title: Inter- and intra-subject variability in gabapentin absorption and absolute bioavailability.
abstract: Gabapentin (GBP) is a non-metabolized, non-plasma protein bound, renally excreted antiepileptic drug that is actively absorbed via the system L amino acid transporter. Previous studies have demonstrated that gabapentin displays dose-dependent absorption.
  
  
  OBJECTIVE
  These studies were conducted to determine inter- and intra-subject variability of gabapentin absorption. Two prospective clinical studies in healthy adult volunteers were conducted. Coefficient of variation (CV) was used to express variability of gabapentin absorption.
  
  
  METHODS
  Study A: 400-mg single dose, randomized, cross-over study to assess bioavailability of four different gabapentin formulations (n=20, 9 males, 11 females; mean age and weight 41 years, 75.1 kg). Plasma was serially collected up to 48 h and bioavailability (F) calculated post-dose to determine concentration-time curves (AUC). All four formulations were bioequivalent, thus repeated measures analysis was performed to assess inter-and intra-subject variability. Study B: 600-mg single dose study (n=50, 15 males, 35 females; mean age and weight 31.1 years, 72.7 kg) was conducted to determine inter-subject variability in gabapentin F. Urine was collected over 48 h and bioavailability (F) calculated. Urine and plasma gabapentin concentrations were measured by HPLC-UV.
  
  
  RESULTS
  Study A: Overall mean (CV) of GBP AUC values was 34.1+/-24 ug/h per ml. Inter-subject CV for AUC was 22.5% and intra-subject CV was 12.1%. Study B: Overall mean (SD) GBP F was 49.3+/-13.6%. Inter-subject CV of F was 27.6%.
  
  
  CONCLUSIONS
  The inter-subject variability in gabapentin absorption is substantially less than that of the inter-subject variability. This indicates that one would expect a wide range in gabapentin absorption between subjects; however, a much smaller variability within a subject. The within subject variability of gabapentin is small enough that plasma drug monitoring may be used to assess gabapentin absorption for a given subject and the benefit of dose individualization.
authors.affiliation: Department of Neurology, School of Pharmacy, University of Wisconsin, 425 N. Charter Street, Madison, WI 53706, USA. begidal@pharmacy.wisc.edu
authors.forename: B E
authors.initials: BE
authors.lastname: Gidal
authors.forename: L L
authors.initials: LL
authors.lastname: Radulovic
authors.forename: S
authors.initials: S
authors.lastname: Kruger
authors.forename: P
authors.initials: P
authors.lastname: Rutecki
authors.forename: M
authors.initials: M
authors.lastname: Pitterle
authors.forename: H N
authors.initials: HN
authors.lastname: Bockbrader
mesh_terms: D000085:Acetates / Q000097:blood / Q000493:pharmacokinetics* / Q000652:urine; D000328:Adult; D000588:Amines; D000704:Analysis of Variance; D000927:Anticonvulsants / Q000097:blood / Q000493:pharmacokinetics* / Q000652:urine; D018592:Cross-Over Studies; D003509:Cyclohexanecarboxylic Acids; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D005680:gamma-Aminobutyric Acid
chemical_list: D000085:Acetates; D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin