Pharmacokinetics of cetirizine in chronic hemodialysis patients: multiple-dose study.
The serum concentration-time profiles of cetirizine were measured in 8 male end-stage renal failure (ESRF) patients on chronic hemodialysis (HD). Cetirizine (5 mg) was ingested three times a week during the predialysis period. Blood samples were drawn for basal level evaluation, before and after dialysis on 3 days per week, and before HD the following week. The serum levels of cetirizine were measured using a validated atmospheric-pressure ionization liquid chromatography-tandem mass spectrometry method. Basal levels of cetirizine in HD patients were confirmed to be 0 ng/ml. The predialysis levels of cetirizine on days 1, 3, 5, and 8 were (mean +/- SD) 2.74 +/- 7.76, 34.16 +/- 21.55, 35.58 +/- 13.43, and 22.47 +/- 12.92 ng/ml, respectively. The postdialysis levels of cetirizine 4-5 h after ingestion were as follows (ng/ml): day 1, 103.11 +/- 37.27; day 3, 131.34 +/- 51.18, and day 5, 136.48 +/- 48.72. Between dialysis sessions, no supplemental dosage was required to keep the therapeutic range of 14 ng/ml. In addition, the predialysis levels on day 8 were not statistically different from the basal levels. Evidence from the multiple-dose study supports the clinical use of cetirizine for ESRF patients on HD. Thus, it is concluded that a prescription of 5 mg cetirizine three times a week during the predialysis period will be the effective and safety renal dosage for ESRD patients on HD.
Noiri
E
E
Department of Nephrology and Endocrinology, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan. noiri-1im@u-tokyo.ac.jp
Ozawa
H
H
Fujita
T
T
Nakao
A
A
D000293:Adolescent; D000328:Adult; D017332:Cetirizine / Q000008:administration & dosage / Q000493:pharmacokinetics*; D002853:Chromatography, Liquid; D006634:Histamine H1 Antagonists / Q000008:administration & dosage / Q000493:pharmacokinetics*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D011537:Pruritus / Q000188:drug therapy* / Q000378:metabolism; D006435:Renal Dialysis; D014511:Uremia / Q000378:metabolism* / Q000628:therapy
D006634:Histamine H1 Antagonists; D017332:Cetirizine