Johnson B F, Fowle A S, Lader S, Fox J, Munro-Faure A D
Br Med J. 1973 Nov 10;4(5888):323-6. doi: 10.1136/bmj.4.5888.323.
Though established quality control standards were maintained, the bioavailability of digoxin from Lanoxin tablets produced in the United Kingdom fell in 1969, and was restored in 1972. After 1.5 mg doses of representative batches, tablets made between 1969 and 1972 produced mean values for area under the 50 hours plasma concentration/time curve of 36.6 ng/ml/hr and four-day urinary excretion of 340 mug, compared with respective values of 67.5 ng/ml/hr and 696 mug for recently produced tablets.After 0.5 mg doses of four recent independently produced batches of Lanoxin tablets no significant between-batch difference was found for area under the plasma concentration/time curve or cumulative urinary excretion.Absorption of digoxin from batches of Lanoxin manufactured since May 1972 is uniform and consistent. Content uniformity is an inadequate measure of tablet quality, and consistent digoxin bioavailability cannot be ensured by existing regulations.
尽管维持了既定的质量控制标准,但1969年英国生产的地高辛片剂(商品名:Lanoxin)的生物利用度下降,并于1972年恢复。服用1.5毫克代表性批次的片剂后,1969年至1972年生产的片剂在50小时血浆浓度/时间曲线下的面积平均值为36.6纳克/毫升/小时,四天尿排泄量为340微克,而近期生产的片剂相应值分别为67.5纳克/毫升/小时和696微克。服用0.5毫克近期独立生产的四批次Lanoxin片剂后,血浆浓度/时间曲线下面积或累积尿排泄量在批次间未发现显著差异。自1972年5月以来生产的批次的地高辛片剂吸收均匀一致。含量均匀度不足以衡量片剂质量,现有法规无法确保地高辛生物利用度的一致性。