Prediction of the pharmacokinetic parameters of reduced-dolasetron in man using in vitro-in vivo and interspecies allometric scaling.

1. Dolasetron (Anzemet) is a potent and selective 5-HT3 receptor antagonist which is rapidly and extensively reduced to yield its major pharmacologically active metabolite, reduced dolasetron (RD). RD is further metabolized by CYP450 enzymes as well as undergoing renal excretion. As both in vitro and in vivo data on RD were available from animals and man, two approaches to predict the human pharmacokinetic parameters of RD were assessed. 2. First, in vitro studies, using liver microsomes from animal species and man, were undertaken to measure Vmax and K(m) and to assess the intrinsic clearance (CLint). With appropriate liver weight and liver blood flow scaling factors the predicted in vivo metabolic clearance (CLm-pred) was calculated. Human CLm-pred was underestimated by a factor of 5 when it was calculated using the above scaling factors. As, in a prospective study, the observed human in vivo metabolic clearance (CLm-obs) is unknown, CLm-pred was substituted into the least-squares correlation equation obtained from a plot of CLm-pred against CLm-obs' using animal data. The estimate of human CLm-obs was improved as it was only underestimated by a factor of 1.5. 3. Second, allometric scaling of in vivo animal pharmacokinetic data, using body weight, was performed to predict pharmacokinetic parameters in man. Good predictions of human pharmacokinetic parameters of RD were obtained for plasma clearance (1.7 l/min predicted versus 1.61/min observed), half-life (6.0 h predicted versus 5.6 h observed), and volume of distribution (860.91 predicted versus 770.41 observed). 4. The integration of in vitro metabolic data from microsomes gave similar results to conventional allometric scaling, whereas the normalization of clearance by brain weight resulted in an approximately three-fold underestimation of human clearance. 5. For RD, a drug that is eliminated by both renal and metabolic clearance, retrospective conventional allometric scaling allowed accurate prediction of pharmacokinetic parameters in man, whereas in vitro-in vivo scaling resulted in an underestimation of in vivo CLm. Although these results are somewhat at variance, ideally both scaling methods should be applied to improve the prediction of human pharmacokinetic parameters.