title: Pharmacokinetics of the aldose reductase inhibitor tolrestat: studies in healthy young and elderly male and female subjects and in subjects with diabetes.
abstract: Tolrestat is an aldose reductase inhibitor undergoing clinical trials in diabetic subjects that may reduce the severity of chronic tissue damage associated with hyperglycemia. These studies were conducted to evaluate the pharmacokinetics of tolrestat in healthy young and elderly male and female subjects and in young and elderly subjects with diabetes. The drug was administered in a multiple-dose regimen, and steady-state parameters were obtained. There were no important gender-related differences, but mean values for apparent oral clearance, renal clearance, and corresponding unbound parameters were significantly lower for the elderly healthy subjects than for the young healthy subjects. The drug is highly bound to plasma proteins, and the unbound fraction (0.75%) did not differ among the subjects. The results from young and elderly diabetic subjects suggest that diabetes per se has no influence on tolrestat disposition but that there is an age-related reduction in apparent oral clearance (30 versus 18 ml/hr/kg) and a corresponding increase in the minimum steady-state plasma concentration (1.2 versus 1.9 micrograms/ml). These data indicate a possible need to reduce the dose of tolrestat in elderly subjects, assuming the same concentration-response relationship.
authors.affiliation: Wyeth-Ayerst Research, Philadelphia, PA 19101, USA.
authors.forename: R
authors.initials: R
authors.lastname: Fruncillo
authors.forename: S
authors.initials: S
authors.lastname: Troy
authors.forename: V
authors.initials: V
authors.lastname: Parker
authors.forename: M
authors.initials: M
authors.lastname: Mayersohn
authors.forename: D
authors.initials: D
authors.lastname: Hicks
authors.forename: M
authors.initials: M
authors.lastname: Kraml
authors.forename: M
authors.initials: M
authors.lastname: Battle
authors.forename: S
authors.initials: S
authors.lastname: Chiang
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000375:Aging / Q000378:metabolism*; D000449:Aldehyde Reductase / Q000037:antagonists & inhibitors*; D002851:Chromatography, High Pressure Liquid; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000378:metabolism; D004791:Enzyme Inhibitors / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006207:Half-Life; D006801:Humans; D007408:Intestinal Absorption; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009281:Naphthalenes / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D012737:Sex Factors
chemical_list: D004791:Enzyme Inhibitors; D009281:Naphthalenes; C040550:tolrestat; D000449:Aldehyde Reductase