药物动力学的维拉佐酮轻度或中度患者的肾功能损害。

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Boinpally R, Alcorn H,亚当斯MH, Longstreth J,爱德华J

药物动力学的维拉佐酮轻度或中度患者的肾功能损害。

中国药物Investig。2013年3月,33 (3):199 - 206。doi: 10.1007 / s40261 - 013 - 0061 - 5。

PubMed ID
23417352 (在PubMed
]
文摘

背景和目的:在肾功能受损的患者,药物的药物代谢动力学情况可能会发生改变,导致肾排泄或降低新陈代谢,和改变吸收,血浆蛋白质绑定或分布。维拉佐酮是一种选择性血清素再摄取抑制剂和5-HT1A受体部分激动剂治疗重度抑郁症的批准。维拉佐酮广泛hepatically代谢以最小的肾排泄。本研究的主要目的是评估一个20毫克剂量的药物动力学学科维拉佐酮的轻度或中度肾功能损害。方法:这是一个第一阶段,非盲、单剂维拉佐酮的研究主题与肾功能损害和在健康受试者评估维拉佐酮的药物动力学肾功能损害的存在。32受试者登记:8名被轻微(估计肾小球滤过率(est肾小球滤过率(GFR) > 50 - 80毫升/分钟)肾功能损害匹配分别按年龄,性别和身体质量指数8对照组与正常肾功能(肾小球滤过率(GFR)美国东部时间> 80毫升/分钟),和八个科目与温和(肾小球滤过率(GFR)美国东部时间> / = 30 - 50 mL / min)肾功能损害与八个对照组与正常的肾功能。受试者接受一个20毫克剂量的维拉佐酮药物动力学、安全与血浆蛋白结合评估为14天。药代动力学参数计算是最大血浆浓度(Cmax),最大血浆浓度,血浆浓度时间曲线下面积(AUC)从0到24小时,AUC的0到最后可测量的浓度,AUC的0到无穷大估计线性梯形法则和推断,口服间隙,终端消除速率常数,消除半衰期(t(1/2))免费的分数在等离子体中,明显的免费药物清除率,尿液中的维拉佐酮恢复0 - 96 h后药物管理局,剂量率恢复药物管理局后96小时尿,肾清除率和体积的分布。安全评估不良事件,临床实验室测试结果,12导心电图和生命体征。结果:维拉佐酮药代动力学参数在肾功能受损的被试变量而不是大大不同于健康对照组。 Mean values for vilazodone Cmax and AUC were similar among groups. Mean t(1/2) (35.7 and 34.8 h mild and moderate vs. 37.0 and 34.8 h matched controls), total drug clearance (19.9 and 25.1 L/h vs. 26.4 and 26.9 L/h), and mean vilazodone recovery in urine (1.21 % and 0.58 % vs. 0.95 % and 0.81 %) were similar for mild and moderate renally impaired subjects and matched controls with normal renal function. There were no apparent systematic trends in vilazodone pharmacokinetic parameters associated with decreasing renal function. Protein binding was variable (coefficient of variation, 29-65 %) but not substantially different among the three groups, and total drug clearance was not affected. Safety and tolerability of vilazodone were comparable in all groups of subjects. CONCLUSION: This study suggests that systemic exposure of vilazodone is not affected by mild or moderate renal impairment. No dose adjustments are recommended in patients with mild or moderate renal impairment.

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