Miyaoka K, Matsubara T, Matsumoto T, Kanda C
Department of Internal Medicine, Kyoto Miniren Central Hospital, Japan.
Gan To Kagaku Ryoho. 1991 Oct;18(13):2325-8.
A 78 year old patient with non Hodgkin Lymphoma receiving hemodialysis was treated with etoposide at a dose of 50 mg per body and its plasma pharmacokinetics were studied. The patient was dialyzed for 4 hours three times weekly. Etoposide was given by 60 minutes infusion on day 1 and 3, and hemodialysis was performed on day 2. The pharmacokinetic curve was found to fit to two compartment model. T 1/2 beta was 11.29 hours. Total body clearance was 13.65 mg/min/m2 on day 1 and 12.83 mg/min/m2 on day 3 respectively. AUC was 41.53 micrograms.h/ml on day 1 and 44.18 micrograms.h/ml on day 3 respectively. When these results were compared to those reported in patients with normal renal function, half life were longer while total body clearance was lower. In addition, AUC was higher. Hematologic toxicities were severe at this low dose. Hemodialysis did not influence on the decay of concentration during the elimination phase. These results suggest that it is necessary to reduce the dose of etoposide in hemodialysis patients.
一名78岁接受血液透析的非霍奇金淋巴瘤患者接受了依托泊苷治疗，剂量为每千克体重50毫克，并对其血浆药代动力学进行了研究。该患者每周进行3次血液透析，每次4小时。依托泊苷在第1天和第3天通过60分钟静脉输注给药，第2天进行血液透析。药代动力学曲线符合二室模型。β相半衰期为11.29小时。第1天的总体清除率为13.65毫克/分钟/平方米，第3天为12.83毫克/分钟/平方米。第1天的曲线下面积（AUC）为41.53微克·小时/毫升，第3天为44.18微克·小时/毫升。将这些结果与肾功能正常患者的报告结果相比，半衰期更长，而总体清除率更低。此外，AUC更高。在这个低剂量下血液学毒性严重。血液透析对消除期浓度的衰减没有影响。这些结果表明，有必要降低血液透析患者依托泊苷的剂量。
