Skip to main content
Log in

The pharmacokinetics and pharmacodynamics of lignocaine and MEGX in healthy subjects

  • Published:
Journal of Pharmacokinetics and Biopharmaceutics Aims and scope Submit manuscript

Abstract

Lignocaine clearance declines during continuous intravenous infustion in man and in vitrostudies suggest that this may partly be due to inhibition by MEGX, a metabolite of lignocaine, MEGX is pharmacologically active in animals, but this is not yet proven in man. This study examined the pharmacokinetics and pharmacodynamics of lignocaine and MEGX in eight healthy male volunteers given lignocaine HCl 120mg, MEGX HCl 120 mg, lignocaine HCl 120 mg+MEGX HCl 120 mg, and placebo, administered according to a randomized double-blind protocol. One-, two-, or three-compartment models were fitted to drug and metabolite blood concentration-time profiles and clearance, volume (V ss ), andhalf-life values were calculated and compared by paired t-test. Systolic time intervals and QTinterval were recorded and compared by repeated measures ANOVA. When administered in combination with MEGX, lignocaine clearance was significantly reduced from 58±18 to 48±13 L hr(su−1) (p <0.02). The V(inss) was unchanged and there was a trend toward an increase in terminal half-life. Lignocaine, MEGX, and the combination significantly reduced QTinterval up to 30 min after injection and this was maintained to 2 hr with the lignocaine and the combination. Transient side effects were experienced with all active treatments, but were most pronounced with the combination. Thus, lignocaine clearance was inhibited by MEGX, which was pharmacologically active in man.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. J. LeLorier, D. Grenon, Y. Latour, G. Caille, G. Dumont, A. Brosseau, and A. Solignac. Pharmacokinetics of lidocaine after prolonged intravenous infusions in uncomplicated myocardial infarction.Ann. Intern. Med. 87:700–702 (1977).

    Article  CAS  PubMed  Google Scholar 

  2. L. F. Prescott, K. K. Adjepon-Yamoah, and R. G. Talbot. Impaired lignocaine metabolism in patients with myocardial infarction and cardiac failure.Br. Med. J. 1:939–941 (1976).

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. L. A. Bauer, T. Brown, M. Gibaldi, L. Hudson, S. Nelson, V. Raisys, and J. P. Shea. Influence of longterm infusions on lidocaine pharmacokinetics.Clin. Pharmacol. Ther. 31:433–437 (1982).

    Article  CAS  PubMed  Google Scholar 

  4. S. E. Joel, S. M. Bryson, M. Small, W. S. Hillis, A. W. Kelman, and B. Whiting. Kinetic predictive techniques applied to lignocaine therapeutic drug monitoring.Ther. Drug Monit. 5:271–277 (1983).

    Article  CAS  PubMed  Google Scholar 

  5. A. Barchowsky, W. W. Stargel, D. G. Shand, and P. A. Routledge. On the role of alpha-1-acid glycoprotein in lignocaine accummulation following myocardial infarction.Br. J. Clin. Pharmacol. 13:411–415 (1982).

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. J. LeLorier, R. Moison, J. Gagne, and G. Caille. Effect of the duration of infusion on the disposition of lidocaine in dogs.J. Pharmacol. Exp. Ther. 203:507–511 (1977).

    CAS  PubMed  Google Scholar 

  7. M. S. Lennard, G. T. Tucker, and H. F. Woods. Time-dependent kinetics of lignocaine in the isolated perfused rat liver.J. Pharmacokin. Biopharm. 11:165–182 (1983).

    Article  CAS  Google Scholar 

  8. T. Suzuki, S. Fujita, and R. Kawai. Precursor-metabolite interaction in the metabolism of lignocaine.J. Pharm. Sci. 73:136–138 (1984).

    Article  CAS  PubMed  Google Scholar 

  9. J. M. Strong, D. E. Mayfield, A. J. Atkinson, B. C. Burris, F. Raymon, and L. T. Webster. Pharmacological activity, metabolism and pharmacokinetics of glycinexylidide.Clin. Pharmacol. Ther. 17:184–194 (1975).

    CAS  PubMed  Google Scholar 

  10. R. G. Burney, G. A. DiFazio, M. J. Peach, K. A. Petrie, and M. J. Sylvester. Antiarrhythmic effects of lidocaine metabolites.Am. Heart J. 88:765–769 (1974).

    Article  CAS  PubMed  Google Scholar 

  11. H. Halkin, P. Meffin, K. L. Melmon, and M. Rowland. Influence of congestive heart failure on blood levels of lidocaine and its active monodeethylated metabolite.Clin. Pharmacol. Ther. 17:669–676 (1975).

    CAS  PubMed  Google Scholar 

  12. R. L. Nation, E. J. Triggs, and M. Selig. Lignocaine kinetics in cardiac patients and aged subjects.Br. J. Clin. Pharmacol. 4:439–448 (1977).

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. A. H. Beckett, R. N. Boyes, and P. J. Appleton. The metabolism and excretion of lwignocaine in man.J. Pharm. Pharmacol. 18(Suppl.):76s-81s. (1966).

    Article  Google Scholar 

  14. R. L. Nation, G. W. Peng, and W. L. Chiou. High pressure liquid chromatographic method for simultaneous determination of lidocaine and its N-dealkylated metabolite in plasma.J. Chromatogr. 162:466–473 (1979).

    Article  CAS  PubMed  Google Scholar 

  15. L. B. Sheiner. ELSFIT (Users Manual). Division of Clinical Pharmacology, University of California, San Francisco, 1983.

    Google Scholar 

  16. M. Gibaldi and D. Perrier.Pharmacokinetics, Marcel Dekker, New York, 1975.

    Google Scholar 

  17. A. W. Kelman and D. J. Sumner. Systolic time interval v heart rate regression equations using atropine: Reproducibility studies.Br. J. Clin. Pharmacol. 12:15–20 (1981).

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. B. J. Winer.Statistical Problems in Experimental Design, 2nd ed., McGraw-Hill, New York, 1971.

    Google Scholar 

  19. M. Rowland, P. D. Thomson, A. Giuchard, and K. L. Melmon. Disposition kinetics of lidocaine in normal subjects.Ann. N. Y. Acad. Sci. 179:383–398 (1971).

    Article  CAS  PubMed  Google Scholar 

  20. N. O. Benowitz and W. Meister. Clinical pharmacokinetics of lidocaine.Clin. Pharmacokin. 3:177–201 (1978).

    Article  CAS  Google Scholar 

  21. A. H. Thomson, A. W. Kelman, P. J. de Vane, W. S. Hillis, and B. Whiting. Bayesian parameter estimation: Comparison of one and two compartment models for lignocaine. InProceedings of the Second European Congress on Biopharmaceutics and Pharmacokinetics, Salamanca, Spain, 1984.

  22. K. K. Adjepon-Yamoah and L. F. Prescott. Lignocaine metabolism in man.Br. J. Pharmacol. 47:672p-673p (1973).

    CAS  PubMed Central  PubMed  Google Scholar 

  23. P. N. Bennett, L. J. Aarons, M. R. Bending, J. A. Steiner, and M. Rowland. Pharmacokinetics of lidocaine and its dethylated metabolite: Dose and time dependency studies in man.J. Pharmacokin. Biopharm. 10:265–281, (1982).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Thomson, A.H., Elliott, H.L., Kelman, A.W. et al. The pharmacokinetics and pharmacodynamics of lignocaine and MEGX in healthy subjects. Journal of Pharmacokinetics and Biopharmaceutics 15, 101–115 (1987). https://doi.org/10.1007/BF01062338

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01062338

Key words

Navigation