title: Liquid chromatographic-mass spectrometric method for the determination of fluoxetine and norfluoxetine in human plasma: application to clinical study.
abstract: A selective, sensitive, simple, and rapid method for the simultaneous determination of fluoxetine (FL) and norfluoxetine (nor-FL) was developed and validated, and further applied to analyze plasma samples obtained from FL-treated patients with Parkinson disease (n = 18). After one step liquid-liquid extraction with ethyl acetate, plasma samples were chromatographed on a C8 column. The mobile phase was acetate buffer and acetonitrile (40:60 v/v). Determination of FL and nor-FL was performed with MS detection in selective ion monitoring (SIM) mode, so the other components did not interfere with this assay. FL, nor-FL and flumazenil as internal standard were eluted in 6 min. Recoveries ranged from 89.7 to 96.6% and from 80.2 to 85.3% for FL and nor-FL, respectively. The limit of quantitation under described conditions was 2.5 microg/l for FL and 10 microg/l for nor-FL. The method was found to be reproducible with coefficient of variation less than 9%. The parameters of the method were found to be acceptable to enable its routine use for clinical studies. The method was employed to analyze the Parkinsonian patients' plasma samples. A great deviation in plasma concentrations of FL and nor-FL found among 18 studied patients indicates high pharmacokinetic variability of the drug. Obtained results also indicate absence of the influence of Parkinson disease on the drug disposition.
authors.affiliation: Poison Control Center, Department of Toxicological Chemistry, Military Medical Academy, Belgrade, Serbia and Montenegro.
authors.forename: S
authors.initials: S
authors.lastname: Djordjevic
authors.forename: I
authors.initials: I
authors.lastname: Kovacevic
authors.forename: B
authors.initials: B
authors.lastname: Miljkovic
authors.forename: J
authors.initials: J
authors.lastname: Vuksanovic
authors.forename: M
authors.initials: M
authors.lastname: Pokrajac
mesh_terms: D000328:Adult; D000368:Aged; D002853:Chromatography, Liquid; D002986:Clinical Trials as Topic; D005260:Female; D005473:Fluoxetine / Q000031:analogs & derivatives* / Q000097:blood* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D010300:Parkinson Disease / Q000097:blood / Q000188:drug therapy; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D005473:Fluoxetine; C036139:norfluoxetine