Falcoz C, Oliver R, McDowall J E, Ventresca P, Bye A, Daley-Yates P T
Clinical Pharmacology, Glaxo Wellcome Research and Development, Greenford, Middlesex, England.
Clin Pharmacokinet. 2000;39 Suppl 1:9-15. doi: 10.2165/00003088-200039001-00002.
The aim of this study was to determine the absolute oral bioavailability of fluticasone propionate (FP) in healthy volunteers.
A 3-period incomplete block crossover design was used. On separate occasions, 21 male volunteers received a single 250 microg intravenous dose of FP (n = 21) and twice daily oral doses of either micronised FP 0.1 mg (n = 9), 1 mg (n = 12), 10 mg (n = 11) or placebo (n = 9) for 4 days.
FP was not measurable in the plasma after twice daily oral administration of a 0.1 mg dose. FP concentrations just above the limit of quantification could be measured in only 5 volunteers, and only at some time points, after administration of FP 1 mg twice daily. At a dose of 10 mg twice daily the absolute oral bioavailability of the drug was <1% when a liquid chromatography-mass spectrometry assay was used to assess plasma concentrations. Only oral doses of FP 10 mg twice daily, 10 times greater than the recommended maximum inhaled dose, produced any detectable change in urinary cortisol excretion.
The results of this study confirm that oral absorption of FP into the systemic circulation is negligible. The swallowed portion of an inhaled dose of FP is unlikely to increase the systemic exposure to the drug, thus decreasing the likelihood of adverse systemic effects.
本研究旨在确定丙酸氟替卡松(FP)在健康志愿者中的绝对口服生物利用度。
采用3期不完全区组交叉设计。在不同时间,21名男性志愿者分别接受一次250微克的静脉注射剂量的FP(n = 21),以及每日两次口服微粉化FP 0.1毫克(n = 9)、1毫克(n = 12)、10毫克(n = 11)或安慰剂(n = 9),持续4天。
每日两次口服0.1毫克剂量的FP后,血浆中无法检测到FP。每日两次服用1毫克FP后,仅在5名志愿者的某些时间点可检测到略高于定量限的FP浓度。当使用液相色谱-质谱分析法评估血浆浓度时,每日两次服用10毫克剂量的药物绝对口服生物利用度<1%。仅每日两次口服10毫克的FP剂量(比推荐的最大吸入剂量大10倍),才会使尿皮质醇排泄产生任何可检测到的变化。
本研究结果证实,FP口服吸收进入体循环的量可忽略不计。吸入剂量的FP经吞咽后不太可能增加药物的全身暴露量,从而降低出现全身不良反应的可能性。