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严重肾功能损害患者单剂量莫硝唑的药代动力学

Pharmacokinetics of single-dose morinidazole in patients with severe renal impairment.

作者信息

Zhang Hao, Huang Lu, Huang Yuan-yuan, Yi Bin, Pei Qi, Tan Hong-yi, Huang Jie, Liu Ji-shi, Yuan Hong, Yang Guo-ping

出版信息

Int J Clin Pharmacol Ther. 2014 Feb;52(2):159-65. doi: 10.5414/CP202000.

Abstract

OBJECTIVE

To evaluate the pharmacokinetics of morinidazole in individuals with severe renal impairment (RI).

METHODS

This open-label Phase I study enrolled healthy volunteers and patients with severe RI aged 18 - 65 years. All subjects received a single infusion of sodium chloride injection with 500 mg morinidazole. Plasma and urine concentration of morinidazole and one of its metabolites (M4-1) were evaluated by using HPLC-UV and HPLC-MS/MS respectively. Pharmacokinetic parameters were calculated by Phoenix WinNonlin 6.0 software.

RESULTS

22 individuals (healthy: n = 11, severe RI: n = 11) received morinidazole. In both groups, maximum plasma concentration of morinidazole was reached within 1 hour, while the tmax of M4-1 differed greatly. Both AUC0-t and AUC0-∞ of morinidazole were 1.4 times higher in patients with severe RI, while M4-1 were over 7 times higher than healthy groups. Renal excretion of unchanged morinidazole was decreased by 65% in patients with RI, and M4-1 was decreased by 72%. Apparent correlation between CLcr and CL, AUC, t1/2 and CLr were seen in two groups.

CONCLUSIONS

A single dose of 500 mg morinidazole is well tolerated. Changes in pharmacokinetic parameters of morinidazole and M4-1 are seen in patients with RI and may be clinically important.

摘要

目的

评估莫硝唑在严重肾功能损害(RI)个体中的药代动力学。

方法

这项开放标签的I期研究纳入了18至65岁的健康志愿者和严重RI患者。所有受试者均接受了一次含500mg莫硝唑的氯化钠注射液静脉输注。分别采用高效液相色谱-紫外检测法(HPLC-UV)和高效液相色谱-串联质谱法(HPLC-MS/MS)评估莫硝唑及其一种代谢物(M4-1)的血浆和尿液浓度。通过Phoenix WinNonlin 6.0软件计算药代动力学参数。

结果

22名个体(健康者:n = 11,严重RI患者:n = 11)接受了莫硝唑治疗。两组中,莫硝唑的血浆最大浓度均在1小时内达到,而M4-1的达峰时间(tmax)差异很大。严重RI患者中莫硝唑的药时曲线下面积(AUC0-t)和药时曲线下面积至无穷大(AUC0-∞)均高出1.4倍,而M4-1则比健康组高出7倍以上。RI患者中莫硝唑原形经肾排泄减少了65%,M4-1减少了72%。两组中肌酐清除率(CLcr)与清除率(CL)、AUC、半衰期(t1/2)和肾清除率(CLr)之间均存在明显相关性。

结论

单次给予500mg莫硝唑耐受性良好。RI患者中莫硝唑和M4-1的药代动力学参数发生变化,可能具有临床重要性。

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