title: Pharmacokinetics of dexrazoxane in subjects with impaired kidney function.
abstract: Dexrazoxane is approved as a cardioprotective agent for use in female patients with breast cancer who are receiving doxorubicin. The effect of renal insufficiency on elimination is not known. The pharmacokinetics of dexrazoxane 150 mg/m(2), given as a 15-minute constant-rate intravenous infusion, were assessed in 24 men and women with varying degrees of renal function in a single-dose, open-label, parallel-group study. Blood and urine samples were measured by a validated liquid chromatography/mass spectrometry assay. Dexrazoxane pharmacokinetic parameters were derived by standard noncompartmental methods. The effect of kidney function and effect of body surface area on the pharmacokinetics of dexrazoxane were analyzed using linear and nonlinear regression in the SPSS statistical program. Dexrazoxane clearance is decreased in subjects with kidney dysfunction. Compared with normal subjects (creatinine clearance [CL(CR)] >80 mL/min), mean area under the concentration curve from time 0 to infinity (AUC(0-inf)) was 2-fold greater in subjects with moderate (CL(CR) 30-50 mL/min) to severe (CL(CR) <30 mL/min) renal dysfunction. Modeling demonstrated that equivalent exposure (AUC(0-inf)) could be achieved if dosing were reduced by 50% in subjects with CL(CR) less than 40 mL/min compared with control subjects (CL(CR) >80 mL/min). Modeling study results suggested that equivalent exposure could be achieved if dosing was halved in subjects with CL(CR) less than 40 mL/min compared with controls.
authors.affiliation: Department of Veterans Affairs and Division of Nephrology, University of Louisville, Louisville, Kentucky, USA. mike.brier@kdp.louisville.edu
authors.forename: Michael E
authors.initials: ME
authors.lastname: Brier
authors.forename: Shari K
authors.initials: SK
authors.lastname: Gaylor
authors.forename: J Patrick
authors.initials: JP
authors.lastname: McGovren
authors.forename: Paul
authors.initials: P
authors.lastname: Glue
authors.forename: Annie
authors.initials: A
authors.lastname: Fang
authors.forename: George R
authors.initials: GR
authors.lastname: Aronoff
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001830:Body Surface Area; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000652:urine; D002851:Chromatography, High Pressure Liquid; D003404:Creatinine / Q000097:blood; D005260:Female; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D007629:Kentucky; D007668:Kidney / Q000378:metabolism* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D008954:Models, Biological; D017711:Nonlinear Dynamics; D011929:Razoxane / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000652:urine; D051437:Renal Insufficiency / Q000378:metabolism* / Q000503:physiopathology; D053719:Tandem Mass Spectrometry; D055815:Young Adult
chemical_list: D002317:Cardiovascular Agents; D011929:Razoxane; D003404:Creatinine