Modi N B, Wang B, Noveck R J, Gupta S K
ALZA Corporation, Department of Clinical Pharmacology, Mountain View, CA 94039, USA.
J Clin Pharmacol. 2000 Oct;40(10):1141-9.
Methylphenidate hydrochloride (HCl) is frequently used for the treatment of attention deficit/hyperactivity disorder (ADHD). A study was conducted in healthy subjects to evaluate the dose-ranging pharmacokinetics of 18, 36, and 54 mg methylphenidate HCl delivered using an oral, osmotic, controlled-release formulation (OROS). Plasma concentrations of l-methylphenidate were 40-fold lower than those of d-methylphenidate, whereas plasma concentrations of d-alpha-phenyl-2-piperidine acetic acid (d-PPA) and l-PPA, the major metabolite of methylphenidate, were comparable. Mean AUCinf values for d-methylphenidate were 42.2, 80.9, and 120 ng.h/mL for the 18, 36, and 54 mg doses, respectively, increasing dose proportionally. AUCinf values for l-methylphenidate were only approximately 1% of d-methylphenidate (0.43, 0.96, and 1.82 ng.h/mL for the 18, 36, and 54 mg dose groups, respectively). In contrast, AUCinf values of d- and l-PPA were comparable. The dose-normalized d- and l-methylphenidate plasma concentration-time profiles for the three treatment groups were superimposable. Similarly, dose-normalized plasma concentrations of d- and l-PPA were superimposable. Methylphenidate metabolism, measured as the ratio of d-methylphenidate AUCinf to d-PPA AUCinf and as l-methylphenidate AUCinf to l-PPA AUCinf, was similar for the three dose groups, indicating that methylphenidate metabolism was not affected by increasing dose. OROS (methylphenidate HCl) exhibits dose-proportional and linear pharmacokinetics.
盐酸哌甲酯常用于治疗注意力缺陷多动障碍(ADHD)。在健康受试者中开展了一项研究,以评估采用口服渗透控释制剂(OROS)递送18、36和54毫克盐酸哌甲酯的剂量范围药代动力学。左旋哌甲酯的血浆浓度比右旋哌甲酯低40倍,而右旋α-苯基-2-哌啶乙酸(d-PPA)和哌甲酯的主要代谢产物左旋PPA的血浆浓度相当。右旋哌甲酯的平均AUCinf值在18、36和54毫克剂量下分别为42.2、80.9和120纳克·小时/毫升,呈剂量正比增加。左旋哌甲酯的AUCinf值仅约为右旋哌甲酯的1%(18、36和54毫克剂量组分别为0.43、0.96和1.82纳克·小时/毫升)。相比之下,d-PPA和l-PPA的AUCinf值相当。三个治疗组的剂量标准化右旋和左旋哌甲酯血浆浓度-时间曲线可重叠。同样,d-PPA和l-PPA的剂量标准化血浆浓度也可重叠。以右旋哌甲酯AUCinf与d-PPA AUCinf之比以及左旋哌甲酯AUCinf与l-PPA AUCinf之比衡量的哌甲酯代谢在三个剂量组中相似,表明哌甲酯代谢不受剂量增加的影响。OROS(盐酸哌甲酯)呈现剂量正比和线性药代动力学。