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Prolongation of ifosfamide elimination half-life in obese patients due to altered drug distribution

  • Ifosfamide, Drug Distribution. Pharmacokinetics, Bronchial Carcinoma
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Summary

The pharmacokinetics of intravenous ifosfamide were determined in 16 patients with carcinoma of the bronchus. In all 25% (4) of these patients were obese (i.e. >20% over their ideal body weight). The terminal elimination half-life (t1/2 β) was found to be higher in the obese group than in the control group (6.36 h, range 5.77–7.45 h) vs 4.95 h, range 1.82–6.48 h( (P< 0.05). This prolongation of the elimination half-life was due to an increased volume of distribution (Vdβ) in the obese group (42.81 l, range 35.49–51.90 l) vs 33.70 l range (17.76–50.62 l) (P<0.05). There was therefore no significant difference in total plasma clearance between the obese and normal groups. No correlation of ifosfamide plasma half-life was observed with total body weight (TBW) or ideal body weight (IBW). However, a significant positive correlation was observed between the percentage of IBW and plasma half-life. A strong positive correlation was observed between IBW and the plasma clearance of ifosfamide. The Vdβ correlated with both TBW and the percentage of IBW, but not with IBW itself. When Vdβ was normalised for IBW, there was a strong positive correlation with the percentage of IBW, suggesting that ifosfamide distribution into the TBW is higher than that into the IBW.

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References

  1. Abernethy DR, Greenblatt DJ (1982) Pharmacokinetics of drugs in obesity. Clin Pharmacokinet 7: 108–124

    Google Scholar 

  2. Abernethy DR, Greenblatt DJ (1985) Ibuprofen disposition in obese individuals. Arthritis Rheum 28: 1117–1121

    Google Scholar 

  3. Abernethy DR, Greenblatt DJ, (1986) Drug disposition in obese humans, an update. Clin Pharmacokinet 11: 199–213

    Google Scholar 

  4. Abernethy DR, Greenblatt DJ, Divoll M, Harmatz JS, Shader RI (1981) Alterations in drug distribution and clearance due to obesity. J Pharm Exp Ther 217: 681–685

    Google Scholar 

  5. Abernethy DR, Greenblatt DJ, Divoll M, Shader RI (1983) Enhanced glucuronide conjugation of drugs in obesity; studies of lorazepam, oxazepam and acetaminophen. J Lab Clin Med 101: 873–880

    Google Scholar 

  6. Abernethy DR, Todd EL, Schwartz JB (1985) Caffeine disposition in obesity. Br J Clin Pharmacol 20: 61–66

    Google Scholar 

  7. Bauer LA, Wareing-Tran MS, Drew Edwards WA, Raisys V, Jack R, Dellinger P, Simonowitz D (1985) Cimetidine clearance in the obese. Clin Pharmacol Ther 37: 426–430

    Google Scholar 

  8. Benedek IH, Fiske WD, Griffen WO, Bell RM, Blouin RA, McNamara PJ (1983) Serum alpha-1-acid glycoprotein and the binding of drugs in obesity. Br J Clin Pharmacol 16: 751–754

    Google Scholar 

  9. Brade WP, Herdrich K, Varini M (1985) Ifosfamide — pharmacology, safety and therapeutic potential. Cancer Treat Rev 12: 1–47

    Google Scholar 

  10. Brade W, Seeber S, Herdrich K (1986) Comparative activity of cyclophosphamide and ifosfamide. Cancer Chemother Pharmacol 18 [Suppl 2]: 1–9

    Google Scholar 

  11. Brock N (1983) The oxazaphosphorines. Cancer Treat Rev 10 [Suppl A]: 3–15

    Google Scholar 

  12. Brock N, Hohrst H-J (1963) Über die Aktivierung von Cyclophosphamid in vivo und in vitro. Arzneim Forsch 13: 1021–1031

