Disposition and antimuscarinic effects of the urinary bladder spasmolytics propiverine: influence of dosage forms and circadian-time rhythms.
Propiverine extended release is expected to be better tolerated compared to immediate release tablets because of slower drug release and reduced formation of active metabolites in the colon. CYP3A4 and ABCC2, the major variables in pharmacokinetics of propiverine, are less expressed in the colon. Therefore, disposition and pharmacodynamics of propiverine were measured in a double-blind, double-dummy, crossover study with administration of 15 mg immediate release 3 times daily for 7 days compared to 45 mg extended release once daily for 7 days in 24 healthy subjects. Twelve subjects also received 15 mg propiverine intravenously. Serum and urine propiverine levels were measured repeatedly following oral administration on day 7 for up to 72 hours and correlated to duodenal expression of CYP3A4, ABCB1, and ABCC2. Propiverine immediate release 3 times daily was not different to extended release once daily in areas under the serum concentration-time curve (0-24 hours) and peak-trough fluctuation. The areas under the serum concentration-time curve of propiverine immediate release was circadian-time-dependent, with the lowest values during the night. Disposition of intravenous propiverine and propiverine immediate release administered in the night was influenced by intestinal expression of ABCC2. We concluded that oral absorption of propiverine is site-dependent and influenced by dosage form and circadian-time-dependent elimination processes.
May
Karen
K
Department of Clinical Pharmacology, University of Greifswald, Greifswald, Germany.
Westphal
Kristin
K
Giessmann
Thomas
T
Wegner
Danilo
D
Adam
Ulrike
U
Lerch
Markus M
MM
Oertel
Reinhard
R
Warzok
Rolf W
RW
Weitschies
Werner
W
Braeter
Manfred
M
Siegmund
Werner
W
D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics / Q000378:metabolism; D000284:Administration, Oral; D000328:Adult; D019540:Area Under Curve; D001561:Benzilates / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D001682:Biological Availability; D002214:Capsules; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000493:pharmacokinetics; D002940:Circadian Rhythm / Q000502:physiology*; D018592:Cross-Over Studies; D051544:Cytochrome P-450 CYP3A / Q000235:genetics / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D000089762:Multidrug Resistance-Associated Protein 2; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000235:genetics / Q000378:metabolism; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000493:pharmacokinetics; D010276:Parasympatholytics / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics*; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D001743:Urinary Bladder / Q000378:metabolism*
D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D001561:Benzilates; D002214:Capsules; D018680:Cholinergic Antagonists; D051544:Cytochrome P-450 CYP3A; D000089762:Multidrug Resistance-Associated Protein 2; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D018727:Muscarinic Antagonists; D010276:Parasympatholytics; D012333:RNA, Messenger; C513055:ABCB1 protein, human; C000715087:ABCC2 protein, human; C015586:propiverine; C510163:CYP3A4 protein, human