Pharmacokinetic interactions of moricizine and diltiazem in healthy volunteers.

Sixteen healthy male volunteers completed a nonrandomized, sequential, three-phase study. The three phases were 1) moricizine at 250 mg every 8 hours for 7 days with 12 days washout; 2) diltiazem at 60 mg every 8 hours for 7 days; and 3) concomitant administration of moricizine at 250 mg and diltiazem at 60 mg every 8 hours for 7 days. The plasma concentration-time profiles were obtained at the end of each phase for moricizine, diltiazem (with its metabolites desacetyl-diltiazem and N-desmethyl-diltiazem), and both when administered together. Under steady-state conditions, there was a two-way (opposing) pharmacokinetic drug interaction when moricizine and diltiazem were coadministered in healthy volunteers. Both maximum plasma concentration (Cmax) and the area under the plasma concentration-time curve from time 0 to the end of administration (AUC tau) of moricizine increased significantly by 88.9% and 121.1%, respectively. Oral clearance (Clo) decreased by 54%. The terminal half-life (t1/2) of moricizine was not affected, however (2.1 +/- 0.5 hours versus 2.4 +/- 0.7 hours). It is believed that these changes were due to the inhibition of hepatic metabolism by diltiazem, which resulted in an increased systemic availability of moricizine. Moricizine had opposite effects on the pharmacokinetics of diltiazem. Moricizine decreased the Cmax of diltiazem significantly (by 36%) and increased Clo by 52%. A small but statistically significant decrease in the t1/2 from 4.6 +/- 1.3 hours to 3.6 +/- 0.7 hours was observed. Despite this result, no remarkable changes (e.g., in Cmax, AUC, or t1/2) were found for the two major diltiazem metabolites desacetyl-diltiazem and N-desmethyl-diltiazem. It appears that the pharmacokinetic interaction of moricizine and diltiazem was metabolic. With the increase in moricizine concentrations and the decrease in diltiazem concentrations, adjustments in dose may be required to achieve optimal therapeutic response when coadministering both agents.

Relationship of chemical structure and solvent to in vivo scintigraphic distribution patterns of 11C compounds. II. 11C aminonitriles.

The preparation and scintigraphic evaluation of the distribution patterns in dogs of a series of structurally related aminonitriles labeled with 11C is described. Carbon-11-HCN was collected in water containing carrier NaCN following 22 MeV proton bombardment of 99% N2 and 1% H2 gas mixture for 1 hr. Ten 11C alphaN-alkylaminophenylacetonitrile hydrochlorides and 12 11C alpha-N-arylaminoarylacetonitriles were prepared from 11C-NaCN and the corresponding Schiff base, Ar-CH=N-R(Ar). Those 11C aminonitriles that were administered intravenously in aqueous solution showed some initial accumulation of activity in the liver followed by diffuse whole-body distribution and some small accumulation in urine. Aqueous insoluble 11C aminonitriles, which were administered intravenously in ethanol, ether, or DMSO, showed variable initial partial retention of activity in the lungs with prominent accumulation of activity in liver and excretion in bile. Several of these compounds showed pronounced and rapid accumulation of activity in the brain. Such activity in the brain was largely cleared within 15 min. Concentration of activity in the cerebrospinal fluid following clearance from the brain was 30 times greater than blood and equivalent in concentration to that noted in bile 18 min after intravenous administration of 11C alpha-anilinophenylacetonitrile in ethanol. These results suggest the possible correlation of regional brain uptake of activity of certain 11C aminonitriles with regional brain perfusion. Use of these or similar materials could permit assessment of brain tissue morphology followed by scintigraphic imaging of the bulk flow characteristics of cerebrospinal fluid.