Distribution, metabolism and excretion of etomidate, a short-acting hypnotic drug, in the rat. Comparative study of (R)-(+)-(--)-Etomidate.

Tritium-labelled (R)-(+) and (S)-(--)-etomidate was injected intravenously in male Wistar rats at four dose levels. Initial plasma clearance was high and the largest part of etomidate was rapidly distributed over those tissues, that had entered in equilibrium with plasma, such as brain, erythrocytes, heart, spleen, lung, kidney, muscle and intestines. Only in subcutaneous fat, testicles and stomach peak levels appeared after 28 minutes. The levels of etomidate, observed in all these tissues varied proportionally with the dose. Although the contents in brain of thw two isomers were comparable, only (R)-(+)-etomidate possesses hypnotic activity. The concentration in brain of (R)-(+)-etomidate, producing hypnotic activity in rats, was 1.50 +/- 0.35 mug/g tissues. Peak levels in liver appeared shortly after administration. Capacity-limited ester hydrolysis in the liver was the main metabolic pathway, yielding a single amphoteric metabolite. The rate of metabolization of (R)-(+)-etomidate was higher than that of the (S)-(--)-isomer. Excretion of the metabolite was mainly with the urine.