Tanaka Makoto, Takashina Hideo, Tsutsumi Shuichiro
Drug Metabolism and Physicochemical Property Research Laboratory, Daiichi Pharmaceutical Co. Ltd, 16-13 Kita-Kasai 1-Chome, Edogawa-ku, Tokyo 134-8630, Japan.
J Pharm Pharmacol. 2004 Aug;56(8):977-83. doi: 10.1211/0022357043932.
Fluoroquinolones have been reported to have a high affinity for melanin. The ocular tissue distribution and accumulation of radioactivity was compared after repeated oral administration of 14C-levofloxacin and 14C-chloroquine at daily doses of 20 mg (0.054 mmol) kg(-1) and 28 mg (0.054 mmol) kg(-1), respectively, in pigmented rats for 84 days. The mean serum level at 24 h following each dose of 14C-levofloxacin was almost constant in the range of 0.33-0.45 nmol equiv mL(-1) after the 14th dose and thereafter. The melanin-containing ocular tissues, such as iris ciliary body and stratum pigment chorioides sclera, showed a much higher concentration of radioactivity than other non-pigmented ocular tissues. The respective concentration in iris ciliary body and stratum pigment chorioides sclera after the 1st dose was 126.47 and 74.91 nmol equiv g(-1), and gradually increased with increasing dose number, reaching 1261.81 and 447.45 nmol equiv g(-1) after the 84th dose, which was ca. 10 and 6 times higher, respectively, than after the 1st dose. The mean serum level following each dose of 14C-chloroquine was almost constant in the range 0.51-0.87 nmol equiv mL(-1) after the 7th dose and thereafter. The respective concentration in iris ciliary body and stratum pigment chorioides sclera after the 1st dose was 572.10 and 709.41 nmol equiv g(-1), and gradually increased with increasing dose number, reaching 33 317.92 and 12 322.90 nmol equiv g(-1) after the 84th dose, which was ca. 58 and 17 times higher, respectively, than after the 1st dose. The concentration in aqueous humour, cornea, lens, vitreous body and retina after the 84th dose was 1.84, 6.33, 0.48, 5.60 and 11.42 nmol equiv g(-1) for 14C-levofloxacin and 18.84, 264.99, 27.26, 158.43 and 1020.89 nmol equiv g(-1) for 14C-chloroquine (ca. 10, 42, 57, 28 and 89 times higher, respectively, than for 14C-levofloxacin). Especially, the concentration in the retina was markedly higher after 14C-chloroquine administration than after 14C-levofloxacin administration. The concentration and the extent of accumulation of radioactivity not only in melanin-containing ocular tissues but also in other non-pigmented ocular tissues, such as retina, after chronic oral administration of 14C-levofloxacin once daily for 84 days were much lower than those after multiple dosing with 14C-chloroquine under the same conditions. These results indicate that levofloxacin would have a much lower risk for ocular toxicity than chloroquine after chronic dosing.
据报道,氟喹诺酮类药物对黑色素具有较高的亲和力。分别以每日20 mg(0.054 mmol)kg⁻¹和28 mg(0.054 mmol)kg⁻¹的剂量,对有色大鼠重复口服¹⁴C - 左氧氟沙星和¹⁴C - 氯喹84天,比较了放射性物质在眼部组织的分布和蓄积情况。在第14次给药及之后,每次¹⁴C - 左氧氟沙星给药后24小时的平均血清水平几乎恒定,在0.33 - 0.45 nmol当量mL⁻¹范围内。含黑色素的眼部组织,如虹膜睫状体和色素脉络膜巩膜层,显示出比其他无色素眼部组织高得多的放射性浓度。第1次给药后,虹膜睫状体和色素脉络膜巩膜层中的各自浓度分别为126.47和74.91 nmol当量g⁻¹,并随着给药次数的增加而逐渐升高,在第84次给药后分别达到1261.81和447.45 nmol当量g⁻¹,分别约为第1次给药后的10倍和6倍。在第7次给药及之后,每次¹⁴C - 氯喹给药后24小时的平均血清水平几乎恒定,在0.51 - 0.87 nmol当量mL⁻¹范围内。第1次给药后,虹膜睫状体和色素脉络膜巩膜层中的各自浓度分别为572.10和709.41 nmol当量g⁻¹,并随着给药次数的增加而逐渐升高,在第84次给药后分别达到33317.92和12322.90 nmol当量g⁻¹,分别约为第1次给药后的58倍和17倍。第84次给药后,¹⁴C - 左氧氟沙星在房水、角膜、晶状体、玻璃体和视网膜中的浓度分别为1.84、6.33、0.48及5.60和11.42 nmol当量g⁻¹,¹⁴C - 氯喹在其中的浓度分别为18.84、264.99、27.26、158.43和1020.89 nmol当量g⁻¹(分别约为¹⁴C - 左氧氟沙星的10、42、57、28和89倍)。特别是,¹⁴C - 氯喹给药后视网膜中的浓度明显高于¹⁴C - 左氧氟沙星给药后。在相同条件下,每天一次连续口服¹⁴C - 左氧氟沙星84天,放射性物质在含黑色素的眼部组织以及其他无色素眼部组织(如视网膜)中的浓度和蓄积程度远低于多次给药¹⁴C - 氯喹后的情况。这些结果表明,长期给药后,左氧氟沙星引起眼部毒性的风险远低于氯喹。