Compatible stability of methylprednisolone sodium succinate and tropisetron in 0.9% sodium chloride injection.

Background: A combination of methylprednisolone sodium succinate and tropisetron hydrochloride is commonly used to treat the nausea and vomiting associated with antineoplastic therapy. The objective of this study was to investigate the stability of tropisetron hydrochloride and methylprednisolone sodium succinate in 0.9% sodium chloride injection for up to 48 hours. Methods: Commercial solutions of methylprednisolone sodium succinate and tropisetron hydrochloride were obtained and further diluted with 0.9% sodium chloride injection to final concentrations of either 0.4 or 0.8 mg/mL (methylprednisolone sodium succinate) and 0.05 mg/mL (tropisetron). The admixtures were assessed for periods of up to 48 hours after storage at 4°C with protection from light and at 25°C without protection from light. Physical compatibility was determined visually, and the chemical compatibility was measured with high-performance liquid chromatography (HPLC) and by measurement of pH values. Results: HPLC analysis demonstrated that methylprednisolone sodium succinate and tropisetron hydrochloride in the various solutions were maintained at 97% of the initial concentrations or higher during the testing period. There were no changes observed by physical precipitation or pH in any of the prepared solutions. Conclusions: Tropisetron hydrochloride injection and methylprednisolone sodium succinate injection in 0.9% sodium chloride injection are stable for up to 48 hours at 4°C and 25°C.

Simultaneous analysis of dextran-methylprednisolone succinate, methylprednisolone succinate, and methylprednisolone by size-exclusion chromatography.

An analytical HPLC method is reported for simultaneous measurement of low (1.0-100 microg ml(-1)) concentrations of dextran-methylprednisolone succinate (DEX-MPS) and its degradation products methylprednisolone hemisuccinate (MPS) and methylprednisolone (MP). The analytes were detected at 250 nm after resolution using a size exclusion column with a mobile phase of KH2PO4 (10 mM): acetonitrile (3:1) and a flow rate of 1 ml min(-1). The resolution of MP and MPS peaks was substantially affected by the pH of the mobile phase; while MP and MPS co-eluted at pH 3.4, they were baseline-resolved at pH > or = 5. Linear relationships (r > or = 0.997) were found between the detector response and the concentrations of the analytes (1.0-100 microg ml(-1) for MP and MPS and 2.5-100 microg ml(-1) for DEX-MPS). Intra- and inter-run error (< 13%) and precision (CV of < or = 6%) data indicated that the assay could accurately and precisely quantitate all three components in the examined concentration range. The application of the assay to determination of degree of substitution, purity, and stability of DEX-MPS was also demonstrated.

Pharmacokinetic and pharmacodynamic assessment of bioavailability for two prodrugs of methylprednisolone.

AIMS: The aim of this study was to establish whether pharmacokinetic differences between two pro-drugs of methylprednisolone (MP) are likely to be of clinical significance. METHODS: This study was a single-blind, randomized, crossover design comparing the bioequivalence of MP released from the pro-drugs Promedrol (MP suleptanate) and Solu-Medrol (MP succinate) after a single 250 mg (MP equivalent) intramuscular injection to 20 healthy male volunteers. Bioequivalence was assessed by conventional pharmacokinetic analysis, by measuring pharmacodynamic responses plus a novel approach using pharmacokinetic/pharmacodynamic modeling. The main measure of pharmacodynamic response was whole blood histamine (WBH), a measure of basophil numbers. RESULTS: The MP Cmax was less for MP suleptanate due to a longer absorption halflife of the prodrug from the intramuscular injection site. The bioavailability of MP was equivalent when based on AUC with a MP suleptanate median 108% of the MP succinate value (90% CI: 102-114%). For Cmax the MP suleptanate median was 81% of the MP succinate value (90% CI: 75-88%). The tmax for MP from MP suleptanate was delayed relative to MP succinate. The median difference was 200% (90% non-parametric CI: 141-283%). The area under the WBH effect-time curve (AUEC) and the maximum response (Emax) were found to be equivalent (90% CI: 98-113% and 93-109% respectively). The maximum changes in other white blood cell counts, blood glucose concentration and the parameters of the pharmacodynamic sigmoid Emax model (EC50, Emax and gamma) were also not significantly different between prodrugs. CONCLUSIONS: MP suleptanate is an acceptable pharmaceutical alternative to MP succinate. The use of both pharmacokinetic and pharmacodynamic response data together gives greater confidence in the conclusions compared with those based only on conventional pharmacokinetic bioequivalence analysis.