    Google Scholar 

  13. Bryant BM, Jarman M, Ford HT, Smith IE (1980) Prevention of isophosphamide-induced urothelial toxicity with 2-mercaptoethane sulphonate sodium (mesnum) in patients with advanced carcinoma. Lancet II: 657–659

    Google Scholar 

  14. Connors TA, Cox PJ, Farmer PB, Foster AB, Jarman M (1974) Some studies of the active intermediates formed in the microsomal metabolism of cyclophosphamide and isophosphamide. Biochem Pharmacol 23: 115–129

    Google Scholar 

  15. Costanzi JJ, Gagliano R, Loukas D, Panettiere FJ, Hokanson JA (1978) Ifosfamide in the treatment of recurrent or disseminated lung cancer. A phase II study of two dose schedules. Cancer 41: 1715–1719

    Google Scholar 

  16. Dunkelman SS, Fairhurst B, Plager J (1964) Cortisol metabolism in obesity. J Clin Endocrinol Metab 24: 832–841

    Google Scholar 

  17. Gal P, Jusko WJ, Yurchak AM, Franklin BA (1978) Theophylline disposition in obesity. Clin Pharmacol Ther 23: 438–444

    Google Scholar 

  18. Lind MJ, Margison JM, Cerny T, Thatcher N, Wilkinson PM (1989) Comparative pharmacokinetics and alkylating activity of fractionated oral and intravenous ifosfamide in patients with bronchogenic carcinoma. Cancer Res 49: 753–757

    Google Scholar 

  19. Margison JM, Cerny T, Thatcher N, Wilkinson PM (1986) A simple quantitative HPLC assay for ifosfamide in biological fluids. Biomed Chromatogr 1(3): 101–103

    Google Scholar 

  20. McIntosh JEA, McIntosh RP (1980) Mathematical modeling and computing in endocrinology. Springer, Berlin Heidelberg New York

    Google Scholar 

  21. Milsap RL, Plaisance KI, Jusko WJ (1984) Prednisolone disposition in obese men. Clin Pharmacol Ther 36: 824–831

    Google Scholar 

  22. Powis G (1983) Effects of disease states on pharmacokinetics of anticancer drugs. In: Ames MM, Powis G, Kovach JS (eds) Pharmacokinetics of anticancer agents in humans. Elsevier, Amsterdam, p 63

    Google Scholar 

  23. Powis G, Reece P, Ahmann DL, Ingle JN (1987) Effect of body weight on the pharmacokinetics of cyclophosphamide in breast cancer patients. Cancer Chemother Pharmacol 20: 219–222

    Google Scholar 

  24. Rodvold KA, Rushing DA, Tewksbury DA (1988) Doxorubicin clearance in the obese. J Clin Oncol 6: 1321–1327

    Google Scholar 

  25. Rohrbaugh TM, Danish M, Ragni MC, Yaffe (1982) The effect of obesity on the apparent volume of distribution of theophylline. Pediatr Pharmacol 2: 75–83

    Google Scholar 

  26. Sketris I, Lesar T, Zaske DE, Cipolle RJ (1981) Effect of obesity on gentamicin pharmacokinetics. J Clin Pharmacol 21: 288–293

    Google Scholar 

  27. Silverstone JT, Gordon RP, Stunkard AJ (1969) Social factors in obesity in London. Practitioner 202: 682

    Google Scholar 

  28. Teufel G, Pfleiderer A (1986) Ifosfamid im Vergleich zu Endoxan bei fortgeschrittenen Ovarialkarzinomen. Geburtshilfe Frauenheilkd 36: 274

    Google Scholar 

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Lind, M.J., Margison, J.M., Cerny, T. et al. Prolongation of ifosfamide elimination half-life in obese patients due to altered drug distribution. Cancer Chemother. Pharmacol. 25, 139–142 (1989). https://doi.org/10.1007/BF00692355

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  • DOI: https://doi.org/10.1007/BF00692355

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