Disposition of Misoprostol and Its Active Metabolite in Impaired Hepatic Function.
The pharmacokinetics of misoprostol and its active metabolite, misoprostol acid, was assessed in 17 healthy subjects and 17 subjects with various degrees of hepatic impairment. Before misoprostol administration, subjects underwent antipyrine and indocyanine green clearance studies to assess hepatic functional capacity. Subjects were administered 400 mcg of oral misoprostol in an open-label design. There was a lower antipyrine clearance in the group with hepatic disease as compared to normal volunteers (0.56 versus 0.80 ml min(minus sign1) kg(minus sign1), respectively, p = 0.022). There was no difference in indocyanine green clearance values between groups. The C(max), t(1/2)&bgr, and &lsqb;Formula: see text] tended to be larger in the hepatic group; however, there was no statistical difference. Adverse events, mostly gastrointestinal in nature, occurred more often in the subjects with hepatic disease. These data suggest the pharmacokinetics of misoprostol may be altered in the presence of hepatic disease. However, because of significant interpatient variability, definitive dosing recommendations cannot be made. Further study in this area is needed.
Foote
Edward F.
EF
The Drug Evaluation Unit, Division of Nephrology, Department of Medicine, Hennepin County Medical Center, Minneapolis, MN, USA and College of Pharmacy, University of Minnesota, Minneapolis, MN, USA.
Garnett
William R.
WR
Lee
Daniel R.
DR
Karim
Aziz
A
Luketic
Velimar A.C.
VA
Keane
William F.
WF
Halstenson
Charles E.
CE
St Peter
John V.
JV