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1996-01-30
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Document 0029
DOCN M9610029
TI Clinical pharmacokinetics of cidofovir in human immunodeficiency
virus-infected patients.
DT 9601
AU Cundy KC; Petty BG; Flaherty J; Fisher PE; Polis MA; Wachsman M; Lietman
PS; Lalezari JP; Hitchcock MJ; Jaffe HS; Gilead Sciences, Inc., Foster
City, California 94404, USA.
SO Antimicrob Agents Chemother. 1995 Jun;39(6):1247-52. Unique Identifier :
AIDSLINE MED/96012180
AB The pharmacokinetics of cidofovir (HPMPC;
(S)-1-[3-hydroxy-2-(phosphonylmethoxy)propyl]cytosine) were examined at
five dose levels in three phase I/II studies in a total of 42 human
immunodeficiency virus-infected patients (with or without asymptomatic
cytomegalovirus infection). Levels of cidofovir in serum following
intravenous infusion were dose proportional over the dose range of 1.0
to 10.0 mg/kg of body weight and declined biexponentially with an
overall mean +/- standard deviation terminal half-life of 2.6 +/- 1.2 h
(n = 25). Approximately 90% of the intravenous dose was recovered
unchanged in the urine in 24 h. The overall mean +/- standard deviation
total clearance of the drug from serum (148 +/- 25 ml/h/kg; n = 25)
approximated renal clearance (129 +/- 42 ml/h/kg; n = 25), which was
significantly higher (P < 0.001) than the baseline creatinine clearance
in the same patients (83 +/- 21 ml/h/kg; n = 12). These data indicate
that active tubular secretion played a significant role in the clearance
of cidofovir. The steady-state volume of distribution of cidofovir was
approximately 500 ml/kg, suggesting that the drug was distributed in
total body water. Repeated dosing with cidofovir at 3.0 and 10.0
mg/kg/week did not alter the pharmacokinetics of the drug. Concomitant
administration of intravenous cidofovir and oral probenecid to hydrated
patients had no significant effect on the pharmacokinetics of cidofovir
at a 3.0-mg/kg dose. At higher cidofovir doses, probenecid appeared to
block tubular secretion of cidofovir and reduce its renal clearance to a
level approaching glomerular filtration.
DE Adult Antiviral Agents/ADMINISTRATION & DOSAGE/ANALYSIS/
*PHARMACOKINETICS AIDS-Related Opportunistic
Infections/COMPLICATIONS/DRUG THERAPY/ METABOLISM Cytomegalovirus
Infections/COMPLICATIONS/DRUG THERAPY/METABOLISM Cytosine/*ANALOGS &
DERIVATIVES/ADMINISTRATION & DOSAGE/ANALYSIS/ PHARMACOKINETICS
Dose-Response Relationship, Drug Drug Therapy, Combination Female
Human HIV Infections/COMPLICATIONS/DRUG THERAPY/*METABOLISM
*Immunocompromised Host Kidney/METABOLISM Kidney Function Tests Male
Metabolic Clearance Rate Middle Age Organophosphorus
Compounds/ADMINISTRATION & DOSAGE/ANALYSIS/ *PHARMACOKINETICS
Probenecid/ADMINISTRATION & DOSAGE/PHARMACOLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).