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Wakuda H, Xiang Y, Sodhi JK, Uemura N, Benet LZ. An Explanation of Why Dose-Corrected Area Under the Curve for Alternate Administration Routes Can Be Greater than for Intravenous Dosing. AAPS J 2024; 26:22. [PMID: 38291293 DOI: 10.1208/s12248-024-00887-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
It is generally believed that bioavailability (F) calculated based on systemic concentration area under the curve (AUC) measurements cannot exceed 1.0, yet some published studies report this inconsistency. We teach and believe, based on differential equation derivations, that rate of absorption has no influence on measured systemic clearance following an oral dose, i.e., determined as available dose divided by AUC. Previously, it was thought that any difference in calculating F from urine data versus that from systemic concentration AUC data was due to the inability to accurately measure urine data. A PubMed literature search for drugs exhibiting F > 1.0 and studies for which F was measured using both AUC and urinary excretion dose-corrected analyses yielded data for 35 drugs. We show and explain, using Kirchhoff's Laws, that these universally held concepts concerning bioavailability may not be valid in all situations. Bioavailability, determined using systemic concentration measurements, for many drugs may be overestimated since AUC reflects not only systemic elimination but also absorption rate characteristics, which is most easily seen for renal clearance measures. Clearance of drug from the absorption site must be significantly greater than clearance following an iv bolus dose for F(AUC) to correctly correspond with F(urine). The primary purpose of this paper is to demonstrate that studies resulting in F > 1.0 and/or greater systemic vs urine bioavailability predictions may be accurate. Importantly, these explications have no significant impact on current regulatory guidance for bioequivalence testing, nor on the use of exposure (AUC) measures in making drug dosing decisions.
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Affiliation(s)
- Hirokazu Wakuda
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California San Francisco, San Francisco, California, 94143-0912, USA
- Department of Clinical Pharmacology and Therapeutics, School of Medicine, Oita University, 1-1 Idai gaoka, Hasama-machi, Yufu City, Oita, 879-5593, Japan
| | - Yue Xiang
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California San Francisco, San Francisco, California, 94143-0912, USA
| | - Jasleen K Sodhi
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California San Francisco, San Francisco, California, 94143-0912, USA
- Department of Drug Metabolism and Pharmacokinetics, Septerna, South San Francisco, California, 94080, USA
| | - Naoto Uemura
- Department of Clinical Pharmacology and Therapeutics, School of Medicine, Oita University, 1-1 Idai gaoka, Hasama-machi, Yufu City, Oita, 879-5593, Japan
| | - Leslie Z Benet
- Department of Bioengineering and Therapeutic Sciences, Schools of Pharmacy and Medicine, University of California San Francisco, San Francisco, California, 94143-0912, USA.
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Bianco AW, Moore GE, Cooper BR, Taylor SD. In vitro anti-LPS dose determination of ketorolac tromethamine and in vivo safety of repeated dosing in healthy horses. J Vet Pharmacol Ther 2017; 41:98-104. [PMID: 28600856 DOI: 10.1111/jvp.12425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 05/06/2017] [Indexed: 12/27/2022]
Affiliation(s)
- A. W. Bianco
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Purdue University; West Lafayette IN USA
| | - G. E. Moore
- Department of Veterinary Administration; College of Veterinary Medicine; Purdue University; West Lafayette IN USA
| | - B. R. Cooper
- Bindley Bioscience Center; Purdue University; West Lafayette IN USA
| | - S. D. Taylor
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Purdue University; West Lafayette IN USA
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Bhateria M, Rachumallu R, Yerrabelli S, Saxena AK, Bhatta RS. Insight into stereoselective disposition of enantiomers of a potent antithrombotic agent, S002-333 following administration of the racemic compound to mice. Eur J Pharm Sci 2017; 101:107-114. [DOI: 10.1016/j.ejps.2017.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 11/30/2022]
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Bianco AW, Constable PD, Cooper BR, Taylor SD. Pharmacokinetics of ketorolac tromethamine in horses after intravenous, intramuscular, and oral single-dose administration. J Vet Pharmacol Ther 2015; 39:167-75. [PMID: 26416348 DOI: 10.1111/jvp.12260] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 07/20/2015] [Indexed: 12/01/2022]
Affiliation(s)
- A. W. Bianco
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Purdue University; West Lafayette IN USA
| | - P. D. Constable
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois; Urbana-Champaign IL USA
| | - B. R. Cooper
- Bindley Bioscience Center; Purdue University; West Lafayette IN USA
| | - S. D. Taylor
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; Purdue University; West Lafayette IN USA
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Ferraresi C, Villa R, Ravasio G, Zonca A, Carli S, Pecile A, Fonda D, Cagnardi P. Pharmacokinetics of IV Ketorolac in Horses Undergoing Orchiectomy. J Equine Vet Sci 2014. [DOI: 10.1016/j.jevs.2014.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Determination of Racemic Ketorolac, Ketorolac Enantiomers and Their Metabolites in Human Plasma and Urine by LC–UV, Applied in Clinical Study During and After Pregnancy. Chromatographia 2014. [DOI: 10.1007/s10337-014-2670-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cagnardi P, Zonca A, Gallo M, Villa R, Carli S, Beccaglia M, Fonda D, Ravasio G. Pharmacokinetics and perioperative efficacy of intravenous ketorolac in dogs. J Vet Pharmacol Ther 2013; 36:603-8. [DOI: 10.1111/jvp.12044] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 01/30/2013] [Indexed: 11/29/2022]
Affiliation(s)
- P. Cagnardi
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare; Università degli Studi di Milano; Milano Italy
| | - A. Zonca
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare; Università degli Studi di Milano; Milano Italy
| | - M. Gallo
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare; Università degli Studi di Milano; Milano Italy
| | - R. Villa
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare; Università degli Studi di Milano; Milano Italy
| | - S. Carli
- Dipartimento di Scienze Veterinarie per la Salute, la Produzione Animale e la Sicurezza Alimentare; Università degli Studi di Milano; Milano Italy
| | - M. Beccaglia
- Ambulatorio Veterinario Beccaglia, Lissone; Monza Brianza Italy
| | - D. Fonda
- Dipartimento di Scienze Veterinarie e Sanità Pubblica; Università degli Studi di Milano; Milano Italy
| | - G. Ravasio
- Dipartimento di Scienze Veterinarie e Sanità Pubblica; Università degli Studi di Milano; Milano Italy
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