Pharmacokinetics of etoricoxib in patients with renal impairment.
The effect of renal insufficiency on the pharmacokinetics of etoricoxib, a selective inhibitor of cyclooxygenase-2, was examined in 23 patients with varying degrees of renal impairment (12 moderate [creatinine clearance between 30 and 50 mL/min/1.73 m2], 5 severe [creatinine clearance below 30 mL/min/1.73 m2], and 6 with end-stage renal disease requiring hemodialysis) following administration of single 120-mg oral doses of etoricoxib. Even the most severe renal impairment was found to have little effect on etoricoxib pharmacokinetics. The low recovery of etoricoxib in dialysate (less than 6% of the dose) supports that hemodialysis also has little effect on etoricoxib pharmacokinetics, and binding of etoricoxib to plasma proteins was generally unaffected by renal disease. Single doses of etoricoxib were generally well tolerated by patients with renal impairment. Based on pharmacokinetic considerations, dosing adjustments are not necessary for patients with any degree of renal impairment. However, because patients with advanced renal disease (creatinine clearance below 30 mL/min/1.73 m2) are likely to be very sensitive to any further compromise of renal function, and there is no long-term clinical experience in these patients, the use of etoricoxib is not recommended in patients with advanced renal disease.
Agrawal
Nancy G B
NG
Department of Drug Metabolism, Merck Research Laboratories, West Point, PA 19486, USA.
Matthews
Catherine Z
CZ
Mazenko
Ralph S
RS
Kline
Walter F
WF
Woolf
Eric J
EJ
Porras
Arturo G
AG
Geer
Leslie A
LA
Wong
Peggy H
PH
Cho
Meehung
M
Cote
Josee
J
Marbury
Thomas C
TC
Moncrief
Jack W
JW
Alcorn
Harry
H
Swan
Suzanne
S
Sack
Marshall R
MR
Robson
Richard A
RA
Petty
Kevin J
KJ
Schwartz
Jules I
JI
Gottesdiener
Keith M
KM
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001682:Biological Availability; D002986:Clinical Trials as Topic; D016861:Cyclooxygenase Inhibitors / Q000493:pharmacokinetics*; D000077613:Etoricoxib; D005260:Female; D006207:Half-Life; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000628:therapy; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D011485:Protein Binding; D011725:Pyridines / Q000493:pharmacokinetics*; D006435:Renal Dialysis; D013450:Sulfones / Q000493:pharmacokinetics*
D016861:Cyclooxygenase Inhibitors; D011725:Pyridines; D013450:Sulfones; D000077613:Etoricoxib