Effect of dose and exposure protocol on the toxicokinetics and first-pass elimination of trichloroethylene and 1,1,1-trichloroethane.

Trichloroethylene (TCE) and 1,1,1-trichloroethane (TRI) are frequent contaminants of drinking water and of groundwater at hazardous waste sites. There is relatively little information on the target organ deposition of TRI, despite its ingestion and common occurrence in humans. An important aim of the study was to delineate and contrast the toxicokinetics (TK) and bioavailability (F) of TRI and its well metabolized congener, TCE. Blood profiles were obtained from male Sprague-Dawley rats given aqueous emulsions of 6 or 48 mg TRI/kg and 10 or 50 mg TCE/kg as an oral bolus (po) or by gastric infusion (gi) over 2 h. TCE exhibited nonlinear TK, with a disproportionate increase in AUC and decrease in clearance and F with increase in dose. TRI exhibited linear TK. F did not vary significantly with TRI dose or dosage regimen. F values were substantially higher for TRI than for the respective TCE groups. TRI was distributed widely to tissues of rats gavaged with 6 mg TRI/kg, with accumulation in fat. This experiment yielded tissue uptake and elimination profiles and in vivo tissue:blood partition coefficients (PCs). Finally, additional rats were given 10 mg/kg of TCE and TRI po, ia and iv, so that first-pass hepatic (FPh) and pulmonary (FPp) elimination could be measured directly. Total and FPh elimination of TCE exceeded that of TRI. TRI, with its higher air:blood PC, exhibited the higher FPp. TCE and TRI, despite several common physical and chemical properties resulting in similar absorption and systemic distribution, displayed dissimilar dosage and dose rate effects on their TK.

Bioequivalence and food effect of heat-stressed and non-heat-stressed dapagliflozin 2.5- and 10-mg tablets.

Physical storage of formulations may result in physical composition changes that affect pharmacokinetics. Dapagliflozin, an oral sodium-glucose cotransporter 2 inhibitor used for type 2 diabetes mellitus, stored under prolonged exposure to heat converts crystalline dapagliflozin to an amorphous form. Bioequivalence of the amorphous to crystalline form and food effects of each form in the 2.5-mg formulation are unknown. Two open-label, crossover, single-dose studies in healthy participants assessed pharmacokinetics for heat-stressed (HS) and non-heat-stressed (NH) dapagliflozin 10-mg (study 1, N=29, fasted+HS food effect) and 2.5-mg (study 2, N=28, fasted+HS and NH food effect) tablets. The 90% confidence intervals for geometric mean ratios of area under the concentration-time curve (AUC) and peak concentration (Cmax) for HS 2.5- and 10-mg tablets were within 80-125%, indicating bioequivalence. In the fed vs. fasted state for 2.5-mg and 10-mg HS tablets, AUCs were similar, time to Cmax was prolonged by 1.25h, and Cmax decreased by approximately 50%. No serious adverse events were reported. Given that dapagliflozin's efficacy is dependent upon AUC, it was concluded that HS and NH dapagliflozin tablets are bioequivalent in 2.5- and 10-mg doses with no clinically meaningful food effect for either form.

Pharmacokinetics of nalbuphine hydrochloride extended release tablets in hemodialysis patients with exploratory effect on pruritus.

BACKGROUND: Uremic pruritus is a common and deleterious condition among hemodialysis (HD) patients. Central gating of µ/κ opiate circuitry plays an important role in mediating and countering pruritogenic sensation. The objective of this study was to assess the safety and pharmacokinetics (PK) of the mixed µ-antagonist/κ-agonist nalbuphine, administered orally as nalbuphine HCl extended release (ER) tablets in HD patients, and explore its effect on pruritus. METHODS: In this open-label multiple escalating dose study, 15 HD patients with pruritus and 9 matched healthy subjects were enrolled. Nalbuphine HCl ER dose was escalated from 30 mg QD to 240 mg BID over 15 days. A full PK profile was obtained under dialysis and non-dialysis conditions as a function of dose. Clearance during dialysis was determined by sampling dialysate and arterial/venous blood during dialysis. Pruritus severity was assessed twice daily using a Visual Analog Scale (VAS). Safety monitoring included extensive monitoring of EKG, blood pressure, and pulse oximetry. RESULTS: In HD patients, nalbuphine concentration peaked within 4-9 hours and attained steady state within 2-3 days, with no significant accumulation. Mean half-life was 14.2 hours, mean Cmax and AUCtau ranged between 13 and 83 ng/mL and 118 and 761 ng∙h/mL, respectively, with exposure increasing in a nearly dose-proportional fashion. Exposure in HD patients was about 2-fold higher than in healthy subjects. There was no meaningful difference between exposure on dialysis and non-dialysis days with 1% or less of the dose removed by dialysis. Nalbuphine suppressed itch in a dose-dependent manner, reducing mean VAS score from 4.0 to 1.2 at 180 mg and 0.4 at 240 mg. CONCLUSIONS: Nalbuphine HCl ER tablets can be safely administered to HD patients without dose adjustment up to 240 mg BID and may hold promise in treating uremic pruritus.