John B, Wood S G, Ramis J, Izquierdo I, Forn J
Huntingdon Life Sciences, Department of Drug Metabolism, Cambridgeshire, England.
Arzneimittelforschung. 1998 May;48(5):512-7.
In order to improve the effectiveness of treatment of vaginal yeast infections, flutrimazole, (CAS 119006-77-8), a broad spectrum local imidazolic fungicide, has been formulated in an advanced delivery system (Site Release, here in after briefly referred to as SR) designed to improve vaginal retention of the drug. To determine the extent of absorption of 14C-flutrimazole from this formulation, the absorption and excretion of total radioactivity have been studied in healthy postmenopausal female volunteers after intravaginal administration of approximately 5 g of SR Vaginal Cream containing 2% 14C-flutrimazole. Concentrations of unchanged flutrimazole have also been measured in plasma and urine, using a validated gas chromatography-mass spectrometry method. The rate of absorption was slow, with a mean peak plasma radioactivity concentration, Cmax, of 56 ng equivalents/ml, achieved at a mean Tmax of 28 h. Corresponding parameters for flutrimazole were 1.94 ng/ml at 24 h. At 24 h post-dose, unchanged flutrimazole represented only 3% of plasma total radioactivity which indicates that flutrimazole is extensively metabolised in man. Total radioactivity and unchanged flutrimazole were eliminated from plasma with terminal half-lives of 37 and 22 h, respectively. From the proportion of the radioactive dose excreted in urine and faeces, the maximal extent of absorption indicated for the intravaginal dose was about 8%, which is similar to that observed with other imidazolic compounds administered by this route. Thus, the formulation achieves the aim of prolonged drug action through the maintenance of therapeutic concentrations of the drug at the site of infection without notably increased absorption.
为提高阴道酵母菌感染的治疗效果,氟曲马唑(CAS 119006-77-8),一种广谱局部咪唑类杀菌剂,已被制成一种先进的给药系统(位点释放,以下简称SR),旨在提高药物在阴道内的保留时间。为了确定该制剂中14C-氟曲马唑的吸收程度,在健康绝经后女性志愿者阴道内给予约5 g含2% 14C-氟曲马唑的SR阴道乳膏后,研究了总放射性的吸收和排泄情况。还使用经过验证的气相色谱-质谱法测定了血浆和尿液中未变化的氟曲马唑浓度。吸收速率缓慢,平均血浆放射性浓度峰值Cmax为56 ng当量/ml,在平均达峰时间28小时时达到。氟曲马唑的相应参数在24小时时为1.94 ng/ml。给药后24小时,未变化的氟曲马唑仅占血浆总放射性的3%,这表明氟曲马唑在人体内被广泛代谢。总放射性和未变化的氟曲马唑从血浆中消除的终末半衰期分别为37小时和22小时。根据尿液和粪便中排泄的放射性剂量比例,阴道给药剂量的最大吸收程度约为8%,这与通过该途径给药的其他咪唑类化合物所观察到的情况相似。因此,该制剂通过在感染部位维持药物治疗浓度实现了延长药物作用的目的,而吸收并未显著增加。