Pharmacokinetics of quinine in patients with chronic renal failure.
METHODS. We investigated the pharmacokinetics of quinine (Qn) following administration of a single oral dose of 600 mg Qn sulphate in six male Thai patients with a moderate degree of chronic renal failure (CRF), and six male Thai subjects with normal renal function. RESULTS. The drug was well tolerated in both groups of subjects; no major adverse reactions were observed. A marked alteration in the pharmacokinetics of Qn was found in patients with CRF compared to healthy subjects; there were six significant changes in the pharmacokinetic parameters. Absorption was delayed, but increased in CRF (tmax 4.5 vs 1.6 h, Cmax 6.17 vs 3.45 micrograms.ml-1). Total clearance was significantly reduced (0.94 vs 2.84 ml.min-1.kg-1, whereas Vz/f remained unchanged (1.82 vs 2.78 l. kg-1). This resulted in the increased values of AUC and prolongation of the t1/2z and MRT in the patients (AUC 181.5 vs 61.8 micrograms.min-1.ml-1, t1/2z 26 vs 9.7 h, MRT 36.4 vs 11.3 h). Median concentrations of plasma unbound fraction of Qn collected at 4 h after drug administration in patients and healthy subjects were 7.3 vs 9.8%, respectively.
Rimchala
P
P
Department of Medicine, Prapokklao Hospital, Chantaburi Province, Thailand.
Karbwang
J
J
Sukontason
K
K
Banmairuroi
V
V
Molunto
P
P
Na-Bangchang
K
K
D000042:Absorption; D000284:Administration, Oral; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011803:Quinine / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*
D000962:Antimalarials; D015415:Biomarkers; D011803:Quinine