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Protein binding of ...
Protein binding of rifampicin is not saturated when using high-dose rifampicin
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- Litjens, Carlijn H. C. (author)
- Radboud Univ Nijmegen, Med Ctr, Radboud Inst Hlth Sci, Dept Pharm, Nijmegen, Netherlands;Radboud Univ Nijmegen, Med Ctr, Radboud Inst Hlth Sci, Dept Pharmacol & Toxicol, Nijmegen, Netherlands
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- Aarnoutse, Rob E. (author)
- Radboud Univ Nijmegen, Med Ctr, Radboud Inst Hlth Sci, Dept Pharm, Nijmegen, Netherlands
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- Kolmer, Eleonora W. J. van Ewijk-Beneken (author)
- Radboud Univ Nijmegen, Med Ctr, Radboud Inst Hlth Sci, Dept Pharm, Nijmegen, Netherlands
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- Svensson, Elin, 1985- (author)
- Uppsala universitet,Institutionen för farmaceutisk biovetenskap,Radboud Univ Nijmegen, Med Ctr, Radboud Inst Hlth Sci, Dept Pharm, Nijmegen, Netherlands
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- Colbers, Angela (author)
- Radboud Univ Nijmegen, Med Ctr, Radboud Inst Hlth Sci, Dept Pharm, Nijmegen, Netherlands
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- Burger, David M. (author)
- Radboud Univ Nijmegen, Med Ctr, Radboud Inst Hlth Sci, Dept Pharm, Nijmegen, Netherlands
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- Boeree, Martin J. (author)
- Radboud Univ Nijmegen, Dept Pulm Dis, Med Ctr, Nijmegen, Netherlands
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- te Brake, Lindsey H. M. (author)
- Radboud Univ Nijmegen, Med Ctr, Radboud Inst Hlth Sci, Dept Pharm, Nijmegen, Netherlands
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Aarnoutse, Rob (author)
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Boeree, Martin (author)
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Heinrich, Norbert (author)
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Diacon, Andreas (author)
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Dawson, Rodney (author)
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Rehal, Sunita (author)
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Kibiki, Gibson (author)
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Churchyard, Gavin (author)
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Sanne, Ian (author)
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Ntinginya, Nyanda (author)
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Minja, Lilian (author)
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Hunt, Robert (author)
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Charalambous, Salome (author)
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Hanekom, Madeleine (author)
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Semvua, Hadija (author)
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Mpagama, Stellah (author)
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Manyama, Christina (author)
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Mtafya, Bariki (author)
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Reither, Klaus (author)
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Wallis, Robert (author)
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Venter, Amour (author)
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Narunsky, Kim (author)
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Mekota, Anna-Maria (author)
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Henne, Sonja (author)
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van Balen, Georgette Plemper (author)
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Gillespie, Stephen (author)
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Phillips, Patrick (author)
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Hoelscher, Michael (author)
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(creator_code:org_t)
- 2018-12-28
- 2019
- English.
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In: Journal of Antimicrobial Chemotherapy. - : OXFORD UNIV PRESS. - 0305-7453 .- 1460-2091. ; 74:4, s. 986-990
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background Higher doses of rifampicin are being investigated as a means to optimize response to this pivotal TB drug. It is unknown whether high-dose rifampicin results in saturation of plasma protein binding and a relative increase in protein-unbound (active) drug concentrations. Objectives To assess the free fraction of rifampicin based on an in vitro experiment and data from a clinical trial on high-dose rifampicin. Methods Protein-unbound rifampicin concentrations were measured in human serum spiked with increasing total concentrations (up to 64mg/L) of rifampicin and in samples obtained by intensive pharmacokinetic sampling of patients who used standard (10mg/kg daily) or high-dose (35mg/kg) rifampicin up to steady-state. The performance of total AUC(0-24) to predict unbound AUC(0-24) was evaluated. Results The in vitro free fraction of rifampicin remained unaltered (approximate to 9%) up to 21mg/L and increased up to 13% at 41mg/L and 17% at 64mg/L rifampicin. The highest (peak) concentration in vivo was 39.1mg/L (high-dose group). The arithmetic mean percentage unbound to total AUC(0-24)in vivo was 13.3% (range=8.1%-24.9%) and 11.1% (range=8.6%-13.6%) for the standard group and the high-dose group, respectively (P=0.214). Prediction of unbound AUC(0-24) based on total AUC(0-24) resulted in a bias of -0.05% and an imprecision of 13.2%. Conclusions Plasma protein binding of rifampicin can become saturated, but exposures after high-dose rifampicin are not high enough to increase the free fraction in TB patients with normal albumin values. Unbound rifampicin exposures can be predicted from total exposures, even in the higher dose range.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Farmakologi och toxikologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Pharmacology and Toxicology (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Litjens, Carlijn ...
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Aarnoutse, Rob E ...
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Kolmer, Eleonora ...
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Svensson, Elin, ...
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Colbers, Angela
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Burger, David M.
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show more...
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Boeree, Martin J ...
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te Brake, Lindse ...
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Aarnoutse, Rob
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Boeree, Martin
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Heinrich, Norber ...
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Diacon, Andreas
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Dawson, Rodney
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Rehal, Sunita
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Kibiki, Gibson
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Churchyard, Gavi ...
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Sanne, Ian
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Ntinginya, Nyand ...
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Minja, Lilian
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Hunt, Robert
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Charalambous, Sa ...
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Hanekom, Madelei ...
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Semvua, Hadija
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Mpagama, Stellah
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Manyama, Christi ...
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Mtafya, Bariki
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Reither, Klaus
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Wallis, Robert
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Venter, Amour
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Narunsky, Kim
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Mekota, Anna-Mar ...
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Henne, Sonja
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van Balen, Georg ...
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Gillespie, Steph ...
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Phillips, Patric ...
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Hoelscher, Micha ...
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- MEDICAL AND HEALTH SCIENCES
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Journal of Antim ...
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Uppsala University