Pharmacokinetics of single, oral-dose voriconazole in peritoneal dialysis patients.
BACKGROUND
Voriconazole is a new triazole antifungal drug. Its pharmacokinetics and transfer to peritoneal dialysate in peritoneal dialysis (PD) patients have not been studied.


METHODS
Five patients with end-stage renal disease requiring support by PD were administered a single dose of 200 mg of voriconazole orally. Plasma and peritoneal dialysate were collected for measurement of voriconazole concentrations at times 1, 2, 4, and 24 hours.


RESULTS
Voriconazole was absorbed and achieved maximum concentration (Cmax) in plasma at mean time 2.4 +/- 0.7 (SE) hours. Time to Cmax in dialysate was 2.8 +/- 0.5 hours. Mean Cmax for plasma was 0.55 +/- 0.20 microg/mL, and for dialysate, approximately half that of plasma (0.25 +/- 0.09 mug/mL). The dialysate to plasma ratio of voriconazole was 0.66 +/- 0.11. Less than 1% of the administered voriconazole dose (1.3 +/- 0.2 mg) was recovered in dialysate 24 hours after dosing.


CONCLUSIONS
Voriconazole penetrates well into peritoneal fluid. There is minimal peritoneal clearance of voriconazole; therefore, no dosage adjustment is needed for patients on PD therapy.
Peng
Luon W
LW
Department of Medicine, University of Arizona Health Sciences Center, Tucson, AZ 85724, USA.
Lien
Yeong-Hau H
YH
D000284:Administration, Oral; D000328:Adult; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D015314:Dialysis Solutions / Q000737:chemistry; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*; D014230:Triazoles / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*; D065819:Voriconazole
D000935:Antifungal Agents; D015314:Dialysis Solutions; D011743:Pyrimidines; D014230:Triazoles; D065819:Voriconazole