The pharmacokinetic profile of amlodipine.
Amlodipine, a dihydropyridine calcium antagonist, was synthesized in an attempt to develop a compound with a pharmacokinetic profile characteristic of this class, which would also have an increased oral bioavailability and extended clearance time. A single intravenous dose of 10 mg resulted in an absolute bioavailability of 64% and a calculated elimination half-life of 34 hours. The pharmacokinetic profile of oral doses showed similar changes. These results were significantly different from those seen with most other dihydropyridines (elimination half-life of 3 to 10 hours and absolute bioavailability of 10% to 30%) and nondihydropyridine calcium antagonists (elimination half-life 3 to 6 hours and low absolute bioavailability). With chronic oral dosing of amlodipine once daily for 14 days, support was provided for the linearity of amlodipine's pharmacokinetics and absence of such with chronic oral dosing with verapamil, diltiazem, and nifedipine. In the elderly population, elimination half-life of 5 mg oral doses is significantly prolonged (48 vs 35 hours; p less than 0.025) suggesting decreased oral clearance or increased bioavailability. Comparison of the pharmacokinetics of amlodipine in patients with chronic stable angina pectoris with the profile in healthy volunteers suggested that clearance is not altered in patients with chronic stable angina, steady state being reached 6 to 12 hours after administration of the drug. In patients with cirrhosis, elimination half-life is significantly prolonged (60 vs 34 hours; p less than 0.01) suggesting that there is a greater accumulation of amlodipine in patients with severe liver disease than in individuals with normal hepatic function.(ABSTRACT TRUNCATED AT 250 WORDS)
Abernethy
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Division of Clinical Pharmacology, Brown University, Providence, RI.
D000284:Administration, Oral; D000375:Aging / Q000378:metabolism; D017311:Amlodipine; D000787:Angina Pectoris / Q000097:blood; D000818:Animals; D001682:Biological Availability; D002121:Calcium Channel Blockers; D002927:Cimetidine / Q000493:pharmacokinetics; D004077:Digoxin / Q000493:pharmacokinetics; D004347:Drug Interactions; D006207:Half-Life; D006801:Humans; D007275:Injections, Intravenous; D007674:Kidney Diseases / Q000378:metabolism; D008103:Liver Cirrhosis / Q000378:metabolism; D009543:Nifedipine / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
D002121:Calcium Channel Blockers; D017311:Amlodipine; D004077:Digoxin; D002927:Cimetidine; D009543:Nifedipine