Are there any known interactions between anabolic androgenic steroids (AAS) and antibiotics?



Fråga: Are there any known interactions between anabolic androgenic steroids (AAS) and antibiotics?

Sammanfattning: No information was found concerning interactions between anabolic androgenic steroids and antibiotics. Theoretically, erythromycin and clarithromycin could inhibit and rifampicin induce the metabolism of testosterone.

Svar: No information on interactions between anabolic androgenic steroids and antibiotics was found in Medline, Drugline or standard pharmacological literature. Concomitant use of AAS and antibiotics that are mainly excreted unchanged (penicillin, trimethoprim, cephalosporins, most tetracyclines, aminoglycosides, nitrofurantoine), is not expected to lead to important drug metabolic interaction.

Erythromycin and clarithromycin are metabolised by the isoenzyme cytochrome P450 CYP3A4 (1, 2). One of the CYP3A enzymes also metabolises testosterone (3). As erythromycin and clarithromycin are known to inhibit the metabolism of various substrates for CYP3A4, this could theoretically be a mechanism for interaction. Oral contraceptives are also metabolised by CYP3A and it is possible that these enzymes could be involved in the metabolism of AAS such as nandrolone, ethyloestrenol, oxymetholone and stanozolol as well, although this has not been confirmed (4-6).

Rifampicin is metabolised by CYP3A4, and as it is known to induce this cytochrome isoenzyme, it could possibly interact at least with testosterone (7). 1 Drugline no 13497 (year 1998) 2 Gorski JC, Jones DR, Haehner-Daniels BD, Hamman MA, O´Mara EM Jr, Hall SD: The contribution of intestinal and hepatic CYP3A to the interaction between midazolam and clarithromycin. Clin Pharmacol Ther 1998; 62: 133-143 3 Drugline no 14814 (year 1998) 4 Dollery C Sir, editor. Therapeutic drugs. 2nd ed. Edinburgh: Churchill Livingstone; 1998. p. N28-N31 5 Dollery C Sir, editor. Therapeutic drugs. 2nd ed. Edinburgh: Churchill Livingstone; 1998. p. S91-S93 6 Drugline no 15744 (year 1997) 7 Drugline no 15817 (year 1998)

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