Your browser doesn't support javascript.
loading
Population Pharmacokinetics of Clozapine and Norclozapine and Switchability Assessment between Brands in Uruguayan Patients with Schizophrenia.
Olmos, Ismael; Ibarra, Manuel; Vázquez, Marta; Maldonado, Cecilia; Fagiolino, Pietro; Giachetto, Gustavo.
Afiliação
  • Olmos I; Pharmacy Department, Vilardebó Hospital, Avenida Millán 2515, 11800 Montevideo, Uruguay.
  • Ibarra M; Pharmaceutical Sciences Department, Faculty of Chemistry, Universidad de la República, Avenida General Flores 2124, P. O. Box 1157, 11800 Montevideo, Uruguay.
  • Vázquez M; Pharmaceutical Sciences Department, Faculty of Chemistry, Universidad de la República, Avenida General Flores 2124, P. O. Box 1157, 11800 Montevideo, Uruguay.
  • Maldonado C; Pharmaceutical Sciences Department, Faculty of Chemistry, Universidad de la República, Avenida General Flores 2124, P. O. Box 1157, 11800 Montevideo, Uruguay.
  • Fagiolino P; Pharmaceutical Sciences Department, Faculty of Chemistry, Universidad de la República, Avenida General Flores 2124, P. O. Box 1157, 11800 Montevideo, Uruguay.
  • Giachetto G; C Pediatrics Clinics, Pereira Rossell Hospital, Bulevar Gral. Artigas 1550, 11600 Montevideo, Faculty of Medicine, Universidad de la República, Uruguay.
Biomed Res Int ; 2019: 3163502, 2019.
Article em En | MEDLINE | ID: mdl-30956977
Clozapine (CZP) is an atypical antipsychotic agent commonly used in the treatment of schizophrenia. It is metabolized primarily by CYP1A2 enzyme, yielding a pharmacologically active metabolite, norclozapine (NCZP). Significant intra- and interindividual pharmacokinetic (PK) variability for CZP and NCZP has been observed in routine therapeutic drug monitoring. So the goal of this study was to evaluate the magnitude and variability of concentration exposure to CZP and its active metabolite NCZP on pharmacokinetic parameters in Uruguayan patients with schizophrenia with a focus on covariates such as cigarette smoking, age, sex, caffeine consumption, brands available of CZP, and comedication using population PK (PPK) modeling methodologies. Patients with a diagnosis of schizophrenia treated with brand-name CZP (Leponex®) for more than a year were included in the study. Then these patients were switched to the similar brand of CZP (Luverina®). Morning predose blood samples for determination of CZP and NCZP using a HPLC system equipped with a UV detector were withdrawn on both occasions at steady state and under the same comedication. Ninety-eight patients, 22 women and 76 men, took part in the study. Mean ± standard deviation for CZP and NCZP concentration was 421 ± 262 ng/mL and 275 ± 180 ng/mL, respectively. After covariate evaluation, only smoking status remained significant in CZP apparent clearance, inducing a mean increment of 32% but with no clinical impact. The results obtained with the two brands of CZP should ensure comparable efficacy and tolerability with the clinical use of either product. Smoking was significantly associated with a lower exposure to CZP due to higher clearance. The results obtained with the two brands commercialized in our country hint a bioequivalence scenario in the clinical setting.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esquizofrenia / Clozapina / Modelos Biológicos Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Uruguay Idioma: En Revista: Biomed Res Int Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Uruguai País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Esquizofrenia / Clozapina / Modelos Biológicos Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Uruguay Idioma: En Revista: Biomed Res Int Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Uruguai País de publicação: Estados Unidos