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口服缓释二甲双胍制剂药代动力学-药效学原理的临床前评估

Preclinical evaluation of pharmacokinetic-pharmacodynamic rationale for oral CR metformin formulation.

作者信息

Stepensky D, Friedman M, Srour W, Raz I, Hoffman A

机构信息

Department of Pharmaceutics, School of Pharmacy, The Hebrew University of Jerusalem, P.O. Box 12065, 91120, Jerusalem, Israel.

出版信息

J Control Release. 2001 Mar 12;71(1):107-15. doi: 10.1016/s0168-3659(00)00374-6.

Abstract

We examined the pharmacokinetic (PK) and pharmacodynamic (PD) rationales to develop controlled release (CR) formulations of metformin. Unrestrained diabetic rats received the drug as intravenous bolus (i.v.), oral solution (p.o.), intra-duodenal bolus, 4-h infusion, or intra-colonic bolus. In addition, we developed two CR-gastroretentive dosage forms (CR-GRDF) that released the drug over 3 or 6 h (in vitro), and retained in the rats' stomach for 8-10 h. Metformin exhibited flip-flop PK. The colonic absorption was low but sustained and was associated with highly variable glucose-lowering effects, thus providing a PK rationale to develop CR-GRDF. In addition, the glucose-lowering effect was greater following p.o. vs. i.v. administration, despite equivalent AUC, indicating a first pass PD effect, thus, adding a PD rationale to develop metformin CR-GRDF. When administered to the diabetic rats, CR-GRDFs produced bioavailability and extent of glucose-lowering effects that were similar to those of the duodenal infusion and p.o. metformin administration. These findings are attributed to the adsorption of metformin to the intestine that yields slow and prolonged absorption even following p.o. administration of drug solution. The data indicates that unless the CR formulation could significantly extend the absorption period, it is not likely to improve glucose-lowering efficacy.

摘要

我们研究了开发二甲双胍控释(CR)制剂的药代动力学(PK)和药效学(PD)原理。未受限制的糖尿病大鼠接受静脉推注(i.v.)、口服溶液(p.o.)、十二指肠推注、4小时输注或结肠内推注给药。此外,我们开发了两种控释胃滞留剂型(CR-GRDF),其在体外3或6小时内释放药物,并在大鼠胃中滞留8-10小时。二甲双胍表现出反翻转PK。结肠吸收较低但持续,且与高度可变的降糖效果相关,因此为开发CR-GRDF提供了PK原理。此外,尽管曲线下面积(AUC)相当,但口服给药后的降糖效果比静脉给药更大,表明存在首过PD效应,因此,为开发二甲双胍CR-GRDF增加了PD原理。当给糖尿病大鼠给药时,CR-GRDF产生的生物利用度和降糖效果程度与十二指肠输注和口服二甲双胍给药相似。这些发现归因于二甲双胍对肠道的吸附,即使在口服药物溶液后也会产生缓慢而持久的吸收。数据表明,除非CR制剂能显著延长吸收期,否则不太可能提高降糖疗效。

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