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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 58 (1980), S. 889-896 
    ISSN: 1432-1440
    Keywords: Bezafibrat ; Niereninsuffizienz ; Pharmakokinetik ; Dosierungsschema ; Renale Clearance ; Extrarenale Clearance ; Bezafibrate ; Pharmacokinetics ; Dosage scheme ; Renal failure ; Renal clearance ; Extrarenal clearance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The pharmacokinetics of bezafibrate were investigated in the serum and urine of 22 patients with impaired renal function of different degrees after a single oral dose. The results of the first study were checked by a second study in another 12 patients with advanced renal insufficiency using multiple dosing. Both studies revealed an almost identical hyperbolic relationship between the mean serum concentration over 24 h and the endogenous creatinine clearance. Since the vertex of this hyperbola is positioned at a creatinine clearance of 50 ml/min, only greater impairment of the renal function requires dose reduction, the respective nomograms and schedules for which are given. Even in advanced renal failure (creatinine clearance 10–25 ml/min) the total serum clearance of bezafibrate was considerably higher (27 ml/min) than that reported in the literature for clofibric acid. It is of interest to note that not only the renal but also the “extrarenal” clearance, which in normals accounts for approximately half of the total clearance of bezafibrate, was considerably depressed in advanced renal failure. This might indicate that part of the extrarenal mechanism of bezafibrate elimination, e.g. the glucuronidation, might occur in the kidneys. Knowledge of the kinetic behaviour of bezafibrate in patients with impaired renal function also allows rational therapy in the presence of this condition.
    Notes: Zusammenfassung Die Pharmakokinetik von Bezafibrat wurde in Serum und Urin von 22 Patienten mit unterschiedlich eingeschränkter Nierenfunktion nach einmaliger oraler Gabe untersucht. Die hierbei gewonnenen Ergebnisse wurden in einer zweiten Studie bei 12 weiteren Patienten (Kreatinin Clearance 10–25 ml/min) unter steady-state-Bedingungen überprüft. Beide Studien ergaben eine nahezu identische hyperbole Beziehung zwischen der mittleren Serumkonzentration über 24 h und der endogenen Kreatinin-Clearance. Da der Scheitel dieser Hyperbel bei einer Kreatinin-Clearance von ca. 50 ml/min, liegt, ist eine Dosis-Reduktion erst bei weitergehender Einschränkung der Nierenfunktion erforderlich. Entsprechende Nomogramme und Dosisempfehlungen werden angegeben. Selbst bei fortgeschrittener Niereninsuffizienz (Kreatin-Clearance 10–25 ml/min) ist die totale Clearance des Bezafibrats noch mehrfach höher (27 ml/min) als die in der Literatur unter vergleichbaren Bedingungen für Clofibrinsäure bestimmte. Interessanterweise ist nicht nur die renale, sondern auch die extrarenale Clearance von Bezafibrat, die normalerweise ca. die Hälfte der totalen Clearance ausmacht, bei fortgeschrittener Niereninsuffizienz deutlich vermindert. Dies weist darauf hin, daß ein Teil der „extrarenalen“ Eliminationsmechanismen des Bezafibrat, z.B. der Umsatz zu Glucuronsäurekonjugaten auch in der Niere ablaufen dürfte. Insgesamt erlaubt nun die Kenntnis der Pharmakokinetik des Bezafibrat bei Niereninsuffizienz eine rationale Therapieführung bei derartigen Patienten.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 16 (1979), S. 31-38 
    ISSN: 1432-1041
    Keywords: bezafibrate ; hyperlipoproteinemia ; bioavailability ; pharmacokinetics ; GC-MS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The disposition kinetics of bezafibrate, a newly developed drug of great lipid-lowering potency, were investigated in normal male subjects. Five male volunteers received14C-labelled bezafibrate orally in solution, and a further 10 were given the same dose (300 mg) of un-labelled drug as tablets. The concentration of bezafibrate in serum and urine from the latter was determined by GC, and in the former total radioactivity in serum, urine and feces was followed for 48 h, and urinary excretion products were analysed by TLC and GC-MS. Rapid absorption from the gastrointestinal tract led to peak serum levels 30 min and 2 h after administration of solution and tablets, respectively. Since approximately 95% of the administered14C-bezafibrate was excreted in urine within 48 h, and almost all the remainder was detected in feces, absorption can be regarded as complete after administration in solution. The relative optimal bioavailability from the tablets was also complete, since in both cases approximately 50% of the administered dose was detected as unchanged bezafibrate in urine within 24 h by GC in the tablet study, and by TLC in the solution study. Of the decomposition products, more than 20% of the dose was present as glucuronides and the remainder consisted of several more polar compounds, one of which was identified as a hydroxyderivative of bezafibrate. Since the apparent halflife of bezafibrate in serum was 2.1 h, this new drug possesses favourable pharmacokinetic features: rapid and complete absorption, even from tablets, combined with a conveniently short half-life, and clearance which is half renal (56 ml/min) and half metabolic (43 ml/min), giving a total clearance of 99 ml/min.
    Type of Medium: Electronic Resource
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