Insights into the pharmacokinetic properties of antitubercular drugs.
BACKGROUND
The furiously advancing cases of multidrug-resistant tuberculosis (TB) along with the recent emergence of total drug resistant TB and TB-AIDS comorbidity present an increased threat to global public health. Knowledge of pharmacokinetic properties helps in selecting an appropriate anti-TB dosage regimen to achieve optimal results in patients.


METHODS
This article provides a brief compilation of the information available regarding published pharmacokinetic data for anti-TB drugs and may act as a single window for investigators/medical practitioners in this field. The information regarding absorption, tissue distribution, elimination and pharmacokinetic interactions of the first- and second-line anti-TB drugs and candidate drugs under clinical trials is discussed.


CONCLUSIONS
Pharmacokinetic properties such as poor absorption, too short biological half-life, extensive first-pass metabolism, drug-food and drug-drug related interactions are not attractive for prospective anti-TB drugs and significantly contribute to treatment failure and further resistance. The long duration, monotonous and multidrug treatment plan leads to poor patient compliance and resulted in a greater occurrence of anti-TB drug resistance worldwide. Few new agents, which are in development phase, are considering the aspect of shortening duration of the treatment regimen and provide a boost in therapy that is sorely needed.
a Pharmacokinetics & Metabolism Division , CSIR-Central Drug Research Institute , Lucknow , India.|b Academy of Scientific and Innovative Research , New Delhi , India.
Mahendra
M
Shukla
a Pharmacokinetics & Metabolism Division , CSIR-Central Drug Research Institute , Lucknow , India.|b Academy of Scientific and Innovative Research , New Delhi , India.
Abhisheak
A
Sharma
a Pharmacokinetics & Metabolism Division , CSIR-Central Drug Research Institute , Lucknow , India.|b Academy of Scientific and Innovative Research , New Delhi , India.
Swati
S
Jaiswal
a Pharmacokinetics & Metabolism Division , CSIR-Central Drug Research Institute , Lucknow , India.|b Academy of Scientific and Innovative Research , New Delhi , India.
Jawahar
J
Lal
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000818:Animals; D000995:Antitubercular Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D004347:Drug Interactions; D024901:Drug Resistance, Multiple, Bacterial; D018565:Food-Drug Interactions; D014943:Global Health; D006207:Half-Life; D006801:Humans; D055118:Medication Adherence; D011634:Public Health; D014018:Tissue Distribution; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents
Anti-TB; absorption; distribution; excretion; metabolism