Tenero David M, Henderson Linda S, Baidoo Charlotte A, Harter Angela H, Campanile Andrea M, Danoff Theodore M, Boyle Duane
Department of Clinical Pharmacokinetics, Modeling, and Simulation, GlaxoSmithKline, King of Prussia, Pennsylvania 19406, USA.
Am J Cardiol. 2006 Oct 2;98(7A):5L-16L. doi: 10.1016/j.amjcard.2006.07.014. Epub 2006 Aug 28.
This review summarizes the pharmacokinetics (PK) of carvedilol after administration of a new once-daily controlled-release (CR) formulation. The plasma concentration-time profiles for both R(+)- and S(-)-carvedilol indicate that carvedilol CR will provide coverage over a 24-hour period similar to the current immediate-release (IR) twice-daily formulation. Exposures for both enantiomers, based on area under the curve (AUC), maximum plasma concentrations (C(max)), and trough concentrations, are equivalent for carvedilol CR compared with carvedilol IR. C(max) and AUC of the enantiomers of carvedilol increase in an approximate dose-proportional manner after administration of carvedilol CR over the dose range of 10-80 mg, indicating that the formulation provides consistent PK performance across the dose strengths proposed for marketing. The intrasubject and intersubject variability of carvedilol CR was comparable to carvedilol IR. For carvedilol CR, mean AUC and C(max) were increased <20% after a high-fat meal compared with a standard meal. The CR and IR formulations of carvedilol exhibited equivalent steady-state PK characteristics in the target hypertension and heart failure populations. The availability of once-daily dosing is expected to improve treatment adherence and thereby enhance the effectiveness of carvedilol in routine clinical use.
本综述总结了新型每日一次控释(CR)制剂给药后卡维地洛的药代动力学(PK)。R(+)-和S(-)-卡维地洛的血浆浓度-时间曲线表明,卡维地洛CR将提供与当前每日两次的即释(IR)制剂相似的24小时覆盖范围。基于曲线下面积(AUC)、最大血浆浓度(C(max))和谷浓度,卡维地洛CR与卡维地洛IR相比,两种对映体的暴露量相当。在10-80 mg剂量范围内给予卡维地洛CR后,卡维地洛对映体的C(max)和AUC以近似剂量比例的方式增加,表明该制剂在拟上市的剂量强度范围内提供了一致的PK性能。卡维地洛CR的受试者内和受试者间变异性与卡维地洛IR相当。对于卡维地洛CR,与标准餐相比,高脂餐后平均AUC和C(max)增加<20%。卡维地洛的CR和IR制剂在目标高血压和心力衰竭人群中表现出等效的稳态PK特征。每日一次给药的可用性有望提高治疗依从性,从而增强卡维地洛在常规临床使用中的有效性。