High-performance liquid chromatography separation and quantitation of methylprednisolone from rat brain.

A sensitive, reliable method for the extraction, separation, and quantitation of methylprednisolone from rat brain is reported. The method can accurately quantitate methylprednisolone levels between 9.8 and 2500 ng/injection using a two-step HPLC separation and monitoring absorbance at 254 nm. A 90% extraction recovery of methylprednisolone (interday variation of 9.0% and an intraday variation of 0.0 to 7.7%) from rat cortex was obtained with a double extraction method using low toxicity solvents. These solvents are known to quantitatively extract the neutral lipids and phospholipids from brain. Combined with the ability to separate the neutral lipid and methylprednisolone fractions for further separation, and the ability to separate all phospholipid classes in the first run, this method offers great utility combined with the reliable, high extraction recovery and sensitive quantitation of methylprednisolone.

Two chromatographic methods for the determination of corticosteroids in human biological fluids: pharmacokinetic applications.

Two techniques, high-performance liquid chromatography (HPLC) and quantitative high-performance thin-layer chromatography coupled with densitometry (HPTLC), were developed for the determination of prednisolone (PL), methylprednisolone (MP), and methylprednisolone sodium succinate (MPSS) in human plasma, saliva, and urine. The HPLC and HPTLC methods shared a single and simple step of an organic extraction procedure and separation of steroids using a normal-phase column or HPTLC plate. The methods allow simultaneous measurement of endogenous cortisol in plasma following the administration of PL and MP. The calibration curves of steroids in all biological fluids were linear over a wide range of concentrations of PL and MP in all biological fluids (0.025-4 micrograms/mL). The limit of detection of both assays for PL and MP was 10 ng/mL in plasma and saliva and 25 ng/mL in urine, and of MPSS was 50 ng/mL in plasma. Both methods were reproducible with an inter- and intra-assay coefficient of variation of less than 10% for all steroids over a wide range of concentrations in all biological fluids. No interference from endogenous steroids was found. The presented methods are simple, rapid, specific, sensitive, reproducible, and economical for the pharmacokinetic study of these steroids. The application of these methods for the pharmacokinetic study of both MP and PL in vivo and the in vitro hydrolysis of MPSS is discussed.

Determination of methylprednisolone in rat tissue by high-performance liquid chromatography.

Methylprednisolone was determined in various types of rat tissue following an intravenous injection of methylprednisolone sodium succinate. Two modes of tissue work-up were investigated: digestion with subtilisin Carlsberg, a proteolytic enzyme, and homogenization with methanol. The final determination was by reversed-phase high-performance liquid chromatography with dexamethasone as internal standard. The extraction yields of methylprednisolone and dexamethasone from tissue homogenate and the extraction yield of methylprednisolone after incubation with viable tissue were determined. The experiments show that methylprednisolone and the internal standard are extracted in similar yields from tissue homogenates and that methylprednisolone can be recovered in a good yield after incubation with viable tissue, provided that the tissue does not have a high metabolic activity. There was a good agreement between the analytical results from the two different types of tissue work-up. The method of analysis proved feasible for pharmacokinetic work.

Compatibility of aminophylline and methylprednisolone sodium succinate intravenous admixtures.

The stability of aminophylline and methylprednisolone sodium succinate in admixtures containing both drugs was studied. Admixtures containing aminophylline 1.0 mg/mL and methylprednisolone sodium succinate 2.0 and 0.5 mg/mL were prepared in both 5% dextrose injection and 0.9% sodium chloride injection. Each admixture was prepared in triplicate and samples were kept at room temperature in glass. Immediately after admixture and at one, two, and three hours, samples were visually inspected, tested for pH, filtered, and assayed in duplicate by high-performance liquid chromatography for theophylline concentration and for both methylprednisolone sodium succinate and methylprednisolone alcohol. Control solutions containing only one of the two drugs were also tested. No visual changes were observed. The admixtures had higher pH values after aminophylline was added, but pH of the samples did not change significantly. Aminophylline concentrations did not change significantly throughout the study period. In 0.9% sodium chloride admixtures with methylprednisolone sodium succinate 0.5 mg/mL, less than 90% of the initial methylprednisolone concentration remained at two hours at the 2.0 mg/mL initial concentration, less than 90% remained at three hours. However, methylprednisolone alcohol (a pharmacologically active form of methylprednisolone sodium succinate) was detected in increasing concentrations after the first hour. Aminophylline in a final concentration of 1.0 mg/mL or less can be mixed with methylprednisolone sodium succinate in a final concentration of 2.0 mg/mL or less in 5% dextrose injection or 0.9% sodium chloride injection and administered intravenously within three hours after mixing.

Carboxyl group catalysis of acyl transfer reactions in corticosteroid 17- and 21-monoesters.

Succinate esters, although frequently employed as water-soluble prodrugs of poorly soluble parent drugs, are not sufficiently stable to allow long-term storage in solution. Intramolecular catalysis of ester hydrolysis by the terminal succinate carboxyl group is a contributing factor to this instability. Methylprednisolone 21-succinate has recently been reported to undergo both hydrolysis and 21 in equilibrium 17 acyl migration in aqueous solutions. Intramolecular catalysis by the terminal carboxyl group is seen in both reactions, but the catalytic mechanisms are not well understood. While acyl migration can only be catalyzed via the carboxyl group acting as a general acid or general base, hydrolysis may undergo either nucleophilic or general acid-base catalysis. To gain further insight into the catalytic mechanism, hydrolysis of methylprednisolone 21-succinate was carried out in aniline buffers to trap any succinic anhydride (as the anilide) that would form if the catalysis were nucleophilic. The nucleophilic mechanism was shown to account for only 15-20% of the overall catalysis. Comparisons of the rates of the intramolecularly catalyzed reactions of methylprednisolone 21- and 17-succinate were made with the same reactions of methylprednisolone 21- and 17-acetate catalyzed intermolecularly by acetate ion. Interestingly, intramolecular catalysis appears to favor acyl migration over hydrolysis. Hence, the hydrolysis of methylprednisolone 21-succinate is faster in basic solutions (pH greater than 7.4), while acyl migration becomes the dominant reaction in the catalyzed region of the pH profile between pH 3.6 and 7.4. Arguments are presented to account for these differences in catalytic efficiency in terms of the transition-state structures for the two reactions.

Analysis of cortisol, methylprednisolone, and methylprednisolone hemisuccinate. Absence of effects of troleandomycin on ester hydrolysis.

A sensitive, selective, and reproducible high-performance liquid chromatographic assay for the simultaneous measurement of cortisol and methylprednisolone using dexamethasone as the internal standard is presented. Samples are extracted with methylene chloride, washed with sodium hydroxide and then water, and chromatographed on a microparticle silica gel column with ultraviolet detection at 254 nm. Sensitivity is greater than 10 ng/ml and the intra-day coefficient of variation is less than 5% for both steroids. The use of porcine liver esterase allows the quantitation of the hemisuccinate ester of methylprednisolone. This assay has been applied in pharmacokinetic studies including investigations of troleandomycin--methylprednisolone interactions. A typical plasma concentration--time profile for methylprednisolone and its ester prodrug is presented for one subject before and after receiving troleandomycin therapy. Although methylprednisolone elimination is reduced in the presence of troleandomycin therapy, there is no effect on the pharmacokinetics of methylprednisolone sodium succinate.

Stability of methylprednisolone sodium succinate in small volumes of 5% dextrose and 0.9% sodium chloride injections.

The stability of methylprednisolone sodium succinate in small volumes of 5% dextrose and 0.9% sodium chloride injections was studied. Vials of methylprednisolone sodium succinate (125-3000 mg) were reconstituted and added to 50- and 100-ml volumes of the two diluents. These piggyback solutions were visually inspected for the development of haze over a 24-hour period. A nephelometer was used to quantitate the development of turbidity with time. The effect of pH on haze formation was investigated, and infrared spectroscopy was used to identify the haze. Nephelometer readings were found to correlate well with visual inspections. The haze was identified as being formed by the precipitation of free methylprednisolone. The rate of change of turbidity was directly related to the pH. A 1.4-3.2 percentage-point increase in the free methylprednisolone concentration secondary to hydrolysis over the 24-hour period was noted. The duration of stability was variable among the investigated lots and concentrations. Nineteen of the 24 admixtures stored at room temperature remained stable and free of visible haze for at least 12 hours after preparation. For all dosage strengths of methylprednisolone sodium succinate studied, these data indicate that solutions can be made stable for at least 12 hours by selecting the appropriate volume of diluent.